title: Impact of an acceptance facilitating intervention on diabetes patients' acceptance of Internet-based interventions for depression: a randomized controlled trial.
abstract: OBJECTIVE
  To (1) determine diabetes patients' acceptance of Internet-based interventions (IBIs) for depression, to (2) examine the effectiveness of an acceptance facilitating intervention (AFI) and to (3) explore subgroup specific effects.
  
  
  METHODS
  141 diabetes patients from two inpatient rehabilitation units and one outpatient clinic in Germany were randomly allocated to an intervention (IG) and a no-intervention control group (CG). The IG received an AFI consisting of a personal information session before filling-out a questionnaire on patients' acceptance of IBIs, predictors of acceptance (performance expectancy, effort expectancy, social influence, facilitating conditions, and Internet anxiety) as well as sociodemographic, depression-related and diabetes-related variables. The CG filled out the questionnaire immediately. Patients' acceptance of IBIs was measured with a four-item scale (sum-score ranging from 4 to 20).
  
  
  RESULTS
  The CG showed a low (50.7%) to medium (40.8%) acceptance with only 8.5% of all diabetes patients reporting a high acceptance of IBIs for depression. The AFI had no significant effect on acceptance (IG: M=10.55, SD=4.69, n=70; KG: M=9.65, SD=4.27, n=71; d=0.20 [95%-CI: -0.13;0.53]) and the predictors of acceptance. Yet, subgroup analyses yielded a trend for depressed, diabetes-related distressed, female and younger (<59) participants and for those who do not frequently use the Internet to profit from the AFI.
  
  
  CONCLUSIONS
  Diabetes patients show a rather low acceptance toward IBIs for depression. Findings indicate that the AFI is likely to be effective in the subgroup of depressed, diabetes-related distressed, female or younger diabetes patients, but not in the whole target population. Hence, AFIs might need to be tailored to the specific needs of subpopulations.
authors.affiliation: Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany; Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Germany. Electronic address: baumeister@psychologie.uni-freiburg.de.
authors.forename: H
authors.initials: H
authors.lastname: Baumeister
authors.affiliation: Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany.
authors.forename: L
authors.initials: L
authors.lastname: Nowoczin
authors.affiliation: Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany; Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Seifferth
authors.affiliation: Endocriniology and Diabetology, University Medical Center Freiburg, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Seufert
authors.affiliation: Endocriniology and Diabetology, University Medical Center Freiburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Laubner
authors.affiliation: Leuphana University, Innovation Incubator, Division Health Trainings Online, Lueneburg, Germany; Philipps University Marburg, Department of Psychology, Clinical Psychology and Psychotherapy, Marburg, Germany.
authors.forename: D D
authors.initials: DD
authors.lastname: Ebert
mesh_terms: D001007:Anxiety / Q000209:etiology / Q000517:prevention & control; D016022:Case-Control Studies; D003866:Depressive Disorder / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D048909:Diabetes Complications / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011795:Surveys and Questionnaires; D013813:Therapy, Computer-Assisted / Q000379:methods*
keywords: Acceptance; Depression; Diabetes; E-health; Psychotherapy