Abstract

Abstract Background Delayed initial treatment contact for mental disorders is an important public health problem. The objective of this study was to develop persuasive messages to encourage help-seeking for depression. Methods Firstly, we conducted a questionnaire survey among Japanese adults to understand the reasons why people avoid seeking professional help for depression (BMC Public Health 2016). Secondly, we created 6 depression help-seeking messages with 3 frames× 2 formats and assessed their effectiveness in eliciting help-seeking intentions for depression (BMJ Open 2018). Thirdly, we redesigned the loss-framed formatted message to make it more visually appealing and made a trial of repeated message exposure with the aim of sustaining the messaging effect over time. Results Less than 40 % of survey participants reported a positive help-seeking intention for depression. The neutral-, loss-, and gain-framed messages were selected so as to be matched against the top 3 reasons for having no help-seeking intention, respectively. The loss-framed formatted message functioned better than the others; help-seeking intentions increased from 36% to 47% after the message exposure. Repeated message exposure increased the message retention rate (once 26% vs. twice 48% at 2-week follow-up) which enhanced the elicitation of help-seeking intentions. Conclusions The depression help-seeking message can elicit the intent to do so among people who otherwise lack this. Key messages The Step approach to Message Design and Testing is useful for developing public health messages and materials. Acknowledge: This work was supported by JSPS KAKENHI Grant Number JP25460815, JP16K09147 and the Uehara Memorial Foundation Research Grant.

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