Abstract
BackgroundOnline, self-guided programs exist for a wide range of mental health conditions, including bipolar disorder, and discussion boards are often part of these interventions. The impact engagement with these discussion boards has on the psychosocial well-being of users is largely unknown. More specifically we need to clarify the influence of the type and level of engagement on outcomes.The primary aim of this exploratory study is to determine if there is a relationship between different types (active, passive or none) and levels (high, mid and low) of discussion board engagement and improvement in outcome measures from baseline to follow up, with a focus on self-reported social support, stigma, quality of life and levels of depression and mania. The secondary aim of this study is to identify any differences in demographic variables among discussion users.Methods/designThe present study is a sub-study of the MoodSwings 2.0 3-arm randomised controlled trial (discussion board only (arm 1), discussion board plus psychoeducation (arm 2), discussion board, psychoeducation plus cognitive behavioural therapy-based tools (arm 3)). Discussion engagement will be measured via online participant activity monitoring. Assessments include online self-report as well as blinded phone interviews at baseline, 3, 6, 9 and 12 months follow up.DiscussionThe results of this study will help to inform future programs about whether or not discussion boards are a beneficial inclusion in online self-help interventions. It will also help to determine if motivating users to actively engage in online discussion is necessary, and if so, what level of engagement is optimal to produce the most benefit. Future programs may benefit through being able to identify those most likely to poorly engage, based on demographic variables, so motivational strategies can be targeted accordingly.Trial registrationClinicalTrials.gov NCT02118623 registered April 15 2014 and NCT02106078 registered May 16 2013.
Highlights
Online, self-guided programs exist for a wide range of mental health conditions, including bipolar disorder, and discussion boards are often part of these interventions
The results of this study will help to inform future programs about whether or not discussion boards are a beneficial inclusion in online self-help interventions
It will help to determine if motivating users to actively engage in online discussion is necessary, and if so, what level of engagement is optimal to produce the most benefit
Summary
Online discussion boards have been shown to have great potential in improving social support, reducing perceived stigma [18] and improving quality of life [27]; it is unclear what type or level of engagement is necessary to reap any benefit and what structures facilitate or inhibit such engagement. The MoodSwings online psychotherapeutic intervention for bipolar disorder offers a valuable opportunity to deliver online discussion boards in an environment where natural usage patterns can be observed and accurately monitored. This will allow clear comparisons between users and non-users, as well as users with differing types and levels of engagement on a broad range of both self-report and clinician administered outcome measures. This research will assist in clarifying and maximising the benefits of online discussion, provide data guiding the design and utilisation of discussion boards, and will give clinicians and online users the best chance of positively utilizing online mental health communities. All authors were involved in the development of the study design, made a substantial contribution to developing the final manuscript, and read and approved the final manuscript
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