Determining Acceptance of e-Mental Health Interventions in Digital Psychodiabetology Using a Quantitative Web-Based Survey: Cross-sectional Study.

UTAUT acceptance diabetes e-mental health e-mental health intervention mental health psychodiabetology

Journal

JMIR formative research
ISSN: 2561-326X
Titre abrégé: JMIR Form Res
Pays: Canada
ID NLM: 101726394

Informations de publication

Date de publication:
30 Jul 2021
Historique:
received: 25 01 2021
accepted: 31 05 2021
revised: 21 05 2021
entrez: 30 7 2021
pubmed: 31 7 2021
medline: 31 7 2021
Statut: epublish

Résumé

Diabetes is a very common chronic disease that exerts massive physiological and psychological burdens on patients. The digitalization of mental health care has generated effective e-mental health approaches, which offer an indubitable practical value for patient treatment. However, before implementing and optimizing e-mental health tools, their acceptance and underlying barriers and resources should be first determined for developing and establishing effective patient-oriented interventions. This study aims to assess the acceptance of e-mental health interventions among patients with diabetes and explore its underlying barriers and resources. A cross-sectional study was conducted in Germany from April 9, 2020, to June 15, 2020, through a web-based survey for which patients were recruited via web-based diabetes channels. The eligibility requirements were adult age (18 years or older), a good command of the German language, internet access, and a diagnosis of diabetes. Acceptance was measured using a modified questionnaire, which was based on the well-established Unified Theory of Acceptance and Use of Technology (UTAUT) and assessed health-related internet use, acceptance of e-mental health interventions, and its barriers and resources. Mental health was measured using validated and established instruments, namely the Generalized Anxiety Disorder Scale-7, Patient Health Questionnaire-2, and Distress Thermometer. In addition, sociodemographic and medical data regarding diabetes were collected. Of the 340 participants who started the survey, 261 (76.8%) completed it and the final sample comprised 258 participants with complete data sets. The acceptance of e-mental health interventions in patients with diabetes was overall moderate (mean 3.02, SD 1.14). Gender and having a mental disorder had a significant influence on acceptance (P<.001). In an extended UTAUT regression model (UTAUT predictors plus sociodemographics and mental health variables), distress (β=.11; P=.03) as well as the UTAUT predictors performance expectancy (β=.50; P<.001), effort expectancy (β=.15; P=.001), and social influence (β=.28; P<.001) significantly predicted acceptance. The comparison between an extended UTAUT regression model (13 predictors) and the UTAUT-only regression model (performance expectancy, effort expectancy, social influence) revealed no significant difference in explained variance (F This study supports the viability of the UTAUT model and its predictors in assessing the acceptance of e-mental health interventions among patients with diabetes. Three UTAUT predictors reached a notable amount of explained variance of 75% in the acceptance, indicating that it is a very useful and efficient method for measuring e-mental health intervention acceptance in patients with diabetes. Owing to the close link between acceptance and use, acceptance-facilitating interventions focusing on these three UTAUT predictors should be fostered to bring forward the highly needed establishment of effective e-mental health interventions in psychodiabetology.

Sections du résumé

BACKGROUND BACKGROUND
Diabetes is a very common chronic disease that exerts massive physiological and psychological burdens on patients. The digitalization of mental health care has generated effective e-mental health approaches, which offer an indubitable practical value for patient treatment. However, before implementing and optimizing e-mental health tools, their acceptance and underlying barriers and resources should be first determined for developing and establishing effective patient-oriented interventions.
OBJECTIVE OBJECTIVE
This study aims to assess the acceptance of e-mental health interventions among patients with diabetes and explore its underlying barriers and resources.
METHODS METHODS
A cross-sectional study was conducted in Germany from April 9, 2020, to June 15, 2020, through a web-based survey for which patients were recruited via web-based diabetes channels. The eligibility requirements were adult age (18 years or older), a good command of the German language, internet access, and a diagnosis of diabetes. Acceptance was measured using a modified questionnaire, which was based on the well-established Unified Theory of Acceptance and Use of Technology (UTAUT) and assessed health-related internet use, acceptance of e-mental health interventions, and its barriers and resources. Mental health was measured using validated and established instruments, namely the Generalized Anxiety Disorder Scale-7, Patient Health Questionnaire-2, and Distress Thermometer. In addition, sociodemographic and medical data regarding diabetes were collected.
RESULTS RESULTS
Of the 340 participants who started the survey, 261 (76.8%) completed it and the final sample comprised 258 participants with complete data sets. The acceptance of e-mental health interventions in patients with diabetes was overall moderate (mean 3.02, SD 1.14). Gender and having a mental disorder had a significant influence on acceptance (P<.001). In an extended UTAUT regression model (UTAUT predictors plus sociodemographics and mental health variables), distress (β=.11; P=.03) as well as the UTAUT predictors performance expectancy (β=.50; P<.001), effort expectancy (β=.15; P=.001), and social influence (β=.28; P<.001) significantly predicted acceptance. The comparison between an extended UTAUT regression model (13 predictors) and the UTAUT-only regression model (performance expectancy, effort expectancy, social influence) revealed no significant difference in explained variance (F
CONCLUSIONS CONCLUSIONS
This study supports the viability of the UTAUT model and its predictors in assessing the acceptance of e-mental health interventions among patients with diabetes. Three UTAUT predictors reached a notable amount of explained variance of 75% in the acceptance, indicating that it is a very useful and efficient method for measuring e-mental health intervention acceptance in patients with diabetes. Owing to the close link between acceptance and use, acceptance-facilitating interventions focusing on these three UTAUT predictors should be fostered to bring forward the highly needed establishment of effective e-mental health interventions in psychodiabetology.

Identifiants

pubmed: 34328429
pii: v5i7e27436
doi: 10.2196/27436
pmc: PMC8367156
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e27436

Informations de copyright

©Mirjam Damerau, Martin Teufel, Venja Musche, Hannah Dinse, Adam Schweda, Jil Beckord, Jasmin Steinbach, Kira Schmidt, Eva-Maria Skoda, Alexander Bäuerle. Originally published in JMIR Formative Research (https://formative.jmir.org), 30.07.2021.

Références

Int J Med Inform. 2016 Jun;90:22-31
pubmed: 27103194
J Med Internet Res. 2019 Aug 09;21(8):e13432
pubmed: 31400101
Annu Rev Clin Psychol. 2016;12:157-79
pubmed: 26652054
Diabetologia. 2010 Dec;53(12):2480-6
pubmed: 20711716
Health Commun. 2020 Mar;35(3):350-355
pubmed: 32013612
Cochrane Database Syst Rev. 2013 Mar 28;(3):CD008776
pubmed: 23543567
Diabet Med. 2008 Sep;25(9):1096-101
pubmed: 19183314
JMIR Form Res. 2018 Dec 12;2(2):e11977
pubmed: 30684408
World Psychiatry. 2014 Oct;13(3):288-95
pubmed: 25273302
J Med Internet Res. 2018 Aug 21;20(8):e244
pubmed: 30131313
Depress Res Treat. 2014;2014:790457
pubmed: 24804089
J Clin Psychol. 2001 Apr;57(4):457-78
pubmed: 11255202
Malays Fam Physician. 2015 Aug 31;10(2):9-21
pubmed: 27099657
Clin J Pain. 2015 Jun;31(6):528-35
pubmed: 24866854
J Med Internet Res. 2019 May 21;21(5):e12246
pubmed: 31115345
J Public Health (Oxf). 2020 Nov 23;42(4):672-678
pubmed: 32657323
JAMA Netw Open. 2019 Aug 2;2(8):e198634
pubmed: 31390035
J Public Health (Oxf). 2020 Aug 18;42(3):644-646
pubmed: 32393966
J Psychosom Res. 2005 Feb;58(2):163-71
pubmed: 15820844
J Med Internet Res. 2016 Dec 23;18(12):e337
pubmed: 28011445
J Med Internet Res. 2018 Sep 17;20(9):e262
pubmed: 30224334
JMIR Diabetes. 2020 Jan 6;5(1):e15744
pubmed: 31904580
J Consult Clin Psychol. 1992 Aug;60(4):628-38
pubmed: 1506511
JMIR Cancer. 2016 Sep 14;2(2):e13
pubmed: 28410189
J Psychosom Res. 2002 Dec;53(6):1053-60
pubmed: 12479986
Qual Life Res. 2019 Jan;28(1):277-282
pubmed: 30284181
Diabetes Res Clin Pract. 2018 Apr;138:271-281
pubmed: 29496507
Psychol Health Med. 2007 Oct;12(5):545-55
pubmed: 17828675
Disabil Rehabil. 2015;37(5):447-55
pubmed: 24901351
J Pers Med. 2021 Jan 06;11(1):
pubmed: 33418971
PLoS One. 2010 Oct 13;5(10):e13196
pubmed: 20967242
J Med Internet Res. 2004 Sep 29;6(3):e34
pubmed: 15471760
J Diabetes Sci Technol. 2014 Feb 21;8(2):230-237
pubmed: 24876572
Diabetes Educ. 2010 May-Jun;36(3):446-56
pubmed: 20375351
Behav Res Ther. 2011 Nov;49(11):729-36
pubmed: 21851929
J Med Internet Res. 2015 Oct 05;17(10):e224
pubmed: 26441467
Diabetes Care. 2011 Feb;34(2):320-5
pubmed: 21216855
Med Care. 2008 Mar;46(3):266-74
pubmed: 18388841
Diabet Med. 2002 Apr;19(4):265-73
pubmed: 11942996
Br J Gen Pract. 2010 Jun;60(575):e239-45
pubmed: 20529487
BMJ Open. 2017 Sep 27;7(9):e016009
pubmed: 28954789
J Am Med Inform Assoc. 2013 May 1;20(3):526-34
pubmed: 23171659
Psychiatry Res. 2020 Jun;288:112954
pubmed: 32325383
Asian J Psychiatr. 2020 Aug;52:102066
pubmed: 32302935
Int J Environ Res Public Health. 2020 Mar 06;17(5):
pubmed: 32155789
Diabetes Educ. 2018 Feb;44(1):35-50
pubmed: 29346744
Diabet Med. 2018 Jun;35(6):677-693
pubmed: 29460506
J Med Internet Res. 2018 Jun 08;20(6):e201
pubmed: 29884608
Diabetes Care. 2004 May;27(5):1066-70
pubmed: 15111522
Diabet Med. 2017 Jan;34(1):99-107
pubmed: 27334444
Australas Psychiatry. 2011 Jun;19(3):259-64
pubmed: 21682626
Ment Health Fam Med. 2010 Sep;7(3):127
pubmed: 22477933
Telemed J E Health. 2013 Sep;19(9):683-91
pubmed: 23734700
Exp Ther Med. 2013 Apr;5(4):1137-1142
pubmed: 23599736
Diabetes Res Clin Pract. 2014 Jul;105(1):30-9
pubmed: 24862240
BMC Health Serv Res. 2010 Aug 12;10:235
pubmed: 20704720
J Affect Disord. 2015 May 1;176:9-17
pubmed: 25682378
Diabet Med. 2006 Nov;23(11):1165-73
pubmed: 17054590
JAMA. 2008 Jun 18;299(23):2751-9
pubmed: 18560002
Curr Diab Rep. 2014 Jun;14(6):491
pubmed: 24743941
Int J Med Inform. 2017 May;101:75-84
pubmed: 28347450
Int J Environ Res Public Health. 2019 Feb 21;16(4):
pubmed: 30795623
J Clin Med. 2020 Jun 10;9(6):
pubmed: 32531884
Drugs. 2015 Apr;75(6):577-87
pubmed: 25851098
J Diabetes Res. 2019 May 14;2019:2634094
pubmed: 31218230
Diabetes Care. 2003 Jun;26(6):1841-6
pubmed: 12766120
Diabet Med. 2013 Jan;30(1):88-94
pubmed: 22924587

Auteurs

Mirjam Damerau (M)

Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg Essen, Essen, Germany.

Martin Teufel (M)

Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg Essen, Essen, Germany.

Venja Musche (V)

Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg Essen, Essen, Germany.

Hannah Dinse (H)

Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg Essen, Essen, Germany.

Adam Schweda (A)

Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg Essen, Essen, Germany.

Jil Beckord (J)

Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg Essen, Essen, Germany.

Jasmin Steinbach (J)

Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg Essen, Essen, Germany.

Kira Schmidt (K)

Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg Essen, Essen, Germany.

Eva-Maria Skoda (EM)

Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg Essen, Essen, Germany.

Alexander Bäuerle (A)

Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg Essen, Essen, Germany.

Classifications MeSH