Preferred Features of E-Mental Health Programs for Prevention of Major Depression in Male Workers: Results From a Canadian National Survey.
Major depression is a prevalent mental disorder and imposes considerable burden on health and productivity. Men are not immune to major depression, yet they often delay seeking help because of perceived stigma and gender norms. E-mental health programs hold potential for early prevention of major depression. However, we have little knowledge about men's preferences for design features of e-mental health programs.



The objective of this study was to (1) estimate and compare the proportions of Internet use for medical information, preferred design features, and likely use of e-mental health programs; (2) examine factors associated with the likely use of e-mental health programs; and (3) understand potential barriers to the use of e-mental health programs among Canadian working men, who were at high risk of a major depressive episode (MDE).



A cross-sectional survey in 10 Canadian provinces was conducted between March and December 2015. Random digit dialing method was used through household landlines and cell phones to collect data from 511 working men who were at high risk of having an MDE and 330 working men who were at low risk of having an MDE.



High-risk men were more likely to endorse the importance of accessing health resources on the Internet than low-risk men (83.4% vs 75.0%, respectively; P=.01). Of the 17 different features assessed, the top three features most likely to be used by high-risk men were: "information about improving sleep hygiene" (61.3%), "practice and exercise to help reduce symptoms of stress and depression" (59.5%), and "having access to quality information and resources about work stress issues" (57.8%). Compared with men at low risk for MDE, men at high risk for MDE were much more likely to consider using almost every one of the different design features. Differences in preferences for the design features by age among men at high risk of MDE were found only for 3 of 17 features. Differences in preferences for design features between English- and French-speaking participants were found only for 4 out of the 17 features. Analysis of qualitative data revealed that privacy issues, perceived stigma, ease of navigation, personal relevance, and lack of personal interaction, time, and knowledge were identified as barriers to the use of e-mental health programs in working men who were at high risk of MDE.



E-mental health programs may be a promising strategy for prevention of depression in working men. Development of e-mental health programs should consider men's preferences and perceived barriers to enhance the acceptability of this approach.
Department of Psychiatry, University of Calgary, Calgary, AB, Canada. jlwang@ucalgary.ca.
JianLi
0000-0002-1329-914X
J
Wang
Raymond W
0000-0001-7142-4669
RW
Lam
Kendall
0000-0002-4936-9031
K
Ho
Mark
0000-0003-1852-2168
M
Attridge
Bonnie M
0000-0001-6476-8981
BM
Lashewicz
Scott B
0000-0001-9871-4041
SB
Patten
Alain
0000-0002-0996-7141
A
Marchand
Alice
0000-0003-2469-9445
A
Aiken
Norbert
0000-0001-7777-6323
N
Schmitz
Sarika
0000-0002-2174-344X
S
Gundu
Nitika
0000-0002-0948-3438
N
Rewari
David
0000-0003-2737-5200
D
Hodgins
Andrew
0000-0003-3305-7874
A
Bulloch
Zul
0000-0002-4534-7177
Z
Merali
D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000517:prevention & control* / Q000523:psychology; D004651:Employment / Q000523:psychology; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods*; D055815:Young Adult
Internet; depression; design features; e-mental health programs; men; prevention