Users’ experiences of an online intervention for bipolar disorder: important lessons for design and evaluation

Background The evidence base for digital interventions for physical and mental health, including severe and enduring mental health difficulties, is increasing. In a feasibility trial, web-based Enhanced Relapse Prevention (ERPonline) for bipolar disorder demonstrated high recruitment and retention r...

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Main Authors: Richard Morriss, Steven H Jones, Fiona Lobban, Alyson L Dodd, Sara Mallinson, Martin Griffiths
Format: Article
Language:English
Published: BMJ Publishing Group 2017-11-01
Series:BMJ Mental Health
Online Access:https://mentalhealth.bmj.com/content/20/4/133.full
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author Richard Morriss
Steven H Jones
Fiona Lobban
Alyson L Dodd
Sara Mallinson
Martin Griffiths
author_facet Richard Morriss
Steven H Jones
Fiona Lobban
Alyson L Dodd
Sara Mallinson
Martin Griffiths
author_sort Richard Morriss
collection DOAJ
description Background The evidence base for digital interventions for physical and mental health, including severe and enduring mental health difficulties, is increasing. In a feasibility trial, web-based Enhanced Relapse Prevention (ERPonline) for bipolar disorder demonstrated high recruitment and retention rates. Relative to participants in the waitlist control group, those who received ERPonline showed increased monitoring for early warning signs of relapse and had developed more positive illness models.Objective To understand users’ motivations and barriers for taking part in an online/telephone-based trial, and for engagement with ERPonline.Methods Participants from the trial who had been allocated to receive ERPonline were purposively sampled to participate in telephone-based, in-depth qualitative interviews about their experiences. Interviews (n=19) were analysed using framework analysis to identify themes relevant to study aims.Findings Participants took part due to the convenient, flexible and rewarding aspects of the trial design, as well as a desire to improve the mental health of themselves and others. Barriers included extensive assessments, practical difficulties and mood. ERPonline was was generally considered to be accessible, relevant and straightforward, but there were individual preferences regarding design, content and who it was for. Several participants reported positive changes, but there was a sense that digital interventions should not replace routine care.Conclusions There are a number of barriers and facilitators to consider when evaluating and implementing digital interventions. Individual preferences and human contact were key factors for both trial design and engagement with an online intervention.Clinical implications Digital interventions should be co-produced, personalised, interactive and embedded as one component in a broader package of care.Trial registration number ISRCTN56908625; Post-results.
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spelling doaj-art-7e40969400cc44ec8c0bf118835a998d2025-01-31T05:15:10ZengBMJ Publishing GroupBMJ Mental Health2755-97342017-11-0120410.1136/eb-2017-102754Users’ experiences of an online intervention for bipolar disorder: important lessons for design and evaluationRichard Morriss0Steven H Jones1Fiona Lobban2Alyson L Dodd3Sara Mallinson4Martin Griffiths53 National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK2 Spectrum Centre for Mental Health Research, Division of Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, UKSpectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK1 Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle-upon-Tyne, UKDepartment of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada2 Spectrum Centre for Mental Health Research, Division of Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, UKBackground The evidence base for digital interventions for physical and mental health, including severe and enduring mental health difficulties, is increasing. In a feasibility trial, web-based Enhanced Relapse Prevention (ERPonline) for bipolar disorder demonstrated high recruitment and retention rates. Relative to participants in the waitlist control group, those who received ERPonline showed increased monitoring for early warning signs of relapse and had developed more positive illness models.Objective To understand users’ motivations and barriers for taking part in an online/telephone-based trial, and for engagement with ERPonline.Methods Participants from the trial who had been allocated to receive ERPonline were purposively sampled to participate in telephone-based, in-depth qualitative interviews about their experiences. Interviews (n=19) were analysed using framework analysis to identify themes relevant to study aims.Findings Participants took part due to the convenient, flexible and rewarding aspects of the trial design, as well as a desire to improve the mental health of themselves and others. Barriers included extensive assessments, practical difficulties and mood. ERPonline was was generally considered to be accessible, relevant and straightforward, but there were individual preferences regarding design, content and who it was for. Several participants reported positive changes, but there was a sense that digital interventions should not replace routine care.Conclusions There are a number of barriers and facilitators to consider when evaluating and implementing digital interventions. Individual preferences and human contact were key factors for both trial design and engagement with an online intervention.Clinical implications Digital interventions should be co-produced, personalised, interactive and embedded as one component in a broader package of care.Trial registration number ISRCTN56908625; Post-results.https://mentalhealth.bmj.com/content/20/4/133.full
spellingShingle Richard Morriss
Steven H Jones
Fiona Lobban
Alyson L Dodd
Sara Mallinson
Martin Griffiths
Users’ experiences of an online intervention for bipolar disorder: important lessons for design and evaluation
BMJ Mental Health
title Users’ experiences of an online intervention for bipolar disorder: important lessons for design and evaluation
title_full Users’ experiences of an online intervention for bipolar disorder: important lessons for design and evaluation
title_fullStr Users’ experiences of an online intervention for bipolar disorder: important lessons for design and evaluation
title_full_unstemmed Users’ experiences of an online intervention for bipolar disorder: important lessons for design and evaluation
title_short Users’ experiences of an online intervention for bipolar disorder: important lessons for design and evaluation
title_sort users experiences of an online intervention for bipolar disorder important lessons for design and evaluation
url https://mentalhealth.bmj.com/content/20/4/133.full
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