title: Increasing the acceptance of internet-based mental health interventions in primary care patients with depressive symptoms. A randomized controlled trial.
abstract: BACKGROUND
  Internet-based interventions (IBI) are effective in treating depression. However, uptake rates in routine care are still limited. Hence, this study aimed to (1) assess the acceptance of IBIs in primary care patients with depressive symptoms and to (2) examine the effects of a brief acceptance facilitating intervention in the form of an informational video on patients' acceptance of IBIs.
  
  
  METHODS
  Primary care patients (N=128) with Minor or Major Depression were randomly assigned to an intervention (IG) or control group (CG). Patients in the IG were shown a brief informational video about IBIs before receiving a questionnaire that assessed their acceptance of IBIs and other secondary outcomes. Patients of the CG filled out the questionnaire immediately.
  
  
  RESULTS
  Baseline acceptance of IBIs in the CG was high for 6.3%, moderate for 53.1% and low for 40.6% of patients. Acceptance of IBIs was significantly higher in the IG when compared to the CG (d=.71, 95%-CI:.09-2.91). Except for social influence and the general attitude towards psychological treatment, all secondary outcomes were also significantly improved (e.g. effort- (d=.40) and performance-expectancy: d=.65; knowledge about Internet interventions d=.35).
  
  
  CONCLUSIONS
  Depression of the participants was only assessed using a self-report measure (PHQ-9).
  
  
  CONCLUSIONS
  Primary care patients' acceptance of IBIs for depressive symptoms was low but could be increased significantly using a brief acceptance facilitating intervention on the basis of an informational video. Future studies should further examine the potential of acceptance facilitating interventions for patients and health care providers to exploit the public health impact of IBIs.
authors: Leuphana University, Innovation Incubator, Division Health Trainings online, Lueneburg, Germany; Friedrich-Alexander University Nuremberg-Erlangen, Department of Psychology, Clinical Psychology and Psychotherapy, Erlangen, Germany; Department for Health Care Policy, Harvard Medical School, Harvard University, Boston, USA. Electronic address: ebert@leuphana.de.
authors: D D
authors: DD
authors: Ebert
authors: Friedrich-Alexander University Nuremberg-Erlangen, Department of Psychology, Clinical Psychology and Psychotherapy, Erlangen, Germany.
authors: M
authors: M
authors: Berking
authors: Leuphana University, Innovation Incubator, Division Health Trainings online, Lueneburg, Germany; GGZ in Geest, Regional Mental Health Service Centre, VU University Medical Centre, Amsterdam, The Netherlands; Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands.
authors: P
authors: P
authors: Cuijpers
authors: Leuphana University, Innovation Incubator, Division Health Trainings online, Lueneburg, Germany.
authors: D
authors: D
authors: Lehr
authors: Friedrich-Alexander University Nuremberg-Erlangen, Department of Psychology, Clinical Psychology and Psychotherapy, Erlangen, Germany.
authors: M
authors: M
authors: Pörtner
authors: Department of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany.
authors: H
authors: H
authors: Baumeister
mesh_terms: D000328:Adult; D003863:Depression / Q000523:psychology / Q000628:therapy*; D003865:Major Depressive Disorder / Q000628:therapy; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods*; D011795:Surveys and Questionnaires; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
keywords: Acceptance; Depression; Implementation; Internet-based intervention; Randomized-controlled trial; e-health