Efficacy of an Internet-Based Depression Intervention to Improve Rates of Treatment in Adolescent Mothers

Summary

The intervention aimed to encourage Black mothers of low SES to seek depression treatment via an internet-based intervention. The intervention included vignettes, questions and answers, and other resources. In two time points, participants answered questions about their attitude and subjective norms towards mental health treatment, perceived control, intention to seek depression evaluation and treatment, and actually receiving treatment. Only the intervention group received the intervention. The intervention led to significant changes in each of these outcomes.

Overview

Purpose of Intervention:

To test the effectiveness of an internet-based depression intervention on seeking depression treatment

Intervention Type:

Research-Tested — Interventions with strong methodological rigor that have demonstrated short-term or long-term positive effects on one or more targeted health outcomes to improve minority health and/or health disparities through quantitative measures; Studies have a control or comparison group and are published in a peer-review journal; No pilot, demonstration or feasibility studies.

Intervention Details

Intervention was Primarily Driven, Led, or Managed by:

Both Community and Academic/Clinical Researchers

Citations:

Cynthia Logsdon, M., Myers, J., Rushton, J. et al. Efficacy of an Internet-based depression intervention to improve rates of treatment in adolescent mothers. Arch Womens Ment Health 21, 273–285 (2018). https://doi.org/10.1007/s00737-017-0804-z Link
Relevance: Main Intervention

Adaptation of Another Research-based Intervention:

No

Contact Information

Primary Contact Affiliation:

University of Louisville

Intervention URL:

https://web.archive.org/web/20160123133716/http://kyteenmom.com/sign-up-today

Results

Intention

Improve minority health or the health of other populations with health disparities (e.g. rural populations, populations with low SES)

Intervention Primary Outcome:

Rates of depression treatment in adolescents

Intervention Secondary Outcome:

Attitude and subjective norms towards mental health treatment, perceived control, and intention to seek depression evaluation

Key Findings:

Those in the intervention group intended to seek treatment (p=0.003) and actually received treatment (p=0.009) over time when compared to the control group. Within the control group, intention to seek treatment and actual treatment rates did not change (p=0.999 and p=0.081, respectively). Both rates increased over time within the intervention group (p=0.003 and p<0.001, respectively). Scores on two of the instruments (attitude, p=0.041; perceived control, p=0.007) improved significantly more over time for the intervention group when compared to the control group, but subjective norms did not. The scores on the instruments remained consistent over time within the control group (attitude, p=0.841; subjective norms, p=0.784; perceived control, p=0.913), while the scores significantly improved within the intervention group (p=0.018, p=0.040, and p<0.001, respectively).

Statistical Method Used:

Analysis of variance (ANOVA) techniques were used to test for differences between continuous variables, while Kruskal–Wallis, Fischer’s exact tests, and Wilcoxon methods were used to test for differences among categorical variables as appropriate. Repeated measures ANOVA techniques were used to test if changes occurred over time both within groups and between groups using an adjusted approach.

Demographic and Implementation Description

Diseases, Disorders, or Conditions:

Depression, Women's Health and Pregnancy

Race/Ethnicity:

African American or Black, White

Populations with Health Disparities:

People with Lower Socioeconomic Status (SES), Racial and Ethnic Minority Populations, Underserved Rural Communities

Age:

Adolescents (10 - 17 years), Young Adults (18 - 39 years)

Characteristics and Implementation

Intervention Focus Area:

Behavior Change

Disease Continuum:

Secondary Prevention

Delivery Setting:

Clinic / Health Care Facility, Data for the control group was collected in health care clinics and in home visits. The intervention group used a computer of their choice, which was often located in schools and health care facilities., Schools / Colleges

Mode of Delivery:

Online/e-Health

Who delivered the Intervention?:

N/A

Impact, Lessons, Components

Produced an impact or change beyond the primary or secondary outcome:

Yes

Attitude (p=0.041) and perceived control (p=0.007) improved significantly more over time for the intervention group when compared to the control group, but subjective norms did not. Dose of the intervention (measured in time spent on the intervention) significantly impacted (increased) attitudes (B=2.00, p=0.029). Being depressed (OR=2.15, 95% CI 1.15–4.04, p=0.005) and exposed to the intervention (OR=1.65, 95% CI 1.06–2.32, p=0.012) increased the odds of seeking treatment.

Essential Aspects for Success:

Adequate computer capabilities to support the intervention were critical to success. With the use of other technologies, the availability of adequate cell or wireless service is foundational to success.

Products, Materials, and Funding

Expertise, Partnerships, and Funding Sources

	Used for Implementation	Needed for Sustainability
Expertise
Community mobilization, community organization/coalition building	Yes	Unknown
Partnerships
Government agencies (city/state/county health department, law enforcement/criminal justice agencies)	Yes	Unknown
Funding Sources
Public funding (e.g., federal, state or local government)	Yes	Yes
Public funding (e.g., federal, state or local government)	Yes	No

Product/Material/Tools

	Tailored For Language	Material
Outreach/Recruitment Tools
Informed Consent Form	No	N/A
Participant Educational Tools
Description of instruments	No	Attachment available for request at the bottom of the page.
Measurement Tools
Standardized Instrument/Measures	No	Attachment available for request at the bottom of the page.

Implementation Materials and Products

	Material
Implementation/Delivery Materials
No Implementation/Delivery Materials provided.
Implementation/Output Materials
No Implementation/Output Materials provided.

Articles Related to Submitted Intervention

	Article
Reports/Monographs
No Reports/Monographs provided.
Additional Articles
No Additional Articles provided.

Materials Available for Request

Instruments 12-13-23.docx
Instruments 12-13-23.docx
Instruments 12-13-23 (2).docx

Intervention IP-102: Efficacy of an Internet-Based Depression Intervention to Improve Rates of Treatment in Adolescent Mothers