Top

International Journal of Behavioral Medicine

Published in:

01-12-2016

A Systematic Review of Predictors of, and Reasons for, Adherence to Online Psychological Interventions

Authors: Lisa Beatty, Claire Binnion

Published in: International Journal of Behavioral Medicine | Issue 6/2016

Abstract

Purpose

A key issue regarding the provision of psychological therapy in a self-guided online format is low rates of adherence. The aim of this systematic review was to assess both quantitative and qualitative data on the predictors of adherence, as well as participant reported reasons for adhering or not adhering to online psychological interventions.

Methods

Database searches of PsycINFO, Medline, and CINAHL identified 1721 potentially relevant articles published between 1 January 2000 and 25 November 2015. A further 34 potentially relevant articles were retrieved from reference lists. Articles that reported predictors of, or reasons for, adherence to an online psychological intervention were included.

Results

A total of 36 studies met the inclusion criteria. Predictors assessed included demographic, psychological, characteristics of presenting problem, and intervention/computer-related predictors. Evidence suggested that female gender, higher treatment expectancy, sufficient time, and personalized intervention content each predicted higher adherence. Age, baseline symptom severity, and control group allocation had mixed findings. The majority of assessed variables however, did not predict adherence.

Conclusions

Few clear predictors of adherence emerged overall, and most results were either mixed or too preliminary to draw conclusions. More research of predictors associated with adherence to online interventions is warranted.

Barak A, Hen L, Boniel-Nissim M, Shapira NA. A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. J Technol Hum Serv. 2008;26:109–60.CrossRef

Gellatly J, Bower P, Hennessy S, Richards D, Gilbody S, Lovell K. What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression. Psychol Med. 2007;37:1217–28. doi:10.1017/S0033291707000062.CrossRefPubMed

Marks I, Cavanagh K, Gega L. Computer-aided psychotherapy: revolution or bubble? Br J Psychiatry. 2007;191:471–3.CrossRefPubMed

Melville KM, Casey LM, Kavanagh DJ. Dropout from internet-based treatment for psychological disorders. Br J Clin Psychol. 2010;49:455–71. doi:10.1348/014466509X472138.CrossRefPubMed

Cuijpers P, van Straten A, Andersson G. Internet-administered cognitive behavior therapy for health problems: a systematic review. J Behav Med. 2008;31:169–77.CrossRefPubMed

Beatty L, Lambert S. A systematic review of internet-based self-help therapeutic interventions to improve distress and disease-control among adults with chronic health conditions. Clin Psychol Rev. 2013;33:609–22.CrossRefPubMed

Barak A, Klein B, Proudfoot J. Defining internet-supported therapeutic interventions. Ann Behav Med. 2009;38:4–17. doi:10.1007/s12160-009-9130-7.CrossRefPubMed

Griffiths KM, Farrer L, Christensen H. The efficacy of internet interventions for depression and anxiety disorders: a review of randomised controlled trials. Med J Aust. 2010;192:S4.PubMed

Donkin L, Christensen H, Naismith SL, Neal B, Hickie IB, Glozier N. A systematic review of the impact of adherence on the effectiveness of e-therapies. J Med Internet Res. 2011;13:e52. doi:10.2196/jmir.1772.CrossRefPubMedPubMedCentral

10.

Eysenbach G. The law of attrition. J Med Internet Res. 2005;7:e11.CrossRefPubMedPubMedCentral

11.

Christensen H, Griffiths KM, Korten AE, Brittliffe K, Groves C. A comparison of changes in anxiety and depression symptoms of spontaneous users and trial participants of a cognitive behavior therapy website. J Med Internet Res. 2004;6:e46.CrossRefPubMedPubMedCentral

12.

Farvolden P, Denisoff E, Selby P, Bagby RM, Rudy L. Usage and longitudinal effectiveness of a web-based self-help cognitive behavioral therapy program for panic disorder. J Med Internet Res. 2005;7:e7.CrossRefPubMedPubMedCentral

13.

Geraghty AW, Wood AM, Hyland ME. Attrition from self-directed interventions: investigating the relationship between psychological predictors, intervention content and dropout from a body dissatisfaction intervention. Soc Sci Med. 2010;71:30–7.CrossRefPubMed

14.

Christensen H, Griffiths KM, Korten A. Web-based cognitive behavior therapy: analysis of site usage and changes in depression and anxiety scores. J Med Internet Res. 2002;4:e3. doi:10.2196/jmir.4.1.e3.CrossRefPubMedPubMedCentral

15.

Ghaderi A. Attrition and outcome in self-help treatment for bulimia nervosa and binge eating disorder: a constructive replication. Eat Behav. 2006;7:300–8.CrossRefPubMed

16.

Glasgow RE, Nelson CC, Kearney KA, Reid R, Ritzwoller DP, Strecher VJ, et al. Reach, engagement, and retention in an Internet-based weight loss program in a multi-site randomized controlled trial. J Med Internet Res. 2007;9:e11. doi:10.2196/jmir.9.2.e11.CrossRefPubMedPubMedCentral

17.

Christensen H, Griffiths KM, Farrer L. Adherence in internet interventions for anxiety and depression. J Med Internet Res. 2009;11:e13.CrossRefPubMedPubMedCentral

18.

Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions. Wiley Online Library; 2008.

19.

Chambless DL, Hollon SD. Defining empirically supported therapies. J Consult Clin Psychol. 1998;66:7.CrossRefPubMed

20.

Nicholas J, Proudfoot J, Parker G, Gillis I, Burckhardt R, Manicavasagar V, et al. The ins and outs of an online bipolar education program: a study of program attrition. J Med Internet Res. 2010;12:e57.CrossRefPubMedPubMedCentral

21.

Berman MI, Buckey Jr JC, Hull JG, Linardatos E, Song SL, McLellan RK, et al. Feasibility study of an interactive multimedia electronic problem solving treatment program for depression: a preliminary uncontrolled trial. Behav Ther. 2014;45:358–75. doi:10.1016/j.beth.2014.02.001.CrossRefPubMedPubMedCentral

22.

Trompetter H, Bohlmeijer E, Veehof M, Schreurs K. Internet-based guided self-help intervention for chronic pain based on Acceptance and Commitment Therapy: a randomized controlled trial. J Behav Med. 2015;38:66–80. doi:10.1007/s10865-014-9579-0. 15p.CrossRefPubMed

23.

Bewick BM, West R, Gill J, O’May F, Mulhern B, Barkham M, et al. Providing web-based feedback and social norms information to reduce student alcohol intake: a multisite investigation. J Med Internet Res. 2010;12:e59.CrossRefPubMedPubMedCentral

24.

Hebert EA, Vincent N, Lewycky S, Walsh K. Attrition and adherence in the online treatment of chronic insomnia. Behav Sleep Med. 2010;8:141–50. doi:10.1080/15402002.2010.487457.CrossRefPubMed

25.

Scott K, Beatty L. A feasibility study of a self-guided CBT internet intervention for cancer carers. Aust J Prim Health. 2013;19:270–4.CrossRefPubMed

26.

Topolovec-Vranic J, Cullen N, Michalak A, Ouchterlony D, Bhalerao S, Masanic C, et al. Evaluation of an online cognitive behavioural therapy program by patients with traumatic brain injury and depression. Brain Inj. 2010;24:762–72. doi:10.3109/02699051003709599.CrossRefPubMed

27.

Carrard I, Rouget P, Fernández-Aranda F, Volkart A-C, Damoiseau M, Lam T. Evaluation and deployment of evidence based patient self-management support program for bulimia nervosa. Int J Med Inform. 2006;75:101–9. doi:10.1016/j.ijmedinf.2005.07.031.CrossRefPubMed

28.

Cavanagh K, Shapiro DA, Van Den Berg S, Swain S, Barkham M, Proudfoot J. The acceptability of computer-aided cognitive behavioural therapy: a pragmatic study. Cogn Behav Ther. 2009;38:235–46.CrossRefPubMed

29.

Batterham PJ, Neil AL, Bennett K, Griffiths KM, Christensen H. Predictors of adherence among community users of a cognitive behavior therapy website. Patient Prefer Adherence. 2008;2:97.PubMedPubMedCentral

30.

AL-Asadi AM, Klein BDM. Pretreatment attrition and formal withdrawal during treatment and their predictors: an exploratory study of the anxiety online data. J Med Internet Res. 2014;16:e152. doi:10.2196/jmir.2989.CrossRefPubMedPubMedCentral

31.

Pittaway S, Cupitt C, Palmer D, Arowobusoye N, Milne R, Holttum S, et al. Comparative, clinical feasibility study of three tools for delivery of cognitive behavioural therapy for mild to moderate depression and anxiety provided on a self-help basis. Ment Health Fam Med. 2009;6:145–54.PubMedPubMedCentral

32.

El Alaoui S, Ljótsson B, Hedman E, Kaldo V, Andersson E, Rück C, et al. Predictors of symptomatic change and adherence in internet-based cognitive behaviour therapy for social anxiety disorder in routine psychiatric care. PLoS ONE. 2015;10:e0124258. doi:10.1371/journal.pone.0124258.CrossRefPubMedPubMedCentral

33.

Wojtowicz M, Day V, McGrath PJ. Predictors of participant retention in a guided online self-help program for university students: prospective cohort study. J Med Internet Res. 2013;15:136–45.CrossRef

34.

Twomey C, O’Reilly G, Byrne M, Bury M, White A, Kissane S, et al. A randomized controlled trial of the computerized CBT programme, moodGYM, for public mental health service users waiting for interventions. Br J Clin Psychol. 2014;53:433–50. doi:10.1111/bjc.12055.CrossRefPubMed

35.

Richards D, Timulak L. Satisfaction with therapist-delivered vs. self-administered online cognitive behavioural treatments for depression symptoms in college students. Br J Guid Couns. 2013;41:193–207.CrossRef

36.

Strom L, Pettersson R, Andersson G. Internet-based treatment for insomnia: a controlled evaluation. J Consult Clin Psychol. 2004;72:113–20. doi:10.1037/0022-006x.72.1.113.CrossRefPubMed

37.

Andersson G, Stromgren T, Strom L, Lyttkens L. Randomized controlled trial of internet-based cognitive behavior therapy for distress associated with tinnitus. Psychosom Med. 2002;64:810–6.PubMed

38.

Hasson H, Brown C, Hasson D. Factors associated with high use of a workplace web-based stress management program in a randomized controlled intervention study. Health Educ Res. 2010;25:596–607.CrossRefPubMed

39.

Price M, Gros DF, McCauley JL, Gros KS, Ruggiero KJ. Nonuse and dropout attrition for a web-based mental health intervention delivered in a post-disaster context. Psychiatry Interpersonal Biol Process. 2012;75:267–84. doi:10.1521/psyc.2012.75.3.267.CrossRef

40.

Strecher VJ, McClure J, Alexander G, Chakraborty B, Nair V, Konkel J, et al. The role of engagement in a tailored web-based smoking cessation program: randomized controlled trial. J Med Internet Res. 2008;10:e36.CrossRefPubMedPubMedCentral

41.

Gerhards S, Abma T, Arntz A, de Graaf L, Evers S, Huibers M, et al. Improving adherence and effectiveness of computerised cognitive behavioural therapy without support for depression: a qualitative study on patient experiences. J Affect Disord. 2011;129:117–25.CrossRefPubMed

42.

Postel MG, de Haan HA, ter Huurne ED, Becker ES, de Jong CA. Effectiveness of a web-based intervention for problem drinkers and reasons for dropout: randomized controlled trial. J Med Internet Res. 2010;12:e68.CrossRefPubMedPubMedCentral

43.

Boettcher J, Renneberg B, Berger T. Patient expectations in internet-based self-help for social anxiety. Cogn Behav Ther. 2013;42:203–14.CrossRefPubMed

44.

Farrer LM, Griffiths KM, Christensen H, Mackinnon AJ, Batterham PJ. Predictors of adherence and outcome in internet-based cognitive behavior therapy delivered in a telephone counseling setting. Cogn Ther Res. 2014;38:358–67.CrossRef

45.

Donkin L, Hickie IB, Christensen H, Naismith SL, Neal B, Cockayne NL, et al. Rethinking the dose–response relationship between usage and outcome in an online intervention for depression: randomized controlled trial. J Med Internet Res. 2013;15:e231. doi:10.2196/jmir.2771.CrossRefPubMedPubMedCentral

46.

van den Berg SW, Peters EJ, Kraaijeveld JF, Gielissen MF, Prins JB. Usage of a generic web-based self-management intervention for breast cancer survivors: substudy analysis of the BREATH trial. J Med Internet Res. 2013;15:e170.CrossRefPubMedPubMedCentral

47.

vhYeung W-F, Chung K-F, Ho FY-Y, Ho L-M. Predictors of dropout from internet-based self-help cognitive behavioral therapy for insomnia. Behav Res Ther. 2015;73:19–24. doi:10.1016/j.brat.2015.07.008.

48.

Schneider J, Foroushani PS, Grime P, Thornicroft G. Acceptability of online self-help to people with depression: users’ views of MoodGYM versus informational websites. J Med Internet Res. 2014;16:344–56. doi:10.2196/jmir.2871.CrossRef

49.

Nordgreen T, Havik O, Ost L, Furmark T, Carlbring P, Andersson G. Outcome predictors in guided and unguided self-help for social anxiety disorder. Behav Res Ther. 2012;50:13–21.CrossRefPubMed

50.

Titov N, Dear BF, Johnston L, Lorian C, Zou J, Wootton B, et al. Improving adherence and clinical outcomes in self-guided internet treatment for anxiety and depression: randomised controlled trial. PLoS ONE. 2013;8:e62873 [Electronic resource].CrossRefPubMedPubMedCentral

51.

Fernandez-Aranda F, Nunez A, Martinez C, Krug I, Cappozzo M, Carrard I, et al. Internet-based cognitive-behavioral therapy for bulimia nervosa: a controlled study. Cyberpsychol Behav. 2009;12:37–41. doi:10.1089/cpb.2008.0123.CrossRefPubMed

52.

Wagner G, Penelo E, Nobis G, Mayrhofer A, Wanner C, Schau J, et al. Predictors for good therapeutic outcome and drop-out in technology assisted guided self-help in the treatment of bulimia nervosa and bulimia like phenotype. Eur Eat Disord Rev. 2015;23:163–9. doi:10.1002/erv.2336. 7p.CrossRefPubMed

53.

Lancee J, van den Bout J, Sorbi MJ, van Straten A. Motivational support provided via email improves the effectiveness of internet-delivered self-help treatment for insomnia: a randomized trial. Behav Res Ther. 2013;51:797–805.CrossRefPubMed

54.

Ho FY-Y, Chung K-F, Yeung W-F, Ng TH-Y, Cheng SK-W. Weekly brief phone support in self-help cognitive behavioral therapy for insomnia disorder: relevance to adherence and efficacy. Behav Res Ther. 2014;63:147–56. doi:10.1016/j.brat.2014.10.002.CrossRefPubMed

55.

Wangberg SC, Bergmo TS, Johnsen J-AK. Adherence in Internet-based interventions. Patient Preference Adherence. 2008;2:57–65.PubMedPubMedCentral

56.

Brouwer W, Oenema A, Raat H, Crutzen R, de Nooijer J, de Vries NK, et al. Characteristics of visitors and revisitors to an Internet-delivered computer-tailored lifestyle intervention implemented for use by the general public. Health Educ Res. 2010;25:585–95. doi:10.1093/her/cyp063.CrossRefPubMed

57.

Berrigan D, Dodd K, Troiano RP, Krebs-Smith SM, Barbash RB. Patterns of health behavior in U.S. adults. Prev Med. 2003;36:615–23. doi:10.1016/S0091-7435(02)00067-1.CrossRefPubMed

58.

Strauss JL, Guerra VS, Marx CE, Eggleston AM, Calhoun PS. Adherence and psychotherapy. Improving Patient Treatment Adherence. 2010;215–40.

59.

Krueger KP, Berger BA, Felkey B. Medication adherence and persistence: a comprehensive review. Adv Ther. 2005;22:313–56.CrossRefPubMed

60.

Carver CS, Dunham RG. Abstinence expectancy and abstinence among men undergoing inpatient treatment for alcoholism. J Subst Abus. 1991;3:39–57.CrossRef

61.

Simpson DD, Joe GW. Motivation as a predictor of early dropout from drug abuse treatment. Psychother Theory Res Pract Train. 1993;30:357.CrossRef

62.

Murray K, Pombo-Carril MG, Bara-Carril N, Grover M, Reid Y, Langham C, et al. Factors determining uptake of a CD-ROM-based CBT self-help treatment for bulimia: patient characteristics and subjective appraisals of self-help treatment. Eur Eat Disord Rev. 2003;11:243–60.CrossRef

63.

Johansson R, Andersson G. Internet-based psychological treatments for depression. Expert Rev Neurother. 2012;12:861–70. doi:10.1586/ern.12.63.CrossRefPubMed

64.

Christensen H, Griffiths K, Groves C, Korten A. Free range users and one hit wonders: community users of an Internet-based cognitive behaviour therapy program. Aust N Z J Psychiatry. 2006;40:59–62. doi:10.1111/j.1440-1614.2006.01743.x.CrossRefPubMed

65.

Sandaunet AG. The challenge of fitting in: non‐participation and withdrawal from an online self‐help group for breast cancer patients. Sociol Health Illn. 2008;30:131–44.CrossRefPubMed

66.

Martinez R, Williams C. Matching clients to CBT self-help resources. Oxford Guide to Low Intensity CBT Interventions. 2010;113.

67.

Ritterband L, Thorndike F, Vasquez D, Saylor D. Treatment credibility and satisfaction with Internet interventions. Oxford Guide to Low Intensity CBT Interventions. 2010;235.

68.

Danaher B, Seeley J. Methodological issues in research on web-based behavioral interventions. Ann Behav Med. 2009;38:28–39. doi:10.1007/s12160-009-9129-0.CrossRefPubMed

69.

Andersson G, Bergstrom J, Hollandare F, Carlbring P, Kaldo V, Ekselius L. Internet-based self-help for depression: randomised controlled trial. Br J Psychiatry. 2005;187:456–61.CrossRefPubMed

70.

Warmerdam L, van Straten A, Twisk J, Riper H, Cuijpers P. Internet-based treatment for adults with depressive symptoms: randomized controlled trial. J Med Internet Res. 2008;10:e44.CrossRefPubMedPubMedCentral

71.

Waller R, Gilbody S. Barriers to the uptake of computerized cognitive behavioural therapy: a systematic review of the quantitative and qualitative evidence. Psychol Med. 2009;39:705.CrossRefPubMed

Title: A Systematic Review of Predictors of, and Reasons for, Adherence to Online Psychological Interventions
Authors: Lisa Beatty
Claire Binnion
Publication date: 01-12-2016
Publisher: Springer US
Published in: International Journal of Behavioral Medicine / Issue 6/2016
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI: https://doi.org/10.1007/s12529-016-9556-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A Systematic Review of Predictors of, and Reasons for, Adherence to Online Psychological Interventions

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2016

Negative Stress Beliefs Predict Somatic Symptoms in Students Under Academic Stress

The Individual, Joint, and Additive Interaction Associations of Aerobic-Based Physical Activity and Muscle Strengthening Activities on Metabolic Syndrome

Quality of Life in Portuguese Patients with Diabetic Foot Ulcer Before and After an Amputation Surgery

The Prevalence, Attitudes, and Correlates of Waterpipe Smoking Among High School Students in Iran: a Cross-Sectional Study

Pre-Existing Diabetes in Early Stage Breast Cancer Patients is Associated with Lack of Improvement in Quality of Life 2 Years After Diagnosis

Stress Underestimation and Mental Health Outcomes in Male Japanese Workers: a 1-Year Prospective Study