title: Evaluating discussion board engagement in the MoodSwings online self-help program for bipolar disorder: protocol for an observational prospective cohort study.
abstract: BACKGROUND
  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 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
  The 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.
  
  
  CONCLUSIONS
  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 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.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02118623 registered April 15 2014 and NCT02106078 registered May 16 2013.
authors.affiliation: IMPACT Strategic Research Centre, Deakin University, Geelong, Australia. eglid@deakin.edu.au.|The Department of Psychiatry, The University of Melbourne, Parkville, Australia. eglid@deakin.edu.au.
authors.forename: Emma
authors.initials: E
authors.lastname: Gliddon
authors.affiliation: The Department of Psychiatry, The University of Melbourne, Parkville, Australia. suela@barwonhealth.org.au.|The Collaborative Research Network, Federation University, Ballarat, Australia. suela@barwonhealth.org.au.
authors.forename: Sue
authors.initials: S
authors.lastname: Lauder
authors.affiliation: The Department of Psychiatry, The University of Melbourne, Parkville, Australia. l.berk@deakin.edu.au.|Orygen - The National Centre of Excellence in Youth Mental Health, Parkville, Australia. l.berk@deakin.edu.au.|School of Psychology, Deakin University, Burwood, Australia. l.berk@deakin.edu.au.
authors.forename: Lesley
authors.initials: L
authors.lastname: Berk
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, California, USA. veileen@stanford.edu.|Stanford University School of Medicine, Stanford, California, USA. veileen@stanford.edu.
authors.forename: Victoria
authors.initials: V
authors.lastname: Cosgrove
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, California, USA. david.grimm@va.gov.
authors.forename: David
authors.initials: D
authors.lastname: Grimm
authors.affiliation: IMPACT Strategic Research Centre, Deakin University, Geelong, Australia. seetald@barwonhealth.org.au.|The Department of Psychiatry, The University of Melbourne, Parkville, Australia. seetald@barwonhealth.org.au.
authors.forename: Seetal
authors.initials: S
authors.lastname: Dodd
authors.affiliation: VA Palo Alto Health Care System, Palo Alto, California, USA. tsuppes@stanford.edu.|Stanford University School of Medicine, Stanford, California, USA. tsuppes@stanford.edu.
authors.forename: Trisha
authors.initials: T
authors.lastname: Suppes
authors.affiliation: IMPACT Strategic Research Centre, Deakin University, Geelong, Australia. mikebe@barwonhealth.org.au.|The Department of Psychiatry, The University of Melbourne, Parkville, Australia. mikebe@barwonhealth.org.au.|Orygen - The National Centre of Excellence in Youth Mental Health, Parkville, Australia. mikebe@barwonhealth.org.au.|Florey Institute for Neuroscience and Mental Health, Parkville, Australia. mikebe@barwonhealth.org.au.
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003866:Depressive Disorder / Q000628:therapy; D015438:Health Behavior; D020407:Internet; D011446:Prospective Studies; D011788:Quality of Life; D012648:Self Care / Q000379:methods; D057566:Self Report; D012944:Social Support; D013240:Stereotyping; D013689:Telephone; D064887:Observational Studies as Topic