@Article{info:doi/10.2196/67156,
author="Yang, Deliang
and Tang, Yiyi
and Chan, Yi Vivien Kin
and Fang, Qiwen
and Chan, Man Sandra Sau
and Luo, Hao
and Wong, Kei Ian Chi
and Ou, Huang-Tz
and Chan, Yin Esther Wai
and Bishai, Makram David
and Chen, Yingyao
and Knapp, Martin
and Jit, Mark
and Craig, Dawn
and Li, Xue",
title="Population-Wide Depression Incidence Forecasting Comparing Autoregressive Integrated Moving Average and Vector Autoregressive Integrated Moving Average to Temporal Fusion Transformers: Longitudinal Observational Study",
journal="J Med Internet Res",
year="2025",
month="May",
day="12",
volume="27",
pages="e67156",
keywords="population-wide depression incidence",
keywords="depression incidence forecasting",
keywords="structural break scenarios",
keywords="electronic health records",
keywords="machine learning",
keywords="medical informatics",
keywords="ARIMA",
keywords="vector-ARIMA",
keywords="temporal fusion transformers",
keywords="deep learning",
abstract="Background: Accurate prediction of population-wide depression incidence is vital for effective public mental health management. However, this incidence is often influenced by socioeconomic factors, such as abrupt events or changes, including pandemics, economic crises, and social unrest, creating complex structural break scenarios in the time-series data. These structural breaks can affect the performance of forecasting methods in various ways. Therefore, understanding and comparing different models across these scenarios is essential. Objective: This study aimed to develop depression incidence forecasting models and compare the performance of autoregressive integrated moving average (ARIMA) and vector-ARIMA (VARIMA) and temporal fusion transformers (TFT) under different structural break scenarios. Methods: We developed population-wide depression incidence forecasting models and compared the performance of ARIMA and VARIMA-based methods to TFT-based methods. Using monthly depression incidence from 2002 to 2022 in Hong Kong, we applied sliding windows to segment the whole time series into 72 ten-year subsamples. The forecasting models were trained, validated, and tested on each subsample. Within each 10-year subset, the first 7 years were used for training, with the eighth year for setting hold-out validation, and the ninth and tenth years for testing. The accuracy of the testing set within each 10-year subsample was measured by symmetric mean absolute percentage error (SMAPE). Results: We found that in subsamples without significant slope or trend change (structural break), multivariate TFT significantly outperformed univariate TFT, vector-ARIMA (VARIMA), and ARIMA, with an average SMAPE of 11.6\% compared to 13.2\% (P=.01) for univariate TFT, 16.4\% (P=.002) for VARIMA, and 14.8\% (P=.003) for ARIMA. Adjusting for the unemployment rate improved TFT performance more effectively than VARIMA. When fluctuating outbreaks happened, TFT was more robust to sharp interruptions, whereas VARIMA and ARIMA performed better when incidence surged and remained high. Conclusions: This study provides a comparative evaluation of TFT and ARIMA and VARIMA models for forecasting depression incidence under various structural break scenarios, offering insights into predicting disease burden during both stable and unstable periods. The findings support a decision-making framework for model selection based on the nature of disruptions and data characteristics. For public health policymaking, the results suggest that TFT may be a more suitable tool for disease burden forecasting during periods of stable burden level or when sudden temporary interruption, such as pandemics or socioeconomic variation, impacts disease occurrence. ",
doi="10.2196/67156",
url="https://www.jmir.org/2025/1/e67156",
url="http://www.ncbi.nlm.nih.gov/pubmed/40354111"
}


@Article{info:doi/10.2196/66696,
author="Chen, Sihui
and Ngai, Bik Cindy Sing
and Cheng, Cecilia
and Hu, Yangna",
title="Analyzing Themes, Sentiments, and Coping Strategies Regarding Online News Coverage of Depression in Hong Kong: Mixed Methods Study",
journal="J Med Internet Res",
year="2025",
month="Feb",
day="13",
volume="27",
pages="e66696",
keywords="online news coverage",
keywords="depression",
keywords="natural language processing",
keywords="NLP",
keywords="latent Dirichlet allocation",
keywords="LDA",
keywords="sentiment",
keywords="coping strategies",
keywords="content analysis",
abstract="Background: Depression, a highly prevalent global mental disorder, has prompted significant research concerning its association with social media use and its impact during Hong Kong's social unrest and COVID-19 pandemic. However, other mainstream media, specifically online news, has been largely overlooked. Despite extensive research conducted in countries, such as the United States, Australia, and Canada, to investigate the latent subthemes, sentiments, and coping strategies portrayed in depression-related news, the landscape in Hong Kong remains unexplored. Objective: This study aims to uncover the latent subthemes presented in the online news coverage of depression in Hong Kong, examine the sentiment conveyed in the news, and assess whether coping strategies have been provided in the news for individuals experiencing depression. Methods: This study used natural language processing (NLP) techniques, namely the latent Dirichlet allocation topic modeling and the Valence Aware Dictionary and Sentiment Reasoner (VADER) sentiment analysis, to fulfill the first and second objectives. Coping strategies were rigorously assessed and manually labeled with designated categories by content analysis. The online news was collected from February 2019 to May 2024 from Hong Kong mainstream news websites to examine the latest portrayal of depression, particularly during and after the social unrest and the COVID-19 pandemic. Results: In total, 2435 news articles were retained for data analysis after the news screening process. A total of 7 subthemes were identified based on the topic modeling results. Societal system, law enforcement, global recession, lifestyle, leisure, health issues, and US politics were the latent subthemes. Moreover, the overall news exhibited a slightly positive sentiment. The correlations between the sentiment scores and the latent subthemes indicated that the societal system, law enforcement, health issues, and US politics revealed negative tendencies, while the remainder leaned toward a positive sentiment. The coping strategies for depression were substantially lacking; however, the categories emphasizing information on skills and resources and individual adjustment to cope with depression emerged as the priority focus. Conclusions: This pioneering study used a mixed methods approach where NLP was used to investigate latent subthemes and underlying sentiment in online news. Content analysis was also performed to examine available coping strategies. The findings of this research enhance our understanding of how depression is portrayed through online news in Hong Kong and the preferable coping strategies being used to mitigate depression. The potential impact on readers was discussed. Future research is encouraged to address the mentioned implications and limitations, with recommendations to apply advanced NLP techniques to a new mental health issue case or language. ",
doi="10.2196/66696",
url="https://www.jmir.org/2025/1/e66696",
url="http://www.ncbi.nlm.nih.gov/pubmed/39946170"
}


@Article{info:doi/10.2196/53454,
author="Pike, E. Caitlin
and Dohnt, C. Henriette
and Tully, J. Phillip
and Bartik, Warren
and Welton-Mitchell, Courtney
and Murray, V. Clara
and Rice, Kylie
and Cosh, M. Suzanne
and Lykins, D. Amy",
title="A Community Mental Health Integrated Disaster Preparedness Intervention for Bushfire Recovery in Rural Australian Communities: Protocol for a Multimethods Feasibility and Acceptability Pilot Study",
journal="JMIR Res Protoc",
year="2024",
month="Jun",
day="4",
volume="13",
pages="e53454",
keywords="bushfires",
keywords="wildfires",
keywords="rural mental health",
keywords="natural disasters",
keywords="mental health",
keywords="disaster preparedness",
keywords="natural hazards resilience",
keywords="community interventions",
keywords="mixed-methods",
keywords="pilot study",
keywords="disaster",
keywords="preparedness",
keywords="preparation",
keywords="natural hazard",
keywords="psychological distress",
keywords="resilience",
keywords="help-seeking",
abstract="Background: Natural hazards are increasing in frequency and intensity due to climate change. Many of these natural disasters cannot be prevented; what may be reduced is the extent of the risk and negative impact on people and property. Research indicates that the 2019-2020 bushfires in Australia (also known as the ``Black Summer Bushfires'') resulted in significant psychological distress among Australians both directly and indirectly exposed to the fires. Previous intervention research suggests that communities impacted by natural hazards (eg, earthquakes, hurricanes, and floods) can benefit from interventions that integrate mental health and social support components within disaster preparedness frameworks. Research suggests that disaster-affected communities often prefer the support of community leaders, local services, and preexisting relationships over external supports, highlighting that community-based interventions, where knowledge stays within the local community, are highly beneficial. The Community-Based Disaster Mental Health Intervention (CBDMHI) is an evidence-based approach that aims to increase disaster preparedness, resilience, social cohesion, and social support (disaster-related help-seeking), and decrease mental health symptoms, such as depression and anxiety. Objective: This research aims to gain insight into rural Australian's recovery needs post natural hazards, and to enhance community resilience in advance of future fires. Specifically, this research aims to adapt the CBDMHI for the rural Australian context and for bushfires and second, to assess the acceptability and feasibility of the adapted CBDMHI in a rural Australian community. Methods: Phase 1 consists of qualitative interviews (individual or dyads) with members of the target bushfire-affected rural community. Analysis of these data will include identifying themes related to disaster preparedness, social cohesion, and mental health, which will inform the adaptation. An initial consultation phase is a key component of the adaptation process and, therefore, phase 2 will involve additional discussion with key stakeholders and members of the community to further guide adaptation of the CBDMHI to specific community needs, building on phase 1 inputs. Phase 3 includes identifying and training local community leaders in the adapted intervention. Following this, leaders will co-deliver the intervention. The acceptability and feasibility of the adapted CBDMHI within the community will be evaluated by questionnaires and semistructured interviews. Effectiveness will be evaluated by quantifying psychological distress, resilience, community cohesion, psychological preparedness, and help-seeking intentions. Results: This study has received institutional review board approval and commenced phase 1 recruitment in October 2022. Conclusions: The study will identify if the adapted CBDMHI is viable and acceptable within a village in the Northern Tablelands of New South Wales, Australia. These findings will inform future scale-up in the broader rural Australian context. If this intervention is well received, the CBDMHI may be valuable for future disaster recovery and preparedness efforts in rural Australia. These findings may inform future scale-up in the broader rural Australian context. International Registered Report Identifier (IRRID): DERR1-10.2196/53454 ",
doi="10.2196/53454",
url="https://www.researchprotocols.org/2024/1/e53454",
url="http://www.ncbi.nlm.nih.gov/pubmed/38833279"
}


@Article{info:doi/10.2196/50283,
author="Onie, Sandersan
and Armstrong, Oliver Susanne
and Josifovski, Natasha
and Berlinquette, Patrick
and Livingstone, Nicola
and Holland, Sarah
and Finemore, Coco
and Gale, Nyree
and Elder, Emma
and Laggis, George
and Heffernan, Cassandra
and Theobald, Adam
and Torok, Michelle
and Shand, Fiona
and Larsen, Mark",
title="The Effect of Explicit Suicide Language in Engagement With a Suicide Prevention Search Page Help-Seeking Prompt: Nonrandomized Trial",
journal="JMIR Ment Health",
year="2024",
month="Mar",
day="19",
volume="11",
pages="e50283",
keywords="suicide",
keywords="suicide prevention",
keywords="Google",
keywords="Google Ads",
keywords="internet search",
keywords="explicit wording",
keywords="mental health",
keywords="suicidal",
keywords="advertisement",
keywords="advertisements",
keywords="messaging",
keywords="prevention signage",
keywords="campaign",
keywords="campaigns",
keywords="distress",
keywords="engagement",
keywords="prompt",
keywords="prompts",
keywords="information seeking",
keywords="help seeking",
keywords="searching",
keywords="search",
abstract="Background: Given that signage, messaging, and advertisements (ads) are the gateway to many interventions in suicide prevention, it is important that we understand what type of messaging works best for whom. Objective: We investigated whether explicitly mentioning suicide increases engagement using internet ads by investigating engagement with campaigns with different categories of keywords searched, which may reflect different cognitive states. Methods: We ran a 2-arm study Australia-wide, with or without ads featuring explicit suicide wording. We analyzed whether there were differences in engagement for campaigns with explicit and nonexplicit ads for low-risk (distressed but not explicitly suicidal), high-risk (explicitly suicidal), and help-seeking for suicide keywords. Results: Our analyses revealed that having explicit wording has opposite effects, depending on the search terms used: explicit wording reduced the engagement rate for individuals searching for low-risk keywords but increased engagement for those using high-risk keywords. Conclusions: The findings suggest that individuals who are aware of their suicidality respond better to campaigns that explicitly use the word ``suicide.'' We found that individuals who search for low-risk keywords also respond to explicit ads, suggesting that some individuals who are experiencing suicidality search for low-risk keywords. ",
doi="10.2196/50283",
url="https://mental.jmir.org/2024/1/e50283",
url="http://www.ncbi.nlm.nih.gov/pubmed/38502162"
}


@Article{info:doi/10.2196/49325,
author="Scotti Requena, Simone
and Pirkis, Jane
and Currier, Dianne
and Conway, Mike
and Lee, Simon
and Turnure, Jackie
and Cummins, Jennifer
and Nicholas, Angela",
title="An Evaluation of the Boys Do Cry Suicide Prevention Media Campaign on Twitter: Mixed Methods Approach",
journal="JMIR Form Res",
year="2023",
month="Sep",
day="7",
volume="7",
pages="e49325",
keywords="help-seeking",
keywords="masculinity",
keywords="media campaign",
keywords="men",
keywords="men's health",
keywords="mental health",
keywords="self-reliance",
keywords="social media",
keywords="suicide prevention",
keywords="suicide",
abstract="Background: In most countries, men are more likely to die by suicide than women. Adherence to dominant masculine norms, such as being self-reliant, is linked to suicide in men in Western cultures. We created a suicide prevention media campaign, ``Boys Do Cry,'' designed to challenge the ``self-reliance'' norm and encourage help-seeking in men. A music video was at the core of the campaign, which was an adapted version of the ``Boys Don't Cry'' song from ``The Cure.'' There is evidence that suicide prevention media campaigns can encourage help-seeking for mental health difficulties. Objective: We aimed to explore the reach, engagement, and themes of discussion prompted by the Boys Do Cry campaign on Twitter. Methods: We used Twitter analytics data to investigate the reach and engagement of the Boys Do Cry campaign, including analyzing the characteristics of tweets posted by the campaign's hosts. Throughout the campaign and immediately after, we also used Twitter data derived from the Twitter Application Programming Interface to analyze the tweeting patterns of users related to the campaign. In addition, we qualitatively analyzed the content of Boys Do Cry--related tweets during the campaign period. Results: During the campaign, Twitter users saw the tweets posted by the hosts of the campaign a total of 140,650 times and engaged with its content a total of 4477 times. The 10 highest-performing tweets by the campaign hosts involved either a video or an image. Among the 10 highest-performing tweets, the first was one that included the campaign's core video; the second was a screenshot of the tweet posted by Robert Smith, the lead singer of The Cure, sharing the Boys Do Cry campaign's video and tagging the campaign's hosts. In addition, the pattern of Twitter activity for the campaign-related tweets was considerably higher during the campaign than in the immediate postcampaign period, with half of the activity occurring during the first week of the campaign when Robert Smith promoted the campaign. Some of the key topics of discussions prompted by the Boys Do Cry campaign on Twitter involved users supporting the campaign; referencing the original song, band, or lead singer; reiterating the campaign's messages; and having emotional responses to the campaign. Conclusions: This study demonstrates that a brief media campaign such as Boys Do Cry can achieve good reach and engagement and can prompt discussions on Twitter about masculinity and suicide. Such discussions may lead to greater awareness about the importance of seeking help and providing support to those with mental health difficulties. However, this study suggests that longer, more intensive campaigns may be needed in order to amplify and sustain these results. ",
doi="10.2196/49325",
url="https://formative.jmir.org/2023/1/e49325",
url="http://www.ncbi.nlm.nih.gov/pubmed/37676723"
}


@Article{info:doi/10.2196/32475,
author="Morant, Nicola
and Chilman, Natasha
and Lloyd-Evans, Brynmor
and Wackett, Jane
and Johnson, Sonia",
title="Acceptability of Using Social Media Content in Mental Health Research: A Reflection. Comment on ``Twitter Users' Views on Mental Health Crisis Resolution Team Care Compared With Stakeholder Interviews and Focus Groups: Qualitative Analysis''",
journal="JMIR Ment Health",
year="2021",
month="Aug",
day="17",
volume="8",
number="8",
pages="e32475",
keywords="Twitter",
keywords="social media",
keywords="qualitative",
keywords="crisis resolution team",
keywords="home treatment team",
keywords="mental health",
keywords="acute care",
keywords="severe mental illness",
doi="10.2196/32475",
url="https://mental.jmir.org/2021/8/e32475",
url="http://www.ncbi.nlm.nih.gov/pubmed/34402799"
}


@Article{info:doi/10.2196/25742,
author="Chilman, Natasha
and Morant, Nicola
and Lloyd-Evans, Brynmor
and Wackett, Jane
and Johnson, Sonia",
title="Twitter Users' Views on Mental Health Crisis Resolution Team Care Compared With Stakeholder Interviews and Focus Groups: Qualitative Analysis",
journal="JMIR Ment Health",
year="2021",
month="Jun",
day="29",
volume="8",
number="6",
pages="e25742",
keywords="Twitter",
keywords="social media",
keywords="qualitative",
keywords="crisis resolution team",
keywords="home treatment team",
keywords="mental health",
keywords="acute care",
keywords="severe mental illness",
abstract="Background: Analyzing Twitter posts enables rapid access to how issues and experiences are socially shared and constructed among communities of health service users and providers, in ways that traditional qualitative methods may not. Objective: To enrich the understanding of mental health crisis care in the United Kingdom, this study explores views on crisis resolution teams (CRTs) expressed on Twitter. We aim to identify the similarities and differences among views expressed on Twitter compared with interviews and focus groups. Methods: We used Twitter's advanced search function to retrieve public tweets on CRTs. A thematic analysis was conducted on 500 randomly selected tweets. The principles of refutational synthesis were applied to compare themes with those identified in a multicenter qualitative interview study. Results: The most popular hashtag identified was \#CrisisTeamFail, where posts were principally related to poor quality of care and access, particularly for people given a personality disorder diagnosis. Posts about CRTs giving unhelpful self-management advice were common, as were tweets about resource strains on mental health services. This was not identified in the research interviews. Although each source yielded unique themes, there were some overlaps with themes identified via interviews and focus groups, including the importance of rapid access to care. Views expressed on Twitter were generally more critical than those obtained via face-to-face methods. Conclusions: Traditional qualitative studies may underrepresent the views of more critical stakeholders by collecting data from participants accessed via mental health services. Research on social media content can complement traditional or face-to-face methods and ensure that a broad spectrum of viewpoints can inform service development and policy. ",
doi="10.2196/25742",
url="https://mental.jmir.org/2021/6/e25742",
url="http://www.ncbi.nlm.nih.gov/pubmed/34185017"
}


@Article{info:doi/10.2196/15298,
author="Gassman, Ann Ruth
and Dutta, Tapati
and Agley, Jon
and Jayawardene, Wasantha
and Jun, Mikyoung",
title="Social Media Outrage in Response to a School-Based Substance Use Survey: Qualitative Analysis",
journal="J Med Internet Res",
year="2019",
month="Sep",
day="12",
volume="21",
number="9",
pages="e15298",
keywords="social media",
keywords="ATOD",
keywords="survey",
keywords="firestorm",
keywords="digital",
abstract="Background: School-based alcohol, tobacco, and other drug use (ATOD) surveys are a common epidemiological means of understanding youth risk behaviors. They can be used to monitor national trends and provide data, in aggregate, to schools, communities, and states for the purposes of funding allocation, prevention programming, and other supportive infrastructure. However, such surveys sometimes are targeted by public criticism, and even legal action, often in response to a lack of perceived appropriateness. The ubiquity of social media has added the risk of potential online firestorms, or digital outrage events, to the hazards to be considered when administering such a survey. Little research has investigated the influence of online firestorms on public health survey administration, and no research has analyzed the content of such an occurrence. Analyzing this content will facilitate insights as to how practitioners can minimize the risk of generating outrage when conducting such surveys. Objective: This study aimed to identify common themes within social media comments comprising an online firestorm that erupted in response to a school-based ATOD survey in order to inform risk-reduction strategies. Methods: Data were collected by archiving all public comments made in response to a news study about a school-based ATOD survey that was featured on a common social networking platform. Using the general inductive approach and elements of thematic analysis, two researchers followed a multi-step protocol to clean, categorize, and consolidate data, generating codes for all 207 responses. Results: In total, 133 comments were coded as oppositional to the survey and 74 were coded as supportive. Among the former, comments tended to reflect government-related concerns, conspiratorial or irrational thinking, issues of parental autonomy and privacy, fear of child protective services or police, issues with survey mechanisms, and reasoned disagreement. Among the latter, responses showed that posters perceived the ability to prevent abuse and neglect and support holistic health, surmised that opponents were hiding something, expressed reasoned support, or made factual statements about the survey. Consistent with research on moral outrage and digital firestorms, few comments (<10\%) contained factual information about the survey; nearly half of the comments, both supportive and oppositional, were coded in categories that presupposed misinformation. Conclusions: The components of even a small online firestorm targeting a school-based ATOD survey are nuanced and complex. It is likely impossible to be fully insulated against the risk of outrage in response to this type of public health work; however, careful articulation of procedures, anticipating specific concerns, and two-way community-based interaction may reduce risk. ",
doi="10.2196/15298",
url="http://www.jmir.org/2019/9/e15298/",
url="http://www.ncbi.nlm.nih.gov/pubmed/31516129"
}


@Article{info:doi/10.2196/12428,
author="Murphy, Lynn Andrea
and Peltekian, Sophie
and Gardner, M. David",
title="Website Analytics of a Google Ads Campaign for a Men's Mental Health Website: Comparative Analysis",
journal="JMIR Ment Health",
year="2018",
month="Dec",
day="13",
volume="5",
number="4",
pages="e12428",
keywords="alcohol",
keywords="alcoholism",
keywords="analytics",
keywords="anxiety",
keywords="consumer health informatics",
keywords="depression",
keywords="Google Ads",
keywords="insomnia",
keywords="men",
keywords="suicide",
keywords="tobacco",
keywords="tobacco use",
abstract="Background: Men with mental health and addictions problems seek information and help from health service providers and community support less often than women with such problems. Online health resources offer men rapid access to self-care recommendations and resources and anonymity; however, only a few websites are specifically developed for men. Headstrong - Taking Things Head-On was a community pharmacy and online health promotion initiative for men living with mental health and addictions problems. The Headstrong website was developed to offer a curated collection of print and online recommended resources (primarily self-help oriented) for depression, anxiety, insomnia, tobacco and alcohol use problems, and suicide. To increase awareness of the initiative and use of the website's content and resource recommendations, a Google Ads campaign was developed. Objective: This study aimed to compare user acquisition and behavior on the Headstrong website during and after a Google Ads campaign. Methods: The Google Ads campaign was launched on December 21, 2017, and run until February 28, 2018. Website analytics (acquisition of new users, behavior in terms of at-website actions and duration, devices used, and conversions [link-outs to recommended resources]) in a 30-day period during the campaign (January 26, 2018 to February 24, 2018) were compared to a similar 30-day period after the campaign (March 23, 2018 to April 21, 2018). A cost analysis of the ad campaign was also performed. Results: The ad campaign generated 3011 clicks and 4.5 million impressions in total. In addition, the campaign received 1311 website users during the 30-day period of the ad campaign as compared to 241 users during the 30-day period after the ad campaign (P<.001). Return visitor (17.7\% vs 27.8\%) and nonbounce (19.5\% vs 39.8\%) user rates as well as session duration (42 vs 102 seconds) and page views per session (1.4 vs 2.1) were lower during the ad campaign than after the campaign (P<.01 for all). The 30-day period of the ad campaign included 9 sessions with conversions initiated by an ad click. Paid and display ads accounted for 63\% of the site traffic during the ad campaign, most of which came from mobile phone users. Desktops were the most-common device used after the ad campaign acquired the website via direct and organic searches primarily (92\%). The estimated cost per session with one or more conversions was Can \$54.69 and cost per conversion was Can \$32.81. Conclusions: A Google Ads campaign designed to direct men to the Headstrong website increased the number of user visits by more than five-fold. However, engagement by users responding to the ad campaign was substantially lower than that by users who visited the website via other acquisition methods, possibly reflecting the nonspecific online targeting of men by the ad campaign. General targeting of men online to promote men's mental health appears to have limited value. ",
doi="10.2196/12428",
url="http://mental.jmir.org/2018/4/e12428/",
url="http://www.ncbi.nlm.nih.gov/pubmed/30545812"
}