JMIR Mental Health

Internet interventions, technologies and digital innovations for mental health and behaviour change

Online and Smartphone based Cognitive Behavioral Therapy for Bariatric Surgery Patients: Initial Pilot Study

Abstract Background: The respective rates of obesity in Canada and the United states are estimated to be 24.1% and 34.1%. Due to the increased incidence of obesity, Bariatric surgery has been recognized as one of the treatment options. Despite the success of Bariatric surgery, studies have proposed that it has neglected the contributions of other factors, such as psychological factors in the causation as well as the maintenance of obesity amongst individuals. Cognitive behavioral therapy (CBT) is largely a psychosocial intervention that has been shown to be efficacious, as studies have demonstrated that even brief CBT interventions could help in the reduction of binge eating and maintenance of weight loss. Previously identified problems with regards to the integration and the provision of such interventions include that of geographical barriers. In order to overcome the geographical barriers, telephone-based CBT has been conceptualized. Over the past decade, there has been massive advancement and development in Internet, Web-based and smartphone technologies, but there is still a paucity of applications in this area. Objective: Our current research objective is to determine if bariatric surgery patients will be receptive towards an online and smartphone based CBT intervention. Methodology: The Bariatric Surgery Online CBT portal and Smartphone companion application was developed between July 2013 and December 2013. A low-cost methodology of developing the online portal was adopted. In terms of development, 4 core development phases were adopted. These included that of: a) Formulation of users’ requirements, b) System design and development, c) System evaluation and d) System deployment and pilot application. The bariatric surgery workgroup from the Toronto Western Hospital helped with the recruitment of the subjects from the outpatient specialist service. Links to the web-portal was provided to each of the participants recruited. Results: Since the inception of the online portal to date, in terms of usage rates, there have been a total of 2408 visitors to the online portal. The majority of the visitors are from Canada (n=1879). From the analytics, a total of 8 users have participated in the pre-assessment questionnaire and have attempted and tried to use the individual modules. Since the inception of the pilot study from January 2014 till October 2014, 4 individuals have completed at least 3 modules available on the online portal. Conclusions: This is one of the first few studies that have demonstrated the potential feasibility of having an online and smartphone cognitive behavioral portal to serve the psychological needs of bariatric surgery patients.

2014-10-17

As in previous years, JMIR will produce a theme issue (e-collections) of the best papers presented at the ISRII meeting in Valencia. For previous examples see for example http://www.jmir.org/themes/41 (ISRII Theme Issue 2012) http://www.jmir.org/themes/130 (ISRII Theme Issue 2013) JMIR Mental Health (http://mental.jmir.org/) is the best venue for most of the papers presented at ISRII and currently offers publication free of charge. JMIR Mental Health is tailored to the needs of the ISRII community. Another new journal which publishes articles free of charge is JMIR Human Factors (http://humanfactors.jmir.org/) which may be suitable for usability evaluations. JMIR Research Protocols (http://researchprotocols.org) publishes proposals, protocols, and formative/pilot evaluations, and JMIR mHealth (http://mhealth.jmir.org/) and JMIR Serious Games (http://games.jmir.org/) (the latter also has no submission or article processing fees) are further options for papers in these respective areas. Regardless of which journal you choose, it will show up in the ISRII Theme Issue 2014 (as it is an e-collection of papers from various JMIR journals) if you select "JMIR ISRII Theme Issue 2014" on submission. The submission site is at http://mental.jmir.org/author or the respective submission site from other JMIR journals (when in doubt which journal is best suited, submit to JMIR at http://www.jmir.org/author.

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Journal Description

JMIR Mental Health (JMH) is a new spin-off journal of JMIR, the leading eHealth journal (Impact Factor 2013: 4.7). 

JMIR Mental Health focusses on Internet interventions, technologies and digital innovations for mental health, addictions, online counselling and behaviour change. This includes formative evaluation and system descriptions, theoretical papers, review papers, viewpoint/vision papers, and rigorous evaluations.

JMIR Mental Health publishes even faster and has a broader scope with including papers which are more technical or more formative/developmental than what would be published in the Journal of Medical Internet Research

JMIR Mental Health features a rapid and thorough peer-review process, professional copyediting, professional production of PDF, XHTML, and XML proofs (ready for deposit in PubMed Central/PubMed), and an ipad App (in prep.).

JMIR Mental Health adheres to the same quality standards as JMIR and all articles published here are also cross-listed in the Table of Contents of JMIR, the worlds' leading medical journal in health sciences / health services research and health informatics.

Submit your paper before Nov 1st, 2014 to be a founding author of this new journal. There are currently NO SUBMISSION OR PUBLICATION FEES, and we aim to publish within 4 weeks.

Editorial Board members are currently being recruited, please contact us if you are interested (jmir.editorial.office at gmail.com).

 

Recent Articles:

  • A Web-Based Intervention for Users of Amphetamine-Type Stimulants: 3-Month Outcomes of a Randomized Controlled Trial

    Abstract:

    Background: Among illicit drugs, the prevalence of amphetamine-type stimulant (ATS) use is second only to cannabis. Currently, there are no approved pharmacotherapies for ATS problems, but some face-to-face psychotherapies are effective. Web-based interventions have proven to be effective for some substance use problems, but none has specifically targeted ATS users. Objective: The objective of the study was to evaluate the effectiveness of a Web-based intervention for ATS problems on a free-to-access site compared with a waitlist control group. Methods: We used a randomized controlled trial design. The primary outcome measure was self-reported ATS use in the past three months assessed using the Alcohol, Smoking, Substance Involvement Screening Test (ASSIST). Other measures included quality of life (EUROHIS score), psychological distress (K-10 score), days out of role, poly-drug use, general help-seeking intentions, actual help-seeking, and “readiness to change”. The intervention consisted of three fully automated, self-guided modules based on cognitive behavioral therapy and motivation enhancement. The analysis was an intention-to-treat analysis using generalized estimating equation models, with a group by time interaction as the critical assessment. Results: We randomized 160 people (intervention n=81, control n=79). At three months, 35/81 (43%) intervention and 45/79 (57%) control participants provided follow-up data. In the intervention group, 51/81 (63%) completed at least one module. The only significant group by time interaction was for days out of role. The pre/post change effect sizes showed small changes (range d=0.14 to 0.40) favoring the intervention group for poly-drug use, distress, actual help-seeking, and days out of role. In contrast, the control group was favored by reductions in ATS use, improvements in quality of life, and increases in help-seeking intentions (range d=0.09 to 0.16). Conclusions: This Web-based intervention for ATS use produced few significant changes in outcome measures. There were moderate, but nonsignificant reductions in poly-drug use, distress, days partially out of role, and increases in help-seeking. However, high levels of participant attrition, plus low levels of engagement with the modules, preclude firm conclusions being drawn on the efficacy of the intervention and emphasize the problems of engaging this group of clients in a fully automated program. Trial Registration: Australian and New Zealand Clinical Trials Registry: ACTRN 12611000947909; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000947909 (Archived by WebCite at http://www.webcitation.org/6SHTxEnzP).

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Latest Submissions Open for Peer-Review:

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  • Online and Smartphone based Cognitive Behavioral Therapy for Bariatric Surgery Patients: Initial Pilot Study

    Date Submitted: Oct 7, 2014

    Open Peer Review Period: Oct 9, 2014 - Dec 4, 2014

    Abstract Background: The respective rates of obesity in Canada and the United states are estimated to be 24.1% and 34.1%. Due to the increased incidence of obesity, Bariatric surgery has been recogn...

    Abstract Background: The respective rates of obesity in Canada and the United states are estimated to be 24.1% and 34.1%. Due to the increased incidence of obesity, Bariatric surgery has been recognized as one of the treatment options. Despite the success of Bariatric surgery, studies have proposed that it has neglected the contributions of other factors, such as psychological factors in the causation as well as the maintenance of obesity amongst individuals. Cognitive behavioral therapy (CBT) is largely a psychosocial intervention that has been shown to be efficacious, as studies have demonstrated that even brief CBT interventions could help in the reduction of binge eating and maintenance of weight loss. Previously identified problems with regards to the integration and the provision of such interventions include that of geographical barriers. In order to overcome the geographical barriers, telephone-based CBT has been conceptualized. Over the past decade, there has been massive advancement and development in Internet, Web-based and smartphone technologies, but there is still a paucity of applications in this area. Objective: Our current research objective is to determine if bariatric surgery patients will be receptive towards an online and smartphone based CBT intervention. Methodology: The Bariatric Surgery Online CBT portal and Smartphone companion application was developed between July 2013 and December 2013. A low-cost methodology of developing the online portal was adopted. In terms of development, 4 core development phases were adopted. These included that of: a) Formulation of users’ requirements, b) System design and development, c) System evaluation and d) System deployment and pilot application. The bariatric surgery workgroup from the Toronto Western Hospital helped with the recruitment of the subjects from the outpatient specialist service. Links to the web-portal was provided to each of the participants recruited. Results: Since the inception of the online portal to date, in terms of usage rates, there have been a total of 2408 visitors to the online portal. The majority of the visitors are from Canada (n=1879). From the analytics, a total of 8 users have participated in the pre-assessment questionnaire and have attempted and tried to use the individual modules. Since the inception of the pilot study from January 2014 till October 2014, 4 individuals have completed at least 3 modules available on the online portal. Conclusions: This is one of the first few studies that have demonstrated the potential feasibility of having an online and smartphone cognitive behavioral portal to serve the psychological needs of bariatric surgery patients.

  • Promoting Mental Health Awareness amongst GPs

    Date Submitted: Oct 7, 2014

    Open Peer Review Period: Oct 9, 2014 - Dec 4, 2014

    Background: With the development in smartphone technology, there have been an increased number of mobile phone applications designed for delivering medical and mental health care and prevention. A...

    Background: With the development in smartphone technology, there have been an increased number of mobile phone applications designed for delivering medical and mental health care and prevention. Aims This paper aims to illustrate the feasibility of using information technology for mental health care through the illustration of the development process of a prototype of the new Mental Health Wellness (MHWell) application, developed mainly for primary healthcare providers. A feasibility study, a formative evaluation and a qualitative survey will be conducted. Methods The MHWell smartphone prototypical application was developed using an online application builder using HTML5 as the core programming language to build the model. A five-phase developmental method including a) formulation of user requirements, b) system design, c) system development, d) system evaluation and finally e) system application and implementation was adopted. Illustration of the use of the MHWell App and its features will be displayed. An expert panel determined the relevance of the content. A pilot prototype was launched as part of the formative evaluation, followed by a qualitative evaluation to evaluate applicability of the prototype. Results The initial pilot yielded a total of 136 downloads. Qualitative evaluation highlighted the core components as well as the limitations of the application. The barriers encountered by the authors during the development process were also discussed with feasible solutions. Conclusions This article has proposed a new paradigm for using mobile technology in mental health care. More exploration of the use of hand-held devices for primary health care is warranted.