Skill enactment and knowledge acquisition among community users of digital mental health interventions: qualitative study with thematic analysis.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read Online Read More Add to Saved list
  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968559 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-244X (Electronic) Linking ISSN: 1471244X NLM ISO Abbreviation: BMC Psychiatry Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Qualitative Research* ; Health Knowledge, Attitudes, Practice* ; Cognitive Behavioral Therapy*/methods; Humans ; Female ; Middle Aged ; Adult ; Male ; Aged ; Australia ; Telemedicine
    • Abstract:
      Background: The acquisition of knowledge and use of skills from digital mental health interventions (DMHIs) are considered important for effectiveness. However, our understanding of user experiences implementing skills learned from these interventions is limited, particularly outside of research trials. This qualitative study aimed to investigate how community users learn and apply knowledge and skills from DMHIs based on cognitive behavioural therapy (CBT) in daily life. The study also examined factors influencing the selection and use of skills and explored perceived changes in mental health resulting from the intervention.
      Methods: Thirteen adults aged 26 to 66 years (10 females) were recruited using social media advertising and participated in semi-structured interviews by telephone or videoconference. All participants were living in Australia and had used a digital CBT program within the past 3 months. Interviews lasted on average 45 min. Transcripts were analysed using theoretical thematic analysis.
      Results: Participants demonstrated high levels of program engagement. Findings were organised into three topics with six major themes. Participants reported that their chosen intervention reinforced existing knowledge and fostered new skills and insights (Topic 1, Theme 1: knowledge consolidation). Most described actively applying skills (Topic 1, Theme 2: active approach to skill enactment), although the extent of learning and range of skills enacted varied across participants. Influences on skill selection included the perceived relevance of intervention strategies to the user's needs and personal characteristics (Topic 2, Theme 1: relevance of intervention strategies), as well as the perceived or experienced effectiveness of those strategies (Topic 2, Theme 2: perceived and experienced benefit). Challenges to ongoing skill enactment included time scarcity, prioritisation difficulties, and lack of motivation (Topic 2, Theme 3: navigating time constraints and low motivation). Improvements in mental health were generally modest and attributed mainly to participants' proactive efforts (Topic 3, Theme 1: perceived changes).
      Conclusions: DMHIs may reinforce existing understanding of psychotherapeutic strategies, offer new knowledge, and encourage the application of skills in everyday life among community users who actively engage with these interventions. Future research should prioritise personalising DMHIs and investigating methods to optimise the acquisition, retention, and sustained application of knowledge and skills.
      (© 2024. The Author(s).)
    • References:
      J Med Internet Res. 2019 Aug 15;21(8):e14181. (PMID: 31414664)
      Cogn Behav Ther. 2018 Jan;47(1):43-61. (PMID: 28724338)
      PLoS One. 2012;7(5):e37411. (PMID: 22649526)
      Psychol Med. 2023 Jan;53(2):567-579. (PMID: 34047264)
      Annu Rev Clin Psychol. 2019 May 7;15:207-231. (PMID: 30550721)
      JMIR Form Res. 2022 Jul 5;6(7):e38837. (PMID: 35788101)
      Ann Behav Med. 2013 Aug;46(1):81-95. (PMID: 23512568)
      Appl Nurs Res. 2018 Oct;43:30-35. (PMID: 30220360)
      Front Digit Health. 2021 Nov 04;3:764079. (PMID: 34806079)
      Int J Qual Health Care. 2007 Dec;19(6):349-57. (PMID: 17872937)
      Front Digit Health. 2023 May 22;5:1170002. (PMID: 37283721)
      J Consult Clin Psychol. 2023 Aug;91(8):462-473. (PMID: 37104802)
      BMC Med. 2009 Dec 16;7:79. (PMID: 20015347)
      J Med Internet Res. 2023 May 31;25:e44673. (PMID: 37256673)
      Couns Psychol Q. 2018;31(4):497-512. (PMID: 31274964)
      J Anxiety Disord. 2018 Apr;55:70-78. (PMID: 29422409)
      J Behav Ther Exp Psychiatry. 2023 Dec;81:101872. (PMID: 37209636)
      World Psychiatry. 2007 Oct;6(3):177-85. (PMID: 18188443)
      Front Psychiatry. 2019 May 10;10:344. (PMID: 31133906)
      Disabil Rehabil. 2024 Mar;46(6):1034-1044. (PMID: 36861777)
      J Med Internet Res. 2020 Sep 23;22(9):e17880. (PMID: 32965235)
      World Psychiatry. 2014 Feb;13(1):4-11. (PMID: 24497236)
      Clin Psychol Psychother. 2022 Jan;29(1):200-221. (PMID: 34048613)
      Front Psychiatry. 2019 Oct 25;10:749. (PMID: 31708813)
      Implement Sci. 2017 Jun 21;12(1):77. (PMID: 28637486)
      J Med Internet Res. 2013 Oct 17;15(10):e231. (PMID: 24135213)
      Psychol Med. 2015 Oct;45(13):2717-26. (PMID: 25881626)
      BMC Public Health. 2016 Jan 04;16:2. (PMID: 26728002)
      Prev Med. 2004 Mar;38(3):343-9. (PMID: 14766118)
      Behav Ther. 2024 Jan;55(1):201-211. (PMID: 38216233)
      Int J Epidemiol. 2014 Apr;43(2):476-93. (PMID: 24648481)
      J Med Internet Res. 2021 Dec 8;23(12):e17185. (PMID: 34889742)
      JMIR Serious Games. 2015 Mar 03;3(1):e1. (PMID: 25736225)
      Qual Health Res. 2022 Jul;32(8-9):1207-1214. (PMID: 35649292)
      Am J Prev Med. 2016 Nov;51(5):833-842. (PMID: 27745683)
      Int J Behav Nutr Phys Act. 2023 Feb 14;20(1):14. (PMID: 36782207)
      Patient Prefer Adherence. 2008 Feb 02;2:97-105. (PMID: 19920949)
      BMC Psychiatry. 2020 Sep 10;20(1):441. (PMID: 32912154)
      Behav Res Ther. 2017 Jan;88:7-18. (PMID: 28110678)
      J Ment Health. 2024 Apr;33(2):169-176. (PMID: 37212332)
      Qual Health Res. 2016 Nov;26(13):1753-1760. (PMID: 26613970)
      Aust N Z J Psychiatry. 2015 Sep;49(9):821-32. (PMID: 25818334)
      J Med Internet Res. 2021 Mar 24;23(3):e24387. (PMID: 33759801)
      Psychiatr Serv. 2021 Jun;72(6):677-683. (PMID: 33467872)
      Psychiatr Serv. 2020 Mar 1;71(3):256-262. (PMID: 31931686)
      J Epidemiol. 2007 Jul;17(4):114-9. (PMID: 17641446)
      Behav Ther. 2013 Mar;44(1):12-26. (PMID: 23312423)
      Behav Ther. 2018 Mar;49(2):295-307. (PMID: 29530267)
    • Grant Information:
      1173146 National Health and Medical Research Council; DE190101382 Australian Research Council
    • Contributed Indexing:
      Keywords: Computer-assisted therapy; Engagement; Internet; Qualitative; Skill enactment
    • Publication Date:
      Date Created: 20240801 Date Completed: 20240802 Latest Revision: 20240804
    • Publication Date:
      20240804
    • Accession Number:
      PMC11293152
    • Accession Number:
      10.1186/s12888-024-05953-3
    • Accession Number:
      39090611