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. 2022 Aug 9:29:100566.
doi: 10.1016/j.invent.2022.100566. eCollection 2022 Sep.

Digital prevention of depression for farmers? A qualitative study on participants' experiences regarding determinants of acceptance and satisfaction with a tailored guided internet intervention program

Johanna Freund  1   2 , Claudia Buntrock  1   3   4 , Lina Braun  3 , Janika Thielecke  1   2 , Harald Baumeister  3 , Matthias Berking  1 , David Daniel Ebert  1   2 , Ingrid Titzler  1
Affiliations

Digital prevention of depression for farmers? A qualitative study on participants' experiences regarding determinants of acceptance and satisfaction with a tailored guided internet intervention program

Johanna Freund et al. Internet Interv. .

Abstract

Introduction: Farmers, forest workers and gardeners have a higher risk of developing depression compared to other occupational populations. As part of the German pilot project "With us in balance", the potential of six guided internet- and mobile-based interventions (IMIs) to prevent depression among their insurants is examined. The IMI program is tailored to various risk factors of depression, individual symptoms, and needs. Although IMIs have been shown to be effective in reducing depressive symptoms, there is little qualitative research about the acceptance of digital preventive IMIs. The aim of this qualitative study is to gain insights into participants' experiences with the guided IMIs by focusing on determinants for acceptance and satisfaction.

Methods: Semi-structured interviews were conducted with 22/171 (13 %) intervention group (IG) participants of a randomized controlled trial. The interview guide was developed based on theoretical models of user acceptance (Unified Theory of Acceptance and Use of Technology) and patient satisfaction (evaluation model, discrepancy theory). The interviews were evaluated independently by two coders performing a deductive-inductive content analysis and attaining a substantial level of agreement (K = 0.73).

Results: The qualitative analysis revealed 71 determinants for acceptance and satisfaction across ten dimensions: performance expectancy, organisation, e-coach, usability, training content and structure, training usage, training outcome, financing, social influence, and behavioural intention. The most frequently identified drivers for the IMI use include "location independence", "positive relationship to the e-coach" (each n = 19, 86 %), "personal e-coach guidance", "expertise of the e-coach", "target group specific adaptation" (each n = 18, 82 %), "flexibility", "high willingness for renewed participation" (each n = 17, 77 %), "fast and easy availability", "training of health enhancing attitudes and behaviours" and "content with figurative expressions" (each n = 16, 73 %).

Discussion: The qualitative findings predominantly suggest the acceptance of and satisfaction with the IMI program for the prevention of depression in famers and related lines of work. Many identified positive drivers are related to the e-coach guidance, which emphasizes its importance in the preventive setting from the perspective of the participants. Nevertheless, some negative aspects have been identified which help to understand potential weaknesses of the IMI program. Participants indicated different needs in terms of IMI content and usage, which points towards the potential benefit of individualisation. The possibility of being able to use IMIs anonymously, flexibly and independently of location might be highly relevant for this specific target group.

Keywords: Farmers; Implementation; Mental health; Participant's experience; Prevention; Tailored internet interventions.

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Conflict of interest statement

HB has received consultancy fees and fees for lectures/workshops from chambers of psychotherapists and training institutes for psychotherapists in the e-mental-health context. DDE has served as a consultant to/on the scientific advisory boards of Sanofi, Novartis, Minddistrict, Lantern, Schoen Kliniken, Ideamed and German health insurance companies (BARMER, Techniker Krankenkasse) and a number of federal chambers for psychotherapy. MB is scientific advisor of mentalis GmbH and GET.ON Institute/HelloBetter, both providers of digital mental health care products and services. MB is also co-founder and stakeholder of mentalis GmbH. DDE is stakeholder of the GET.ON Institute/HelloBetter, which aims to implement scientific findings related to digital health interventions into routine care. IT reports to have received fees for lectures/workshops in the e-mental-health context from training institutes and congresses for psychotherapists. She was the project lead for the research project ImpleMentAll (funded by the European Commission) at GET.ON which aimed to investigate the effectiveness of tailored implementation strategies compared to implementation as usual (11/2017–03/2021). JF, CB, JT, LB report no conflicts of interest.

Figures

Fig. 1
Fig. 1
Measures for personalizing and tailoring the intervention in the course of the participation.
Fig. 2
Fig. 2
Process model of qualitative data analysis based on the qualitative content analysis by Mayring (2010).
Fig. 3
Fig. 3
Ten dimensions and their theoretical linkage with the UTAUT model for acceptance (Venkatesh et al., 2003) and/or the evaluation model of patient satisfaction (Ware et al., 1978).
See this image and copyright information in PMC

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