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. 2009 Feb 23;11(1):e6.
doi: 10.2196/jmir.1050.

Predictors of adherence by adolescents to a cognitive behavior therapy website in school and community-based settings

Alison L Neil  1 , Philip Batterham, Helen Christensen, Kylie Bennett, Kathleen M Griffiths
Affiliations

Predictors of adherence by adolescents to a cognitive behavior therapy website in school and community-based settings

Alison L Neil et al. J Med Internet Res. .

Abstract

Background: There have been no previous studies of the variables that predict adherence to online depression and anxiety intervention programs among adolescents. However, research of traditionally delivered intervention programs for a variety of health conditions in adolescence suggests that health knowledge, type and level of symptomatology, race, socioeconomic status, treatment setting, and support may predict adherence.

Objective: The aim was to compare adherence rates and identify the predictors of adherence to a cognitive behavior therapy website in two adolescent samples that were offered the program in different settings and under different conditions of support.

Methods: The first adolescent sample consisted of 1000 school students who completed the MoodGYM program in a classroom setting over five weeks as part of a randomized controlled trial. The second sample consisted of 7207 adolescents who accessed the MoodGYM program spontaneously and directly through the open access URL. All users completed a brief survey before the start of the program that measured background characteristics, depression history, symptoms of depression and anxiety, and dysfunctional thinking.

Results: Adolescents in the school-based sample completed significantly more online exercises (mean = 9.38, SD = 6.84) than adolescents in the open access community sample (mean = 3.10, SD = 3.85; t(1088.62) = -28.39, P < .001). A multiple linear regression revealed that school-based setting (P < .001) and female gender (P < .001) were predictive of greater adherence, as were living in a rural area (P < .001) and lower pre-test anxiety (P = .04) scores for the school-based sample and higher pre-test depression scores (P = .01) for the community sample. A history of depression (P = .33) and pre-test warpy thoughts scores (P = .35) were not predictive of adherence in the school-based or community sample.

Conclusion: Adherence is greater in monitored settings, and the predictors of adherence differ between settings. Understanding these differences may improve program effectiveness and efficiency.

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Conflict of interest statement

Helen Christensen and Kathleen Griffiths are authors of the MoodGYM program.

Figures

Figure 1
Figure 1
Number of modules completed
Figure 2
Figure 2
Number of exercises completed
Figure 3
Figure 3
Average number of exercises completed, by number of modules completed
See this image and copyright information in PMC

References

    1. Merry S, McDowell H, Hetrick S, Bir J, Muller N. Psychological and/or educational interventions for the prevention of depression in children and adolescents. Cochrane Database Syst Rev. 2004;(1):CD003380. doi: 10.1002/14651858.CD003380.pub2. - DOI - PubMed
    1. Neil Alison L, Christensen Helen. Australian school-based prevention and early intervention programs for anxiety and depression: a systematic review. Med J Aust. 2007 Mar 19;186(6):305–8. http://www.mja.com.au/public/issues/186_06_190307/nei10799_fm.htmlnei10799_fm - PubMed
    1. Davis M J, Addis M E. Predictors of attrition from behavioral medicine treatments. Ann Behav Med. 1999;21(4):339–49. doi: 10.1007/BF02895967. - DOI - PubMed
    1. van Dulmen Sandra, Sluijs Emmy, van Dijk Liset, de Ridder Denise, Heerdink Rob, Bensing Jozien. Patient adherence to medical treatment: a review of reviews. BMC Health Serv Res. 2007;7(1):55. doi: 10.1186/1472-6963-7-55. http://www.biomedcentral.com/1472-6963/7/551472-6963-7-55 - DOI - PMC - PubMed
    1. Kyngäs Helvi. Motivation as a crucial predictor of good compliance in adolescents with rheumatoid arthritis. Int J Nurs Pract. 2002 Dec;8(6):336–41. doi: 10.1046/j.1440-172X.2002.00389.x.389 - DOI - PubMed

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