Impact of an Acceptance Facilitating Intervention on Patients’ Acceptance of Internet-based Pain Interventions

Baumeister, Harald; Seifferth, Holger; Lin, Jiaxi; Nowoczin, Lisa; Lüking, Marianne; Ebert, David Daniel

doi:10.1097/ajp.0000000000000118

Cited by 110 publications

(109 citation statements)

References 33 publications

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“…First, the external validity of our study may be limited, given that previous studies indicate that participants in internet trials tend to be better educated and thus not representative of the general population (but see (Titov et al, 2010)). In a recent investigation, we identified low levels of acceptance of internet interventions as a potential barrier to uptake in the population of patients with chronic pain (Baumeister et al, 2014c). In accordance with this finding, we will use different ways of advertising and channels of information to increase favourable attitudes and uptake rates regarding our intervention (Andersson & Titov, 2014;Baumeister et al, 2014aBaumeister et al, , 2014cRitterband et al, 2009).…”

Section: Discussionsupporting

confidence: 74%

Effectiveness and cost-effectiveness of a guided and unguided internet-based Acceptance and Commitment Therapy for chronic pain: Study protocol for a three-armed randomised controlled trial.

Lin

Lüking

Ebert

et al. 2015

Internet Interventions

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Background: Acceptance and Commitment Therapy (ACT) is an effective intervention for the treatment of chronic pain. Internet-based pain interventions might be an effective and cost-effective way to overcome treatment barriers of traditional face-to-face pain interventions such as the lack of availability and accessibility. However, little is known about the general (cost-)effectiveness of internet-based pain interventions and the specific (cost-) effectiveness of guided and unguided pain interventions. Therefore, the aim of this study is to investigate the effectiveness and cost-effectiveness of a guided and unguided ACT-based online intervention for persons with chronic pain (ACTonPain). Methods: ACTonPain is a pragmatic three-armed randomised controlled trial comparing ACTonPain with or without therapist guidance against a waitlist control group. Both active conditions differ only with regard to guidance provided by an eCoach, who sends feedback after each module. This study aims to include 300 participants. Randomisation and allocation will be performed using permuted block randomisation with variable block sizes. The intervention contains seven ACT-based modules with interactive exercises, and audio and video clips. Furthermore, the participants have the opportunity to receive daily text messages. Online selfassessments will take place at pre-and post-treatment, as well as at 6 month follow-up. The primary outcome is pain interference. Secondary outcomes include physical and emotional functioning, pain intensity, ACTrelated variables as well as health-related quality of life. Moreover, a cost-effectiveness analysis will be conducted from a societal perspective. Demographic and medical variables will be assessed on the basis of self-reports in order to detect potential moderators or mediators of the effects. The data will be analysed on an intention-totreat basis and also using per-protocol analyses. Discussion: This study will contribute to the evidence base of internet-based pain interventions and provide valuable information about the treatment success and cost-effectiveness regarding the intervention's level of guidance (self-help only vs. guided self-help). If ACTonPain is shown to be effective, investigations in different healthcare settings should follow, to examine possible ways of implementing ACTonPain into existing healthcare systems. The implementation of ACTonPain could help to shorten waiting times, expand access to pain treatment and, potentially, also reduce treatment costs.

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Section: Discussionsupporting

confidence: 74%

Effectiveness and cost-effectiveness of a guided and unguided internet-based Acceptance and Commitment Therapy for chronic pain: Study protocol for a three-armed randomised controlled trial.

Lin

Lüking

Ebert

et al. 2015

Internet Interventions

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“…Interestingly, neither education level nor gender was associated with attitudes. These results are in line with a study on the acceptance of internet-based interventions in chronic pain [66]. If this finding should be replicated, it might be an indicator that the often reported overrepresentation of woman and highly educated participants in RCTs evaluating internet interventions [13,[67][68][69][70][71][72] might not be due to lower acceptance of digital health interventions in general, but due to other relevant barriers such as lower willingness to seek help.…”

Section: Principal Findings Attitudes Toward Guided Internet Intervensupporting

confidence: 76%

“…This finding points at the importance of developing measures to increase awareness of and knowledge about the efficacy of internet-based treatment in the public to raise its acceptance. Acceptance-facilitating interventions (AFI) using brief, highly scalable educational videos have been shown to be a valid strategy to enhance the acceptability of internet interventions in clinical practice [66,71,85]. As AFIs may be easily disseminated through official health care information channels, they might represent an auspicious approach to increase e-awareness and knowledge concerning internet interventions, and thus raise their public acceptance.…”

Section: Raising E-awareness and Knowledgementioning

confidence: 99%

Public Attitudes Toward Guided Internet-Based Therapies: Web-Based Survey Study (Preprint)

Apolinário-Hagen¹,

Harrer²,

Kählke³

et al. 2018

Preprint

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Background: Internet interventions have been proposed to improve the accessibility and utilization of evidence-based psychological treatments. However, little is known about attitudes toward such treatments, which can be an important barrier to their utilization. Objective: This study aimed to (1) determine attitudes toward guided internet interventions, to (2) assess its acceptability compared to other internet-based formats, and to (3) explore predictors of acceptance. Methods: A web-based survey (N=646) assessed attitudes toward guided internet therapies (i.e. "perceived usefulness/helpfulness", "relative advantage compared to face-to face therapy"), preferences for delivery modes ("e-preference": guided Internet interventions, unguided internet interventions, video conferencing psychotherapy (VCP)) as well as potential predictors of attitudes and preferences, including socio-demographics, help seeking-related variables, attachment style, perceived stress. Results: Although most participants perceived internet interventions as useful or helpful (65.9%, 426/646), the minority indicated their relative advantage compared to face-to-face therapy (8.7%, 56/646). Most participants preferred guided internet interventions (39.0%, 252/646) over VCP (22.8%, 147/646), unguided internet interventions (19.2%, 124/646) and not using internet interventions (18.8%, 121/646; missing: 0.2%). Attachment avoidance and stress were related to epreference (all P<.05). Moreover, preference for therapist-guided internet interventions was higher for individuals aware of internet-based treatment (χ

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“…However, even if a less intensive guidance format should yield lower effects in direct comparisons, their potential on a population level might still be higher as such interventions have a greater reach and more participants can be treated for the same costs (28,59). On the other hand, it may very well be the case that employees are less willing to participate in an intervention if no regular content feedback is provided, which would result in lower overall effects in the target population (60,61). Thus, future studies should compare the acceptability, effectiveness and cost-effectiveness of different guidance formats for iSMI (19,62).…”

Section: Discussionmentioning

confidence: 96%

Internet- and mobile-based stress management for employees with adherence-focused guidance: efficacy and mechanism of change

Ebert¹,

Lehr²,

Heber³

et al. 2016

Scand J Work Environ Health

107

104

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The present study adds to the literature by showing that (1) a newly developed internet-based stress-management intervention based on Lazarus' transactional stress model can be effective with only limited human support (<1 hour per participant), and (2) cognitive behavioral therapy (CBT)-based interventions can have enduring effects on mental health and work-related health outcomes that go beyond immediate short-term effects.

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Impact of an Acceptance Facilitating Intervention on Patients’ Acceptance of Internet-based Pain Interventions

Abstract: Patients with chronic pain display a relatively low acceptance of Internet-based psychological pain interventions, which can be substantially increased by a short informational video.

Cited by 110 publications

References 33 publications

Effectiveness and cost-effectiveness of a guided and unguided internet-based Acceptance and Commitment Therapy for chronic pain: Study protocol for a three-armed randomised controlled trial.

Effectiveness and cost-effectiveness of a guided and unguided internet-based Acceptance and Commitment Therapy for chronic pain: Study protocol for a three-armed randomised controlled trial.

Public Attitudes Toward Guided Internet-Based Therapies: Web-Based Survey Study (Preprint)

Internet- and mobile-based stress management for employees with adherence-focused guidance: efficacy and mechanism of change

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