title: Designing messaging to engage patients in an online suicide prevention intervention: survey results from patients with current suicidal ideation.
abstract: BACKGROUND
  Computerized, Internet-delivered interventions can be efficacious; however, uptake and maintaining sustained client engagement are still big challenges. We see the development of effective engagement strategies as the next frontier in online health interventions, an area where much creative research has begun. We also argue that for engagement strategies to accomplish their purpose with novel targeted populations, they need to be tailored to such populations (ie, content is designed with the target population in mind). User-centered design frameworks provide a theoretical foundation for increasing user engagement and uptake by including users in development. However, deciding how to implement this approach to engage users in mental health intervention development is challenging.
  
  
  OBJECTIVE
  The aim of this study was to get user input and feedback on acceptability of messaging content intended to engage suicidal individuals.
  
  
  METHODS
  In March 2013, clinic intake staff distributed flyers announcing the study, "Your Feedback Counts" to potential participants (individuals waiting to be seen for a mental health appointment) together with the Patient Health Questionnaire. The flyer explained that a score of two or three ("more than half the days" or "nearly every day" respectively) on the suicide ideation question made them eligible to provide feedback on components of a suicide prevention intervention under development. The patient could access an anonymous online survey by following a link. After providing consent online, participants completed the anonymous survey.
  
  
  RESULTS
  Thirty-four individuals provided data on past demographic information. Participants reported that they would be most drawn to an intervention where they knew that they were cared about, that was personalized, that others like them had found it helpful, and that included examples with real people. Participants preferred email invitations with subject lines expressing concern and availability of extra resources. Participants also provided feedback about a media prototype including a brand design and advertisement video for introducing the intervention.
  
  
  CONCLUSIONS
  This paper provides one model (including development of an engagement survey, audience for an engagement survey, methods for presenting results of an engagement survey) for including target users in the development of uptake strategies for online mental health interventions.
authors: Group Health Research Institute, Seattle, WA, United States. whiteside.u@ghc.org.
authors: Ursula
authors: U
authors: Whiteside
authors: Anita
authors: A
authors: Lungu
authors: Julie
authors: J
authors: Richards
authors: Gregory E
authors: GE
authors: Simon
authors: Sarah
authors: S
authors: Clingan
authors: Jaeden
authors: J
authors: Siler
authors: Lorilei
authors: L
authors: Snyder
authors: Evette
authors: E
authors: Ludman
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D034742:Electronic Mail; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires; D000092864:Suicide Prevention
keywords: health 2.0; human centered design; suicide; user centered design