Motivations Toward Using Digital Health and Exploring the Possibility of Using Digital Health for Mental Health in Bangladesh University Students: Cross-sectional Questionnaire Study

Abstract

Background Digital health is efficacious for the management and prevention of mental health (MH) problems. It is particularly helpful for the young adult population, who appreciate the autonomy digital health provides, and in low-income countries, where the prevalence of MH problems is high but the supply of professionals trained in MH is low. Objective The objectives of this study are 2-fold: to determine whether university students in Bangladesh find using digital health for MH promotion acceptable and to examine motivational factors for using digital health for MH. Methods This study used a cross-sectional survey to examine the likelihood that university students in Bangladesh (n=311) would use different forms of digital health platforms for MH promotion and assessed drivers of intention to use and actual use of digital health generally and digital health for MH through the lens of the Technology Acceptance Model. The results provided evidence that the university student population in Bangladesh is likely to use digital health to promote their MH. Results Social influence (adjusted odds ratio [aOR] 1.68, 95% CI 1.40-2.01; P<.001), ease of use (aOR 1.85, 95% CI 1.35-2.53; P<.001), and perceived usefulness (aOR 4.12, 95% CI 1.79-9.51; P=.001) of digital health were found to be significant drivers of the intention to use general digital health, and having an intention to use digital health (aOR 2.10, 95% CI 1.17-3.78; P=.01) had the greatest influence on actual use of digital health. Social influence (aOR 1.71, 95% CI 1.43-2.04; P<.001), perceived usefulness (aOR 8.92, 95% CI 4.18-19.04; P<.001), and use of general digital health (aOR 2.16, 95% CI 1.18-3.97; P=.01) were associated with higher intention to use digital health for MH. The use of general digital health (aOR 4.19, 95% CI 2.37-7.41; P<.001) was associated with the actual use of digital health for MH, as were greater non–stigma-related barriers to using traditional clinical MH services (aOR 2.05, 95% CI 1.10-3.80; P=.02). Conclusions Overall, we see that the use of digital health for MH is acceptable in this population and can be helpful for students who perceive barriers to receiving traditional care. We also gain insight into how to promote the intention to use digital health, which in turn promotes the actual use of digital health.

An Examination of Barriers to Accessing Mental Health Care, and Their Association with Depression, Stress, Suicidal Ideation, and Wellness in a Bangladeshi University Student Sample

“…Despite the lack of mental health professionals in Bangladesh, the most endorsed instrumental barrier for this sample was the cost of services in lieu of the availability of services. The high cost of mental health services may be why students of this sample were interested in using digital health for mental health support [34,35], as digital health provides a no to low-cost service for mental health promotion.…”

Development, piloting and evaluation of an app-supported psychosocial prevention intervention to strengthen participation in working life: a study protocol of a mixed-methods approach

“…DHL encompasses searching for and finding health information from digital sources, comprehending and assessing it, and applying acquired knowledge to address health-specific questions and solve problems 31. It also encompasses skills and knowledge to interact productively with technology-enabled health tools 32 33. Other determinants that influence the utilisation of digital health applications include cultural and social factors,33–35 motivation and interest,32 33 36 37 and the accessibility and availability of technology 38–40.…”

“…It also encompasses skills and knowledge to interact productively with technology-enabled health tools 32 33. Other determinants that influence the utilisation of digital health applications include cultural and social factors,33–35 motivation and interest,32 33 36 37 and the accessibility and availability of technology 38–40. Subsequently, there is evidence of a relationship between DHL and adherence to digital health interventions 41 42…”

A qualitative exploration of university student perspectives on mindfulness-based stress reduction exercises via smartphone app in Bangladesh

“…Other advantages of mHealth are convenience, ease, cost-effectiveness, scalability, personalization, and “the ability to send time-sensitive messages with an ‘always on’ device” (Whittaker et al, 2016 ). In a sample of university students in Bangladesh, one study found that 26% (n = 82/311) of the sample currently use digital health for mental health promotion (Sifat, Saperstein, et al, 2022 ). The same study found that the majority of the sample (76.3%) reported that they were either somewhat or extremely likely to use an app for self-paced mindfulness or non-clinical practices to better their mental health.…”

“…Further, mHealth can reach populations who would otherwise not engage with traditional health services (Hamine et al, 2015 ). One study found that higher non-stigma-related barriers to utilizing mental health care (such as not having transportation to access a mental health clinic) were significantly associated with using digital health for mental health Sifat, Saperstein, etal., ( 2022 ). It can also tackle social stigma, as accessing an app on a mobile phone can be done privately without fear of others watching.…”