Predictors of adolescent engagement and outcomes – A cross-sectional study using the togetherall (formerly Big White Wall) digital mental health platform

Marinova, Nushka; Rogers, Tim; MacBeth, Angus

doi:10.1016/j.jad.2022.05.058

Cited by 11 publications

(8 citation statements)

References 58 publications

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“…In total, 4 studies found that engagement in web-based activities was not associated with a decrease in depressive symptoms [90][91][92][93]; whereas, others found that participants with higher levels of online support group participation had a greater resolution of their symptomatology [71,72,81,93,123,124], sometimes indirectly through received and perceived social support or the experience of lower social isolation [92,124]. Only 1 study found that longer use time and session duration were associated with poorer depression outcomes [95]. The diversity of results was supported by a longitudinal study [80], which found that the positive effects of participating in online support groups were small for depressive symptoms.…”

Section: Discussionmentioning

confidence: 99%

The Empowering Role of Web-Based Help Seeking on Depressive Symptoms: Systematic Review and Meta-analysis

Bizzotto¹,

Marciano²,

Bruijn³

et al. 2023

J Med Internet Res

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Background Most research on web-based help seeking for mental health problems has focused on the antecedents of this behavior. Therefore, little is known about the outcomes of web-based help seeking in general or in specific mental health issues. Objective This study was a systematic review and meta-analysis of the literature on the antecedents and consequences of web-based help-seeking behaviors for depressive symptoms. Methods A systematic literature search was carried out in 6 scientific databases, leading to 48 studies (for a total of 314,921 participants) included in the qualitative synthesis and 19 included in the meta-analysis. Results The results indicated a positive relationship between depressive symptoms and web-based help-seeking behaviors through online support groups (r=0.089; P=.009), and Generation Z (r=0.102; P=.008) tended to participate in support groups more than previous generations. In addition, web-based help seeking was positively related to empowerment (r=0.245; P=.004). Other forms of support reported included the internet and specific self-help tools, but no significant relationships were found with depressive symptoms. Conclusions More studies examining the outcomes are needed, together with a more rigorous assessment of web-based help-seeking behaviors. Ultimately, we propose a summary framework for the literature on this topic, including the antecedents, patterns of use, and outcomes of web-based help seeking in the context of depressive symptoms.

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Section: Discussionmentioning

confidence: 99%

The Empowering Role of Web-Based Help Seeking on Depressive Symptoms: Systematic Review and Meta-analysis

Bizzotto¹,

Marciano²,

Bruijn³

et al. 2023

J Med Internet Res

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“…Some forums are established and moderated by people with personal experience of mental health difficulties [18]. Others are delivered by mental health care providers and staffed by formally trained moderators who, depending on the service delivery model, may be health professionals or volunteers [19,20].…”

Section: Introductionmentioning

confidence: 99%

Understanding the Impacts of Online Mental Health Peer Support Forums: Realist Synthesis

Marshall,

Booth,

Coole

et al. 2024

JMIR Ment Health

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Background Online forums are widely used for mental health peer support. However, evidence of their safety and effectiveness is mixed. Further research focused on articulating the contexts in which positive and negative impacts emerge from forum use is required to inform innovations in implementation. Objective This study aimed to develop a realist program theory to explain the impacts of online mental health peer support forums on users. Methods We conducted a realist synthesis of literature published between 2019 and 2023 and 18 stakeholder interviews with forum staff. Results Synthesis of 102 evidence sources and 18 interviews produced an overarching program theory comprising 22 context-mechanism-outcome configurations. Findings indicate that users’ perceptions of psychological safety and the personal relevance of forum content are foundational to ongoing engagement. Safe and active forums that provide convenient access to information and advice can lead to improvements in mental health self-efficacy. Within the context of welcoming and nonjudgmental communities, users may benefit from the opportunity to explore personal difficulties with peers, experience reduced isolation and normalization of mental health experiences, and engage in mutual encouragement. The program theory highlights the vital role of moderators in creating facilitative online spaces, stimulating community engagement, and limiting access to distressing content. A key challenge for organizations that host mental health forums lies in balancing forum openness and anonymity with the need to enforce rules, such as restrictions on what users can discuss, to promote community safety. Conclusions This is the first realist synthesis of online mental health peer support forums. The novel program theory highlights how successful implementation depends on establishing protocols for enhancing safety and strategies for maintaining user engagement to promote forum sustainability. Trial Registration PROSPERO CRD42022352528; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=352528

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“…format, privacy and confidentiality concerns) [ 26 , 27 ]. From a commissioner or health professionals’ point-of-view, issues around risk and management are commonly reported–including how to control content, prevent further deterioration of mental health, managing and supporting those who present in crisis, the need for training of peer supporters and privacy concerns [ 19 , 28 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

“…DMH-delivered peer support has been found to be more effective in improving mental health in people with worsening mental health symptoms compared to DMH without peer support [15]. Specifically, research has shown the provision of DMH coupled with peer support is associated with improvements in mood and anxiety symptoms [16][17][18][19][20]. Improvements in well-being are similar when delivered via peers or clinicians [21].…”

Section: Introductionmentioning

confidence: 99%

Digital mental health and peer support: Building a Theory of Change informed by stakeholders’ perspectives

Thomson,

Henderson,

Rogers

et al. 2024

PLOS Digit Health

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Digital Mental Health and Peer support has the potential to bridge gaps in support through its scalability and accessibility. Despite the increasing use of these platforms, there remains a lack of understanding of how they operate in real life, from initial engagement to longer-term impact. We aimed to explore the key inputs, processes, user interactions, assumptions, barriers, facilitators, outcomes, and impacts associated with the use of DMH and peer support platforms by developing a Theory of Change with stakeholders. Stakeholders (n = 77) contributed to the formulation of the Theory of Change through a series of online workshops, focus groups, interviews, and open-ended survey feedback. Workshops were structured to capture information related to aspects of the Theory of Change and to allow stakeholders to provide feedback to improve the diagram. A thematic framework approach was used to analyze transcripts to enable comparisons of factors reported by members, commissioners, and platform staff. Stakeholders identified a variety of factors contributing to initial inputs, processes, outcomes, and impact. Engagement emerged as the most significant barrier to the use of platforms. Motivations for use included filling in gaps in available support, connecting with others and upskilling. Different member types determined how users would interact with the platform which could influence the social response of others. Outcomes were largely positive including provision of a safe online space, improvement in wellbeing, and feeling connected to others. Stakeholders noted impact was harder to identify due to the preventative nature of these platforms but suggested this related to the knowledge of available support, reduction in waiting for support and in referrals, and increasing engagement and uptake of the platforms. Stakeholders identified assumptions regarding internet access as a significant barrier. The Theory of Change illustrated three distinct pathways in digital mental health and peer support. Further research is needed to improve engagement and factors influencing engagement, the member experience and how impact is measured.

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Predictors of adolescent engagement and outcomes – A cross-sectional study using the togetherall (formerly Big White Wall) digital mental health platform

Cited by 11 publications

References 58 publications

The Empowering Role of Web-Based Help Seeking on Depressive Symptoms: Systematic Review and Meta-analysis

The Empowering Role of Web-Based Help Seeking on Depressive Symptoms: Systematic Review and Meta-analysis

Understanding the Impacts of Online Mental Health Peer Support Forums: Realist Synthesis

Digital mental health and peer support: Building a Theory of Change informed by stakeholders’ perspectives

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