Electronic mental health services (eMHSs) offer additional options for the dissemination of psychological interventions for university students. Still, many university students are reluctant to use eMHSs. Narrative messages may help increase the awareness and acceptance of quality-approved programs. However, little is known about the usefulness of narrative messages to improve attitudes towards eMHSs. In this experiment, we thus aimed to explore in how far different ways of targeting information to students affect their attitudes towards eMHSs for stress prevention and therapy, and to identify potential determinants of attitude change. N = 451 students (Mean = 32.6 years, SD = 10.2, 75% female, 7% with eMHS experience) were randomly assigned to one of four study arms involving information designed to induce different levels of perceived similarity. While the active control condition only received general information (arm 1, “information only”, n = 116), the other experimental arms were additionally exposed to testimonials on specific eMHSs either addressing an unspecified audience (arm 2, n = 112), employees (arm 3, n = 115) or working university students (arm 4, n = 108). Two-way ANOVA revealed no impact of information on the alteration of attitudes towards eMHSs for stress coping (d = 0.20). Only a small effect of target-group specific testimonials on attitudes towards online therapies was identified at post-intervention (d = 0.29). Regression analyses demonstrated significant influences of source credibility and perceived similarity on attitudes for preventative eMHSs (ps<0.01), as well as a partial mediation effect of perceived similarity in favor of testimonials targeted to students (95% CI [0.22, 0.50]). Overall, this study indicated no meaningful impact of information on attitudes and limited evidence for benefits of tailored narrative messages. Since attitudes were already positive at baseline, further research with a representative student sample mimicking real-world decision scenarios is needed to gain an in-depth understanding of acceptance-facilitating message features that may contribute to promote the adoption of evidence-based eMHSs.
The mental health of medical students remains to be a matter of concern. Numerous setting-based and individual-based interventions for student mental health have been proposed in the literature. However, the student perspective on those interventions has been largely neglected. This study aims to explore how medical students perceive different interventions and if they desire any additional changes with regard to their studies. Eight focus groups with 71 participants were conducted at a large German medical school. Focus groups were recorded, transcribed and content-analyzed using MAXQDA 18. We found that medical students prefer setting-based interventions. Most proposed interventions were on a setting-based level. For instance, students asked for more information on the university's psychosocial counseling services and for better information management regarding contact persons. Interventions proposed in the literature received mixed reactions: Several participants did not favour a pass/fail grading system. Students considered a peer-to-peer mentoring program for freshmen very helpful. Students had diverse attitudes towards Balint groups. They approved of several self-management courses, most of them being related to time or stress management. Interestingly, the most urgently wanted interventions appear to be rather easy to implement (e.g. a mentoring program). This study explored the medical student perspective on student mental health interventions. Additionally, our study illustrates the benefit and feasibility of involving students early on in the conception of interventions. Further research with a representative sample is needed to obtain broader information on the acceptance of the suggested interventions.
Background Medical students show low levels of e–mental health literacy. Moreover, there is a high prevalence of common mental illnesses among medical students. Mobile health (mHealth) apps can be used to maintain and promote medical students’ well-being. To date, the potential of mHealth apps for promoting mental health among medical students is largely untapped because they seem to lack familiarity with mHealth. In addition, little is known about medical students’ preferences regarding mHealth apps for mental health promotion. There is a need for guidance on how to promote competence-based learning on mHealth apps in medical education. Objective The aim of this case study is to pilot an innovative concept for an educative workshop following a participatory co-design approach and to explore medical students’ preferences and ideas for mHealth apps through the design of a hypothetical prototype. Methods We conducted a face-to-face co-design workshop within an elective subject with 26 participants enrolled at a medical school in Germany on 5 consecutive days in early March 2020. The aim of the workshop was to apply the knowledge acquired from the lessons on e–mental health and mHealth app development. Activities during the workshop included group work, plenary discussions, storyboarding, developing personas (prototypical users), and designing prototypes of mHealth apps. The workshop was documented in written and digitalized form with the students’ permission. Results The participants’ feedback suggests that the co-design workshop was well-received. The medical students presented a variety of ideas for the design of mHealth apps. Among the common themes that all groups highlighted in their prototypes were personalization, data security, and the importance of scientific evaluation. Conclusions Overall, this case study indicates the feasibility and acceptance of a participatory design workshop for medical students. The students made suggestions for improvements at future workshops (eg, use of free prototype software, shift to e-learning, and more time for group work). Our results can be (and have already been) used as a starting point for future co-design workshops to promote competence-based collaborative learning on digital health topics in medical education.
Zusammenfassung Ziel der Studie Angesichts aktueller gesundheitspolitischer Bestrebungen zur eHealth-Implementierung stellt sich die Frage, welche Bevölkerungsgruppen Online-Gesundheitsangebote in Anspruch nehmen, um diese gezielter auf Nutzerbedürfnisse abstimmen zu können. Die Studie untersucht, ob Unterschiede in der Nutzung von Gesundheitsinformationen und psychologischer Online-Beratung auf Basis soziodemografischer und gesundheitsbezogener Merkmale in der deutschen Bevölkerung bestehen. Methodik Die Grundlage für die Querschnittsuntersuchung mithilfe logistischer Regressionsanalysen bildet die Innovationsstichprobe des deutschen sozioökonomischen Panels, das von September 2016 bis Februar 2017 erhoben wurde, mit 4802 Personen im Alter von 17–95 Jahren. Ergebnisse 55% der Befragten gaben an, Gesundheitsinformationen im Netz zu suchen, während 1,1% angaben, Erfahrungen mit Online-Beratung aufzuweisen. Die Onlinesuche nach Gesundheitsinformationen wurde durch das Alter (Odds Ratio (OR)=0,96; 95-%-KI=0,96–0,97), Geschlecht (OR=1,20; 95-%-KI=1,05–1,36), die Bekanntheit von Internettherapien (OR=2,57; 95-%-KI=2,20–3,00), Erfahrung mit Psychotherapie (OR=1,40; 95-%-KI=1,16–1,69) sowie die Diagnosen Asthma (OR=1,14; 95-%-KI=1,01–1,29) oder Schlaganfall (OR=0,66; 95-%-KI=0,52–0,84) signifikant bestimmt. Bei der Nutzung von Online-Beratung erwiesen sich Bekanntheit von Internettherapie und die Erfahrung mit Psychotherapie als signifikante Determinanten. Schlussfolgerung Mit diesem erstmalig gewonnenen, verlässlichen Bild zur Bekanntheit von Internettherapien und zu Determinanten der Nutzung von Online-Gesundheitsangeboten in der deutschen Bevölkerung können zielgruppenspezifische Strategien zur Verbesserung der Versorgungssituation entwickelt werden.
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