What farmers want from mental health and wellbeing-focused websites and online interventions

Gunn, Kate; Barrett, Alison; Hughes‐Barton, Donna; Turnbull, Deborah; Short, Camille E.; Brumby, Susan; Skaczkowski, Gemma; Dollman, James

doi:10.1016/j.jrurstud.2021.06.016

Cited by 28 publications

(34 citation statements)

References 27 publications

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“…As reported elsewhere [ 41 ], farmers said that they would like a web-based resource that is easy to navigate and compatible with multiple devices and internet connections, as well as their sporadic internet use around work schedules. They preferred a casual and friendly tone, minimal use of jargon, and the inclusion of humor, and they requested information on when and how to seek additional professional help.…”

Section: Resultsmentioning

confidence: 93%

“…As described in detail elsewhere [ 41 ], participants were recruited via articles in print, radio and web-based media, advertising via relevant rural organizations, and personal and professional contacts of the research team. Telephone interviews were used to explore the farmers’ current internet use practices and preferences for websites designed to promote their mental health and well-being.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Combining Farmers’ Preferences With Evidence-Based Strategies to Prevent and Lower Farmers’ Distress: Co-design and Acceptability Testing of ifarmwell

Gunn¹,

Skaczkowski²,

Dollman³

et al. 2022

JMIR Hum Factors

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Background Farming is physically and psychologically hazardous. Farmers face many barriers to help seeking from traditional physical and mental health services; however, improved internet access now provides promising avenues for offering support. Objective This study aims to co-design with farmers the content and functionality of a website that helps them adopt transferable coping strategies and test its acceptability in the broader farming population. Methods Research evidence and expert opinions were synthesized to inform key design principles. A total of 18 farmers detailed what they would like from this type of website. Intervention logic and relevant evidence-based strategies were mapped. Website content was drafted and reviewed by 2 independent mental health professionals. A total of 9 farmers provided detailed qualitative feedback on the face validity of the draft content. Subsequently, 9 farmers provided feedback on the website prototype. Following amendments and internal prototype testing and optimization, prototype usability (ie, completion rate) was examined with 157 registered website users who were (105/157, 66.9%) female, aged 21-73 years; 95.5% (149/156) residing in inner regional to very remote Australia, and 68.2% (107/157) “sheep, cattle and/or grain farmers.” Acceptability was examined with a subset of 114 users who rated at least module 1. Interviews with 108 farmers who did not complete all 5 modules helped determine why, and detailed interviews were conducted with 18 purposively sampled users. Updates were then made according to adaptive trial design methodology. Results This systematic co-design process resulted in a web-based resource based on acceptance and commitment therapy and designed to overcome barriers to engagement with traditional mental health and well-being strategies—ifarmwell. It was considered an accessible and confidential source of practical and relevant farmer-focused self-help strategies. These strategies were delivered via 5 interactive modules that include written, drawn, and audio- and video-based psychoeducation and exercises, as well as farming-related jokes, metaphors, examples, and imagery. Module 1 included distress screening and information on how to speak to general practitioners about mental health–related concerns (including a personalized conversation script). Modules were completed fortnightly. SMS text messages offered personalized support and reminders. Qualitative interviews and star ratings demonstrated high module acceptability (average 4.06/5 rating) and suggested that additional reminders, higher quality audio recordings, and shorter modules would be useful. Approximately 37.1% (52/140) of users who started module 1 completed all modules, with too busy or not got to it yet being the main reason for non-completion, and previous module acceptability not predicting subsequent module completion. Conclusions Sequential integration of research evidence, expert knowledge, and farmers’ preferences in the co-design process allowed for the development of a self-help intervention that focused on important intervention targets and was acceptable to this difficult-to-engage group. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12617000506392; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372526

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Section: Resultsmentioning

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Combining Farmers’ Preferences With Evidence-Based Strategies to Prevent and Lower Farmers’ Distress: Co-design and Acceptability Testing of ifarmwell

Gunn¹,

Skaczkowski²,

Dollman³

et al. 2022

JMIR Hum Factors

Self Cite

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“…Participation has also been associated with decreases in personal stigmatizing attitudes toward depression in the mainstream population [ 17 ] and among immigrants [ 13 ], as well as decreases in stigmatizing attitudes toward suicide [ 18 ] and help seeking [ 19 ]. Importantly, web-based interventions have been identified as acceptable in difficult-to-reach populations such as farmers [ 20 ], young people [ 21 ], and culturally and linguistically diverse groups [ 22 , 23 ]. They can be successfully integrated into routine primary care [ 24 , 25 ], and many Australian GPs support the notion of aiding their patients’ mental well-being through these resources [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Web-Based Interventions to Help Australian Adults Address Depression, Anxiety, Suicidal Ideation, and General Mental Well-being: Scoping Review

Skaczkowski¹,

Kruk²,

Loxton³

et al. 2022

JMIR Ment Health

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Background A large number of Australians experience mental health challenges at some point in their lives. However, in many parts of Australia, the wait times to see general practitioners and mental health professionals can be lengthy. With increasing internet use across Australia, web-based interventions may help increase access to timely mental health care. As a result, this is an area of increasing research interest, and the number of publicly available web-based interventions is growing. However, it can be confusing for clinicians and consumers to know the resources that are evidence-based and best meet their needs. Objective This study aims to scope out the range of web-based mental health interventions that address depression, anxiety, suicidal ideation, or general mental well-being and are freely available to Australian adults, along with their impact, acceptability, therapeutic approach, and key features. Methods The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for scoping reviews (PRISMA-ScR [PRISMA extension for Scoping Reviews]) guided the review process. Keywords for the search were depression, anxiety, suicide, and well-being. The search was conducted using Google as well as the key intervention databases Beacon, Head to Health, and e-Mental Health in Practice. Interventions were deemed eligible if they targeted depression, anxiety, suicidal ideation, or general mental well-being (eg, resilience) in adults; and were web-based, written in English, interactive, free, and publicly available. They also had to be guided by an evidence-based therapeutic approach. Results Overall, 52 eligible programs were identified, of which 9 (17%) addressed depression, 15 (29%) addressed anxiety, 13 (25%) addressed general mental well-being, and 13 (25%) addressed multiple issues. Only 4% (2/52) addressed distress in the form of suicidal ideation. The most common therapeutic approach was cognitive behavioral therapy. Half of the programs guided users through exercises in a set sequence, and most programs enabled users to log in and complete the activities on their own without professional support. Just over half of the programs had been evaluated for their effectiveness in reducing symptoms, and 11% (6/52) were being evaluated at the time of writing. Program evaluation scores ranged from 44% to 100%, with a total average score of 85%. Conclusions There are numerous web-based programs for depression, anxiety, suicidal ideation, and general well-being, which are freely and publicly available in Australia. However, identified gaps include a lack of available web-based interventions for culturally and linguistically diverse populations and programs that use newer therapeutic approaches such as acceptance and commitment therapy and dialectical behavior therapy. Despite most programs included in this review being of good quality, clinicians and consumers should pay careful attention when selecting which program to recommend and use, as variations in the levels of acceptability and impact of publicly available programs do exist.

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“…Although not describing specific interventions, four articles provided evidence-based recommendations for future mental health interventions in farming populations; three addressed farming populations in the US [ 61 , 94 , 152 ] and one addressed farmers in Australia [ 153 ].…”

Section: Systematic Review Resultsmentioning

confidence: 99%

Farmer Mental Health Interventions: A Systematic Review

Younker

Radunovich

2021

IJERPH

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The prevalence of mental health disorders and suicide amongst agricultural producers is a global problem. Community leaders, researchers, policymakers, and clinicians have mobilized to develop programs to address this issue. This study reviewed a wide range of mental health interventions targeting farmer mental health spanning over 50 years and examined their reported effectiveness and constraints. A total of ninety-two articles on farmer mental health were included in a final systematic review. Most articles were written concerning mental health literacy and peer and paraprofessional support interventions in the United States and Australia. Among the 56 studies reporting empirical evaluative data, 21 were mixed-method, 20 quantitative, 11 qualitative, and 5 literature synthesis. Non-experimental, self-reported, and qualitative data suggest efficacy of mental health literacy programs, peer and paraprofessional support, and community-based and agroecological interventions. However, most interventions were not subject to rigorous evaluation and only one intervention was evaluated using a control condition. The heterogeneity of existing studies and paucity of rigorous evaluation proscribes firm conclusions related to program-type efficacy. This review demonstrates that there is still a need for a stronger and broader evidence base in the field of farmer mental health interventions, which should focus on both holistic, multi-component programs and targeted approaches.

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What farmers want from mental health and wellbeing-focused websites and online interventions

Cited by 28 publications

References 27 publications

Combining Farmers’ Preferences With Evidence-Based Strategies to Prevent and Lower Farmers’ Distress: Co-design and Acceptability Testing of ifarmwell

Combining Farmers’ Preferences With Evidence-Based Strategies to Prevent and Lower Farmers’ Distress: Co-design and Acceptability Testing of ifarmwell

Web-Based Interventions to Help Australian Adults Address Depression, Anxiety, Suicidal Ideation, and General Mental Well-being: Scoping Review

Farmer Mental Health Interventions: A Systematic Review

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