Health e-cards as a means of encouraging help seeking for depression among young adults: randomized controlled trial.
BACKGROUND
There is a need to identify interventions that increase help seeking for depression among young adults.


OBJECTIVE
The aim was to evaluate a brief depression information intervention employing health e-cards (personalized emails containing links to health information presented on a Web page).


METHODS
A randomized controlled trial was carried out with 348 19- to 24-year-olds drawn from the community. Participants were randomized to receive one of three conditions, all of which delivered a short series of health e-cards. Two active conditions involved the delivery of depression information designed to increase help-seeking behavior and intentions and to improve beliefs and knowledge associated with help seeking. A control arm delivered information about general health issues unrelated to depression. The primary outcome was help-seeking behavior. Secondary outcomes were help-seeking intentions; beliefs about the efficacy of depression treatments and help sources; ability to recognize depression; knowledge of the help-seeking process; and depressive symptoms. The study's primary focus was outcomes relating to formal help seeking (consultation with a general practitioner or mental health professional) but also targeted behaviors, intentions, and beliefs relating to informal help seeking.


RESULTS
Relative to the control condition, depression health e-cards were not associated with an increase in formal help-seeking behavior, nor were they associated with improved beliefs about depression treatments; ability to recognize depression; knowledge of the help-seeking process; or depressive symptoms. Depression e-cards were associated with improved beliefs about the overall efficacy of formal help sources (z = 2.4, P = .02). At post-intervention, participants in all conditions, relative to pre-intervention, were more likely to have higher intentions of seeking help for depression from a formal help source (t(641) = 5.8, P < .001) and were more likely to rate interpersonal psychotherapy as being helpful (z = 2.0, P = .047). Depression e-cards were not associated with any significant changes in informal help-seeking behavior, intentions, or beliefs.


CONCLUSIONS
The study found no evidence that providing depression information in the form of brief e-cards encourages help seeking for depression among young adults. Involvement in the study may have been associated with increased help-seeking intentions among participants in all conditions, suggesting that mechanisms other than depression information may increase help seeking.
Costin
Daniel L
DL
Centre for Mental Health Research, The Australian National University, Canberra, ACT, Australia.
Mackinnon
Andrew J
AJ
Griffiths
Kathleen M
KM
Batterham
Philip J
PJ
Bennett
Anthony J
AJ
Bennett
Kylie
K
Christensen
Helen
H
D000293:Adolescent; D001294:Attitude to Health; D017281:Cost of Illness; D003376:Counseling; D003863:Depression / Q000628:therapy*; D003866:Depressive Disorder / Q000628:therapy*; D018450:Disease Progression; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010342:Patient Acceptance of Health Care; D011570:Psychiatry; D011586:Psychology, Clinical; D011613:Psychotherapy; D013315:Stress, Psychological / Q000175:diagnosis; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult