JMIR Mental Health
Internet interventions, technologies and digital innovations for mental health and behaviour change
JMIR Mental Health focusses on digital health and Internet interventions, technologies and electronic innovations (software and hardware) 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. The journal is indexed in PubMed, PubMed Central, and ESCI (Emerging Sources Citation Index).
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.
Editorial Board members are currently being recruited, please contact us if you are interested (jmir.editorial.office at gmail.com).
Aug 10, 2017
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Latest Submissions Open for Peer-Review:View All Open Peer Review Articles
Facebook and Subjective Well-Being: A Systematic Review
Date Submitted: Aug 9, 2017
Open Peer Review Period: Aug 10, 2017 - Oct 5, 2017
Objective: This systematic review evaluates various theoretical underpinnings, which may contribute to a better understanding of the effects of Facebook use on subjective well-being among college stud...
Objective: This systematic review evaluates various theoretical underpinnings, which may contribute to a better understanding of the effects of Facebook use on subjective well-being among college students. Methods: The author conducted a PubMed search of experimental studies conducted within a young adult population. Eligible participant data was delimited to undergraduate or graduate students, who were required to be current Facebook users. Results: Six studies were chosen for the review. The findings suggest that Facebook usage may be positively associated with subjective well-being via several theoretical mechanisms founded in social psychology. Conclusions: These findings provide preliminary evidence that Facebook may offer its users unique opportunities to tailor their online self-presentation to assuage the impact of negative psychosocial stimuli presented in real-world environments. Innovative strategies should be conceived to assess the possible relationship between Facebook use and enhanced subjective well-being.
Development of a technology assisted behavioral intervention for extending sleep duration among individuals with short sleep duration
Date Submitted: Aug 2, 2017
Open Peer Review Period: Aug 3, 2017 - Sep 28, 2017
Background: Despite high prevalence of short sleep duration (29.2% of adults sleep <6 hours on weekdays) there are no existing theory based behavioral interventions to extend sleep duration. The popul...
Background: Despite high prevalence of short sleep duration (29.2% of adults sleep <6 hours on weekdays) there are no existing theory based behavioral interventions to extend sleep duration. The popularity of wearable sleep trackers provides an opportunity to engage users in interventions. Objective: This paper outlines the theoretical foundation and iterative process of designing the “Sleep Bunny”, a technology-assisted sleep extension intervention including a smartphone application, wearable sleep tracker and brief telephone coaching. We conducted a two-step process in the development of this intervention. 1. User testing of the application and 2. A small field trial of participants with short sleep duration and a cardiovascular disease risk factor linked to short sleep duration (BMI>25). Methods: All participants had habitual sleep duration <6.5 verified by 7 days of actigraphy. Six individuals completed initial user testing in the development phase and two participants with sleep duration <6.5 hours and BMI >25 completed field testing. Participants in the user testing and field testing responded to open ended surveys about the design and utility of the application. Participants in the field testing completed the Epworth Sleepiness Scale and also wore and actigraph for a 1 week baseline period and during the 4 week intervention. Results: The feedback suggests users enjoyed the wearable sleep tracker and found the application visually pleasing but suggested improvements to the notifications and reminders. The two participants who completed the field test demonstrated significant improvements in sleep duration and daytime sleepiness. Conclusions: Further testing is needed to determine effects of this intervention in populations at risk for the mental and physical consequences of sleep loss.
A randomized controlled trial and process evaluation of a web-based therapy plus telephone support by a coach, compared with information about web-based resources, in depressed patients referred to secondary mental health care
Date Submitted: Jul 19, 2017
Open Peer Review Period: Jul 20, 2017 - Sep 14, 2017
Background: The evidence for the effectiveness of web-based therapies comes mainly from non-clinical populations with a few studies in primary care. There is little evidence from patients referred to...
Background: The evidence for the effectiveness of web-based therapies comes mainly from non-clinical populations with a few studies in primary care. There is little evidence from patients referred to secondary mental health care with depression. A problem with web-based therapies is that a high proportion of people fail to complete the courses. One way to address this is to create a new health service role – an e-coach – to guide people through the therapy which has been shown to increase adherence. Objective: The objective was to test in people referred to secondary care with depression if a web-based therapy (The Journal www.depression.org.nz) supported by an e-coach plus usual care would be more effective in reducing depression compared with usual care plus an information leaflet about on-line resources after twelve weeks. Methods: We conducted a randomized controlled trial with two parallel arms and a process evaluation. The e-coach had a background in occupational therapy. Participants were recruited face to face. Results: We recruited 63 people into the trial (intervention 35 control 28). There were no statistically significant differences in the change in PHQ-9 scores at 12 weeks comparing The Journal with usual care (mean change in PHQ-9 score 9.4 in the intervention group and 7.1 in the control group t-test 1.05 p=0.3; mean difference 2.3, 95% confidence interval -2.1 to 6.7). People who were offered The Journal attended on average about one less out-patient appointment compared with usual care although this difference was not statistically significant (intervention mean number of visits 2.8 (SD 5.5) compared with 4.1 (SD 6.7) in the control group t=- 0.80 p=0.43; mean difference 1.3 95% confidence interval -4.5 to 2.0). The process evaluation found that the mean number of lessons completed in the intervention group was 2.5 SD 1.9 (with a range of 0 to 6) and the number of contacts with the e-coach was a mean of 8.1 SD 4.4 (range 0 to 17). The qualitative interviews highlighted the problem of engaging clinicians in the research and their resistance to recruitment; technical difficulties with The Journal which prevented people logging in easily; difficulty accessing The Journal as it was not available at the time on smartphones or tablets; participants finding lesson three difficult; and participants saying they were too busy to complete the sessions. Conclusions: The study demonstrated that is feasible to use an e-coach in this setting, that people found it helpful and that it did not conflict with other care that participants were receiving. In the future trials need to engage clinicians at an early stage to articulate where web-based therapies fit into existing clinical pathways; web-based therapies should be available on mobile devices; and logging in should be easy. The role of the e-coach should be explored in larger trials. Clinical Trial: Australian and New Zealand Clinical Trials Registry ACTRN: ACTRN12613000015741
Partners in Parenting: A multi-level web-based approach to support parents in prevention and early intervention for adolescent depression and anxiety
Date Submitted: Jul 17, 2017
Open Peer Review Period: Jul 18, 2017 - Sep 12, 2017
Depression and anxiety disorders in young people are a global health concern. Various risk and protective factors for these disorders are potentially modifiable by parents, underscoring the important...
Depression and anxiety disorders in young people are a global health concern. Various risk and protective factors for these disorders are potentially modifiable by parents, underscoring the important role parents play in reducing the risk and impact of these disorders in their adolescent children. However, cost-effective, evidence-based interventions for parents that can be widely disseminated are lacking. In this paper, we propose a multi-level public health approach involving a web-based parenting intervention, Partners in Parenting. We describe the components of the web-based intervention and how each component was developed. Development of the intervention was guided by principles of the Persuasive Systems Design model, to maximize parental engagement and adherence in the program. A co-design approach was used through consultations with parents and adolescents about the content and presentation of the intervention. The Partners in Parenting intervention can be used at varying levels of intensity to tailor to the different needs of parents across the population. Challenges and opportunities for the use of the intervention are discussed. The Partners in Parenting web-based intervention was developed to address the dearth of evidence-based resources to support parents in their important role in their adolescents’ mental health. The proposed public health approach utilizes this intervention at varying levels of intensity based on parents’ needs. Evaluation of each separate level of the model is ongoing. Further evaluation of the whole approach is required to assess the utility of the intervention as a public health approach, as well as its broader effects on adolescent functioning and socioeconomic outcomes.
‘Wish you were here’: Examining assumptions about missing cases from psychotherapeutic trials
Date Submitted: Jul 6, 2017
Open Peer Review Period: Jul 12, 2017 - Sep 6, 2017
Background: Missing cases are common in clinical psychotherapeutic trials, and pose a challenge to the accuracy of measuring clinical outcomes . However, little is known about the characteristics o...
Background: Missing cases are common in clinical psychotherapeutic trials, and pose a challenge to the accuracy of measuring clinical outcomes . However, little is known about the characteristics of psychotherapy participants with missing values, their likely clinical outcomes, or suitability of different statistical assumptions that can characterise missing cases. Objective: Using a large sample, undergoing psychotherapy for depressive symptoms (n=820), this study aimed to explore the characteristics of missing cases (n=138), their likely treatment outcomes, and compare between statistical methods for replacing missing values. Methods: Initially, common participant and treatment features were tested through binary logistic regression, identifying variables that predict missing cases. Secondly, the same variables were screened for their ability to increase, or impede the rate of symptom remission. Third, using recontacted cases at three-month follow-up, to proximally measure treatment outcomes, simulated replacement scores and observed clinical outcomes were compared. Results: Missing cases were dominantly predicted by lower treatment adherence and increased symptoms at pre-treatment, and report symptom that are 30% higher than average at follow-up. Longitudinal statistical methods (GEE or MIXED models) that adjusted their estimates for missing values by treatment adherence rates and baseline symptoms severity (under the MAR assumption), predicted follow-up missing cases outcomes minimal measurement bias (<8%). Conclusions: Missing cases demonstrated characteristics, which can jointly be associated with likelihood of becoming missing and lesser clinical improvement. Under such circumstances, treatment effects can become concealed. Statistical methods that ignore these characteristics can overlook an important clinical phenomenon and generate inaccurate treatment outcome replacement estimates (-32% to 70% off the mark).
French validation of the Work Addiction Risk Test questionnaire
Date Submitted: Jun 30, 2017
Open Peer Review Period: Jul 10, 2017 - Sep 4, 2017
Background: Work addiction is a significant public health problem with a growing prevalence. The Work Addiction Risk Test (WART) is the gold standard questionnaire to detect “Workaholism”. Objecti...
Background: Work addiction is a significant public health problem with a growing prevalence. The Work Addiction Risk Test (WART) is the gold standard questionnaire to detect “Workaholism”. Objective: The main objective was to validate the French version of the WART. Methods: Questionnaires were proposed to voluntary French workers using the Wittyfit software. There were no exclusions criteria. The questionnaire was administered anonymously for initial validity testing and readministered one week later for test-retest reliability. We also assessed the workers’ socio-demographic characteristics, as well as other measurements, for external validity such as stress, well-being, and co-addictions for tobacco, alcohol and cannabis. Several psychometric properties of the French-WART were explored: acceptability, reliability (internal consistency – Cronbach’s alpha coefficient, and reproducibility – Lin concordance coefficient), construct validity (correlation coefficients and principal component analysis) and external validity (correlation coefficients). Results: Among the 1580 workers using WittyFit, 187 (11.8%) agreed to complete the WART questionnaire. Of those, 128 completed the test-retest survey (68.5%). Acceptability found that all respondents had fully completed the questionnaire, with few floor or ceiling effects. Reliability was very good with a Cronbach’s alpha coefficient at 0.90 (internal consistency) and Lin concordance coefficient at 0.903 (95% CI 0.871–0.935) with a difference on the retest of 0.039±4.92 (95% CI -9.61–9.69) (reproducibility). We identified three main dimensions (construct validity). Relationships between the WART and stress and well-being confirmed its external validity. Conclusions: The French version of the WART is a valid and reliable instrument to assess work addiction, with satisfactory psychometric properties. Used in occupational medicine, this tool would allow the diagnosis of work addiction, and may be easily implemented in current practice. Clinical Trial: Clinicaltrials.gov: NCT02596737; https://www.clinicaltrials.gov/ct2/show/NCT02596737.