Understanding the acceptability, utilisation and current evidence base of mHealth and online interventions: a traditional and non-traditional approach.
Introduction: There is an increased acceptance and demand for online and mobile
health (mHealth) interventions to support physical and mental health problems.
However, the uptake and engagement of these interventions is relatively low and the
evidence base for these interventions requires continual updating in line with
technological advances. A systematic review was conducted, focusing on anxiety and
depression, to explore the existing evidence base of both physical health and mental
health mobile applications. The first research paper explores the acceptability of
mHealth interventions for both mental health and physical health problems. The final
research paper explores use and strategies when searching for mental health
information online. Additionally, perceived quality, sentiment and barriers to online
health information was explored.
Methods: Studies were identified by searching for articles published between
January 2008 and January 2016. Databases included: PsycINFO, MEDLINE,
CINAHL PLUS and the Cochrane Central Register of Controlled Trials for 2016. In
the research articles, 218 people completed an online survey in January 2016
exploring, online health seeking for mental health and physical health problems, and
acceptability of mHealth interventions. Sentiment of online health resources was
explored by extracting 432 individual tweets from Twitter.
Results: The systematic review revealed twenty-seven studies for inclusion; 10 with
a physical health focus and 17 with a mental health focus. Targeted depression
applications have the superior evidence base; however, no firm conclusions can be
made regarding interventions that targeted physical health, or those measuring anxiety.
The first research paper found that face-to-face therapy would more likely meet
expectations for treatment of both physical and mental health problems compared to
mHealth interventions. Computerised interventions were more likely to meet
expectations than mobile applications. Expectations of treatment were higher for the
treatment of mental health problems than physical health problems.
The second research paper found that a large proportion of the public use the internet
to search for information on mental health, with half citing it as their primary source
for mental health information. The online survey found that the quality of mental
health information available on the internet was rated favourably, compared to mobile
applications. Overall, the sentiment towards specific online mental health resources
was generally positive.
Conclusions: Research into online and mHealth interventions has developed
considerably in recent years in line with advances in technology. These interventions
have the potential to be an effective treatment of common mental health problems.
The systematic review highlighted that depression applications are more established
and effective than applications targeting anxiety. The first research paper suggests that
mHealth interventions fall short of public expectations for treatment of health
problems. The final research paper reflects that the perceived quality of online mental
health information is rated favourably. However, many barriers still limit uptake.
Future research could focus on continually developing and evaluating evidence based
online and mHealth interventions and the outcome of this study suggests that
incorporating them more widely into existing care systems, alongside face to face
interventions could increase the public’s confidence in these interventions