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Åsberg, K., Blomqvist, J., Lundgren, O., Henriksson, H., Henriksson, P., Bendtsen, P., . . . Bendtsen, M. (2022). Digital multiple health behaviour change intervention targeting online help seekers: protocol for the COACH randomised factorial trial. BMJ Open, 12(7), Article ID e061024.
Open this publication in new window or tab >>Digital multiple health behaviour change intervention targeting online help seekers: protocol for the COACH randomised factorial trial
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2022 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 7, article id e061024Article in journal (Refereed) Published
Abstract [en]

Introduction Unhealthy lifestyle behaviours continue to be highly prevalent, including alcohol consumption, unhealthy diets, insufficient physical activity and smoking. There is a lack of effective interventions which have a large enough reach into the community to improve public health. Additionally, the common co-occurrence of multiple unhealthy behaviours demands investigation of efforts which address more than single behaviours. Methods and analysis The effects of six components of a novel digital multiple health behaviour change intervention on alcohol consumption, diet, physical activity and smoking (coprimary outcomes) will be estimated in a factorial randomised trial. The components are designed to facilitate behaviour change, for example, through goal setting or increasing motivation, and are either present or absent depending on allocation (ie, six factors with two levels each). The study population will be those seeking help online, recruited through search engines, social media and lifestyle-related websites. Included will be those who are at least 18 years of age and have at least one unhealthy behaviour. An adaptive design will be used to periodically make decisions to continue or stop recruitment, with simulations suggesting a final sample size between 1500 and 2500 participants. Multilevel regression models will be used to analyse behavioural outcomes collected at 2 months and 4 months postrandomisation. Ethics and dissemination Approved by the Swedish Ethical Review Authority on 2021-08-11 (Dnr 2021-02855). Since participation is likely motivated by gaining access to novel support, the main concern is demotivation and opportunity cost if the intervention is found to only exert small effects. Recruitment began on 19 October 2021, with an anticipated recruitment period of 12 months.

Place, publisher, year, edition, pages
BMJ Publishing Group, 2022
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-187447 (URN)10.1136/bmjopen-2022-061024 (DOI)000831313800007 ()35882466 (PubMedID)
Note

Funding Agencies|Swedish Cancer Society (Cancerfonden) [0883 Pj]; Swedish Research Council for Health, Working Life and Welfare [2018--01410]

Available from: 2022-08-24 Created: 2022-08-24 Last updated: 2023-08-28
Levin, S., Nilsen, P., Bendtsen, P. & Bülow, P. (2022). Risk-Increasing and Risk-Reducing Factors for Violence: A Qualitative Study of Forensic Patients Perceptions. International Journal of Forensic Mental Health, 21(4), 383-398
Open this publication in new window or tab >>Risk-Increasing and Risk-Reducing Factors for Violence: A Qualitative Study of Forensic Patients Perceptions
2022 (English)In: International Journal of Forensic Mental Health, ISSN 1499-9013, E-ISSN 1932-9903, Vol. 21, no 4, p. 383-398Article in journal (Refereed) Published
Abstract [en]

This study investigated forensic patients perceptions of relevant factors for violence risk, to facilitate an understanding of potential reasons for violence and the effect of risk management interventions. Semi-structured interviews with 13 forensic patients were analyzed with qualitative content analysis using an inductive approach. The sample of participants could identify an array of potentially relevant factors for their use of violence related to themselves, the external context, social and relational aspects, as well as situational factors. Most also actively strived to manage such risk. Considering patients perceptions could potentially add relevant perspectives and improve clinical and structured risk assessments.

Place, publisher, year, edition, pages
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2022
Keywords
Violence; risk factors; protective factors; patient perceptions; risk assessment
National Category
Psychiatry
Identifiers
urn:nbn:se:liu:diva-182771 (URN)10.1080/14999013.2021.2023238 (DOI)000744293600001 ()2-s2.0-85122962266 (Scopus ID)
Available from: 2022-02-10 Created: 2022-02-10 Last updated: 2023-04-21Bibliographically approved
Nilsson, E., Sverker, A. M., Bendtsen, P. & Eldh, A. C. (2021). A Human, Organization, and Technology Perspective on Patients Experiences of a Chat-Based and Automated Medical History-Taking Service in Primary Health Care: Interview Study Among Primary Care Patients. Journal of Medical Internet Research, 23(10), Article ID e29868.
Open this publication in new window or tab >>A Human, Organization, and Technology Perspective on Patients Experiences of a Chat-Based and Automated Medical History-Taking Service in Primary Health Care: Interview Study Among Primary Care Patients
2021 (English)In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 23, no 10, article id e29868Article in journal (Refereed) Published
Abstract [en]

Background: The use of e-visits in health care is progressing rapidly worldwide. To date, studies on the advantages and disadvantages of e-consultations in the form of chat services for all inquiries in primary care have focused on the perspective of health care professionals (HCPs) rather than those of end users (patients). Objective: This study aims to explore patients experiences using a chat-based and automated medical history-taking service in regular, tax-based, not-for-profit primary care in Sweden. Methods: Overall, 25 individual interviews were conducted with patients in the catchment areas of 5 primary care centers (PCCs) in Sweden that tested a chat-based and automated medical history-taking service for all types of patient inquiries. The semistructured interviews were transcribed verbatim before content analysis using inductive and deductive strategies, the latter including an unconstrained matrix of human, organization, and technology perspectives. Results: The service provided an easily managed way for patients to make written contact with HCPs, which was considered beneficial for some patients and issues but less suitable for others (acute or more complex cases). The automated medical history-taking service was perceived as having potential but still derived from what HCPs need to know and how they address and communicate health and health care issues. Technical skills were not considered as necessary for a mobile phone chat as for handling a computer; however, patients still expressed concern for people with less digital literacy. The opportunity to take ones time and reflect on ones situation before answering questions from the HCPs was found to reduce stress and prevent errors, and patients speculated that it might be the same for the HCPs on the other end of the system. Patients appreciated the ability to have a conversation from almost anywhere, even from places not suitable for telephone calls. The asynchronicity of the chat service allowed the patients to take more control of the conversation and initiate a chat at any time at their own convenience; however, it could also lead to lengthy conversations where a single issue in the worst cases could take days to close. The opportunity to upload photographs made some visits to the PCC redundant, which would otherwise have been necessary if the ordinary telephone service had been used, saving patients both time and money. Conclusions: Patients generally had a positive attitude toward e-visits in primary care and were generally pleased with the prospects of the digital tool tested, somewhat more with the actual chat than with the automated history-taking system preceding the chat. Although patients expect their PCC to offer a range of different means of communication, the human, organization, and technology analysis revealed a need for more extensive (end) user experience design in the further development of the chat service.

Place, publisher, year, edition, pages
JMIR Publications Inc, 2021
Keywords
digital encounter; digital healthcare; e-consultation; e-health; interview; patient perspective; primary healthcare; qualitative study; telemedicine; telehealth
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-180755 (URN)10.2196/29868 (DOI)000708587100005 ()34661544 (PubMedID)
Note

Funding Agencies|Region Ostergotland [2019-04123]

Available from: 2021-11-02 Created: 2021-11-02 Last updated: 2024-01-17
Bendtsen, M., Seiterö, A., Bendtsen, P., Olsson, H., Henriksson, P., Thomas, K., . . . Müssener, U. (2021). mHealth intervention for multiple lifestyle behaviour change among high school students in Sweden (LIFE4YOUth): Protocol for a randomised controlled trial. Public Health Nursing, 21(1)
Open this publication in new window or tab >>mHealth intervention for multiple lifestyle behaviour change among high school students in Sweden (LIFE4YOUth): Protocol for a randomised controlled trial
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2021 (English)In: Public Health Nursing, ISSN 0737-1209, E-ISSN 1525-1446, Vol. 21, no 1Article in journal (Refereed) Published
Abstract [en]

BackgroundNational surveys in Sweden demonstrate that the majority of young people do not engage in health promoting behaviours at levels recommended by the Public Health Agency of Sweden. The objective of this study is to estimate the effectiveness of a novel mHealth intervention named LIFE4YOUth, which targets multiple lifestyle behaviours (alcohol, diet, physical activity, and smoking) among high school students in Sweden.MethodsA 2-arm parallel groups single blind randomised controlled trial (1:1) will be employed to estimate the effectiveness of the novel mHealth intervention. Students will be recruited at high schools throughout Sweden, and will be included if they fulfil one of six criteria relating to unhealthy behaviours with respect to alcohol, diet, physical activity and smoking. Eligible participants will be randomised to either receive the novel intervention immediately, or to be placed on a waiting list for 4 months. The intervention consists of a combination of recurring screening, text messages, and an interactive platform which is adaptable to individual preferences. Outcome measures with respect to alcohol, diet, physical activity and smoking will be assessed through questionnaires at 2 and 4 months post randomisation.DiscussionThe findings of this trial could be generalised to a diverse high-school student population as our recruitment encompass a large proportion of schools throughout Sweden with various educational profiles. Furthermore, if effective, the mHealth intervention has good potential to be able to be scaled up and disseminated at high schools nationally.Trial registrationRegistered prospectively on 2020-05-20 in ISRCTN (ISRCTN34468623).

Place, publisher, year, edition, pages
BMC, 2021
Keywords
Telemedicine; Multiple behaviour; mHealth; High school students; Randomised controlled trial
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-178080 (URN)10.1186/s12889-021-11446-9 (DOI)000675238000003 ()34271882 (PubMedID)
Note

Funding: Swedish Research Council for Health, Working Life and WelfareSwedish Research CouncilSwedish Research Council for Health Working Life & Welfare (Forte) [2018-01410]; Linkoping University

Available from: 2021-07-27 Created: 2021-07-27 Last updated: 2021-08-27
Åsberg, K., Lundgren, O., Henriksson, H., Henriksson, P., Bendtsen, P., Löf, M. & Bendtsen, M. (2021). Multiple lifestyle behaviour mHealth intervention targeting Swedish college and university students: protocol for the Buddy randomised factorial trial. BMJ Open, 11(12), Article ID e051044.
Open this publication in new window or tab >>Multiple lifestyle behaviour mHealth intervention targeting Swedish college and university students: protocol for the Buddy randomised factorial trial
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2021 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 11, no 12, article id e051044Article in journal (Refereed) Published
Abstract [en]

Introduction The time during which many attend college or university is an important period for developing health behaviours, with potentially major implications for future health. Therefore, it is concerning that many Swedish students excessively consume alcohol, have unhealthy diets, are not physical active and smoke. The potential of digital interventions which integrate support for change of all of these behaviours is largely unexplored, as are the dismantled effects of the individual components that make up digital lifestyle behaviour interventions. Methods and analysis A factorial randomised trial (six factors with two levels each) will be employed to estimate the effects of the components of a novel mHealth multiple lifestyle intervention on alcohol consumption, diet, physical activity and smoking among Swedish college and university students. A Bayesian group sequential design will be employed to periodically make decisions to continue or stop recruitment, with simulations suggesting that between 1500 and 2500 participants will be required. Multilevel regression models will be used to analyse behavioural outcomes collected at 2 and 4 months postrandomisation. Ethics and dissemination The study was approved by the Swedish Ethical Review Authority on 2020-12-15 (Dnr 2020-05496). The main concern is the opportunity cost if the intervention is found to only have small effects. However, considering the lack of a generally available evidence-based multiple lifestyle behaviour support to university and college students, this risk was deemed acceptable given the potential benefits from the study. Recruitment will begin in March 2021, and it is expected that recruitment will last no more than 24 months. A final data set will, therefore, be available in July 2023, and findings will be reported no later than December 2023.

Place, publisher, year, edition, pages
BMJ Publishing Group, 2021
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-182378 (URN)10.1136/bmjopen-2021-051044 (DOI)000737300500034 ()
Note

Funding Agencies|Swedish Research Council for Health, Working Life and WelfareSwedish Research CouncilSwedish Research Council for Health Working Life & Welfare (Forte) [2018-01410]

Available from: 2022-01-19 Created: 2022-01-19 Last updated: 2023-08-28
Bendtsen, M., Bendtsen, P. & Müssener, U. (2021). Six-Month Outcomes from the NEXit Junior Trial of a Text Messaging Smoking Cessation Intervention for High School Students: Randomized Controlled Trial With Bayesian Analysis. JMIR mhealth and uhealth, 9(10), Article ID e29913.
Open this publication in new window or tab >>Six-Month Outcomes from the NEXit Junior Trial of a Text Messaging Smoking Cessation Intervention for High School Students: Randomized Controlled Trial With Bayesian Analysis
2021 (English)In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 9, no 10, article id e29913Article in journal (Refereed) Published
Abstract [en]

Background: The prevalence of daily or occasional smoking among high school students in Sweden was approximately 20% in 2019, which is problematic since lifestyle behaviors are established in adolescence and track into adulthood. The Nicotine Exit (NEXit) Junior trial was conducted in response to a lack of evidence for the effects of text message smoking cessation interventions among high school students in Sweden. Objective: The aim of this study was to estimate the 3-and 6-month effects of a text messaging intervention among high school students in Sweden on smoking cessation outcomes. Methods: A 2-arm, single-blind randomized controlled trial was employed to estimate the effects of the intervention on smoking cessation in comparison to treatment as usual. Participants were recruited from high schools in Sweden using advertising and promotion by school staff from January 10, 2018, to January 10, 2019. Weekly or daily smokers who were willing to make a quit attempt were eligible for inclusion. Prolonged abstinence and point prevalence of smoking cessation were measured at 3 and 6 months after randomization. Results: Complete case analysis was possible on 57.9% (310/535) of the participants at 6 months, with no observed statistically significant effect on 5-month prolonged abstinence (odds ratio [OR] 1.27, 95% CI 0.73-2.20; P=.39) or 4-week smoking cessation (OR 1.42; 95% CI 0.83-2.46; P=.20). Sensitivity analyses using imputation yielded similar findings. Unplanned Bayesian analyses showed that the effects of the intervention were in the anticipated direction. The findings were limited by the risk of bias induced by high attrition (42.1%). The trial recruited high school students in a pragmatic setting and included both weekly and daily smokers; thus, generalization to the target population is more direct compared with findings obtained under more strict study procedures. Conclusions: Higher than expected attrition rates to follow-up 6 months after randomization led to null hypothesis tests being underpowered; however, unplanned Bayesian analyses found that the effects of the intervention were in the anticipated direction. Future trials of smoking cessation interventions targeting high school students should aim to prepare strategies for increasing retention to mid-and long-term follow-up. Trial Registration: IRCTN Registry ISRCTN15396225; https://www.isrctn.com/ISRCTN15396225 International Registered Report Identifier (IRRID): RR2-10.1186/s13063-018-3028-2

Place, publisher, year, edition, pages
JMIR Publications Inc, 2021
Keywords
smoking; cessation; text messaging; high school; randomized controlled trial; intervention; student; young adult; teenager; outcome; Bayesian; Sweden; prevalence; lifestyle; behavior
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-181699 (URN)10.2196/29913 (DOI)000716399600007 ()34673532 (PubMedID)
Available from: 2021-12-08 Created: 2021-12-08 Last updated: 2022-05-23
Bendtsen, M., McCambridge, J., Åsberg, K. & Bendtsen, P. (2021). Text messaging interventions for reducing alcohol consumption among risky drinkers: systematic review and meta-analysis. Addiction, 116(5), 1021-1033
Open this publication in new window or tab >>Text messaging interventions for reducing alcohol consumption among risky drinkers: systematic review and meta-analysis
2021 (English)In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 116, no 5, p. 1021-1033Article, review/survey (Refereed) Published
Abstract [en]

Background and Aims The global growth of mobile phone use has led to new opportunities for health interventions, including through text messaging. We aimed to estimate the effects of text messaging interventions on alcohol consumption among risky drinkers. Methods Systematic review and meta-analysis of reports on randomized controlled trials (RCTs) published in English. Searches were conducted on 23 May 2019 in PubMed; PubMed Central; CENTRAL; CDSR; DARE; NHS-EED; Scopus; PsycINFO; PsycARTICLES; CINAHL; and Web of Science. Measurements included number of episodes of heavy drinking (HED) per month and weekly alcohol consumption (WAC) in grams. Trials among risky drinkers who were not receiving co-interventions were included in the review (n = 3481, mean age 29 years, 41% female). Data were extracted from reports and authors were contacted for additional data. Results Ten trials were included and all analyses were based on random-effects models. Primary analyses, including seven trials (n = 2528) for HED and five trials (n = 2236) for WAC, found that the interventions may reduce self-reported HED [-0.33 episodes per month; 95% confidence interval (CI) = -0.79, 0.12] and WAC (-18.62 g per week; 95% CI = -39.61, 2.38), although both estimates included the null. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) quality of evidence was judged to be low for both HED and WAC, primarily due to risk of attrition and performance bias, heterogeneity and influence of pilot trials on estimates. Conclusions Text messaging alcohol interventions may reduce alcohol consumption compared with no or basic health information; however, there are doubts about the overall quality of the evidence.

Place, publisher, year, edition, pages
WILEY, 2021
Keywords
Alcohol consumption; brief interventions; meta‐ analysis; risky drinking; telemedicine; text messaging
National Category
Substance Abuse
Identifiers
urn:nbn:se:liu:diva-171933 (URN)10.1111/add.15294 (DOI)000592124100001 ()33047865 (PubMedID)
Available from: 2020-12-16 Created: 2020-12-16 Last updated: 2022-05-26
Bendtsen, M., Thomas, K., Linderoth, C. & Bendtsen, P. (2020). Effects of a Text Messaging Smoking Cessation Intervention Among Online Help Seekers and Primary Health Care Visitors in Sweden: Protocol for a Randomized Controlled Trial Using a Bayesian Group Sequential Design. JMIR Research Protocols, 9(12), Article ID e23677.
Open this publication in new window or tab >>Effects of a Text Messaging Smoking Cessation Intervention Among Online Help Seekers and Primary Health Care Visitors in Sweden: Protocol for a Randomized Controlled Trial Using a Bayesian Group Sequential Design
2020 (English)In: JMIR Research Protocols, E-ISSN 1929-0748, Vol. 9, no 12, article id e23677Article in journal (Refereed) Published
Abstract [en]

Background: A steady decline of the smoking prevalence in Sweden has been recorded over the past decade; however, people still start and continue to smoke. There is a need for effective smoking cessation interventions that can scale to a national level and that are designed to reach individuals requiring smoking cessation support in the general population. Objective: Previous randomized controlled trials of smoking cessation interventions among high school and university students in Sweden have found consistent evidence that text messaging interventions are effective in helping students quit smoking. However, there are no studies that investigate the effects of text messaging interventions in a more general population. The objective of this study is to estimate the effects of a text messaging intervention on individuals seeking help to quit online and individuals visiting primary health care units. Methods: A 2-arm, parallel-group (1:1), randomized controlled trial will be employed to address the study objectives. The trial will follow a Bayesian group sequential design. Recruitment will be conducted using online advertisement (Google, Bing, and Facebook) and through health care professionals at primary health care units. All participants will receive treatment as usual; however, participants who are allocated to the intervention arm will also be given access to a 12-week text message smoking cessation intervention. Primary outcomes are 8-week prolonged abstinence and 4-week point prevalence, measured 3 months and 6 months postrandomization. Mediator variables (self-efficacy, importance, and know-how) will be measured to estimate causal mediation models. Results: Recruitment commenced in September 2020 and will not exceed 24 months. This means that a complete dataset will be available at the latest towards the end of 2022. We expect to publish the findings from this trial by June 2023. Conclusions: This trial will further our understanding of the effects of text messaging interventions among a more general population than has previously been studied. We also aim to learn about differential effects between those who seek support online and those who are given facilitated support at primary health care units. Trial recruitment is limited to the Swedish population; however, a strength of this study is the pragmatic way in which participants are recruited. Through online advertisements, individuals are recruited in reaction to their own interest in seeking help to quit. At primary health care units, individuals who were not necessarily looking for smoking cessation support are given information about the trial. This closely mimics the way the intervention would be disseminated in a real-world setting and may therefore strengthen the argument of generalizability of findings.

Place, publisher, year, edition, pages
JMIR PUBLICATIONS, INC, 2020
Keywords
smoking cessation; text messaging; online help seekers; primary healthcare units; randomized controlled trial; Bayesian group sequential design; Bayesian; smoking; protocol; intervention
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-173200 (URN)10.2196/23677 (DOI)000608186400017 ()33269703 (PubMedID)
Note

Funding Agencies|Region Ostergotland (Forsknings-ALF) [LIO-896081]; Kamprad Family Foundation for Entrepreneurship, Research and Charity [20170008]

Available from: 2021-02-10 Created: 2021-02-10 Last updated: 2024-01-17
Eldh, A. C., Sverker, A. M., Bendtsen, P. & Nilsson, E. (2020). Health Care Professionals Experience of a Digital Tool for Patient Exchange, Anamnesis, and Triage in Primary Care: Qualitative Study. JMIR Human Factors, 7(4), Article ID e21698.
Open this publication in new window or tab >>Health Care Professionals Experience of a Digital Tool for Patient Exchange, Anamnesis, and Triage in Primary Care: Qualitative Study
2020 (English)In: JMIR Human Factors, E-ISSN 2292-9495, Vol. 7, no 4, article id e21698Article in journal (Refereed) Published
Abstract [en]

Background:Despite a growing body of knowledge about eHealth innovations, there is still limited understanding of the implementation of such tools in everyday primary care.

Objective:The objective of our study was to describe health care staff’s experience with a digital communication system intended for patient-staff encounters via a digital route in primary care.

Methods:In this qualitative study we conducted 21 individual interviews with staff at 5 primary care centers in Sweden that had used a digital communication system for 6 months. The interviews were guided by narrative queries, transcribed verbatim, and subjected to content analysis.

Results:While the digital communication system was easy to grasp, it was nevertheless complex to use, affecting both staffing and routines for communicating with patients, and documenting contacts. Templates strengthened equivalent procedures for patients but dictated a certain level of health and digital literacy for accuracy. Although patients expected a chat to be synchronous, asynchronous communication was extended over time. The system for digital communication benefited assessments and enabled more efficient use of resources, such as staff. On the other hand, telephone contact was faster and better for certain purposes, especially when the patient’s voice itself provided data. However, many primary care patients, particularly younger ones, expected digital routes for contact. To match preferences for communicating to a place and time that suited patients was significant; staff were willing to accept some nuisance from a suboptimal service—at least for a while—if it procured patient satisfaction. A team effort, including engaged managers, scaffolded the implementation process, whereas being subjected to a trial without likely success erected barriers.

Conclusions:A digital communication system introduced in regular primary care involved complexity beyond merely learning how to manage the tool. Rather, it affected routines and required that both the team and the context were addressed. Further knowledge is needed about what factors facilitate implementation, and how. This study suggested including ethical perspectives on eHealth tools, providing an important but novel aspect of implementation.

Place, publisher, year, edition, pages
Toronto, Canada: JMIR Publications Inc, 2020
Keywords
communication; content analysis; digital technology; eHealth; interviews; primary health care; qualitative research; telemedicine
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-174495 (URN)10.2196/21698 (DOI)000787613700007 ()33315014 (PubMedID)
Available from: 2021-03-22 Created: 2021-03-22 Last updated: 2022-09-02Bibliographically approved
Müssener, U., Thomas, K., Bendtsen, P. & Bendtsen, M. (2020). High School Students’ Preferences and Design Recommendations for a Mobile Phone–Based Intervention to Improve Psychological Well-Being: Mixed Methods Study. JMIR Pediatrics and Parenting, 3(2), Article ID e17044.
Open this publication in new window or tab >>High School Students’ Preferences and Design Recommendations for a Mobile Phone–Based Intervention to Improve Psychological Well-Being: Mixed Methods Study
2020 (English)In: JMIR Pediatrics and Parenting, ISSN 2561-6722, Vol. 3, no 2, article id e17044Article in journal (Refereed) Published
Abstract [en]

Background:Young adults’ mental health is characterized by relatively high rates of stress and anxiety and low levels of help-seeking behavior. Mobile health (mHealth) interventions could offer a cost-effective and readily available avenue to provide personalized support to young adults. More research needs to be directed at the development of mHealth interventions targeting youths specifically, as well as at determining how to reach young people and how to effectively intervene to improve psychological well-being.

Objective:The objective was to gather perceptions from high school students to inform the development of a prototype mHealth intervention aiming to promote psychological well-being.

Methods:A mixed methods design was used to (1) investigate high school students’ perceptions about stress and its consequences in daily life, as well as their ability to cope with stress, and (2) explore their preferences and design recommendations for an mHealth intervention to improve psychological well-being. Students from two high schools in the southeast of Sweden were invited to take part in the study. Recruitment of high school students was completed over a 6-week period, between October 25 and December 7, 2018. Recruitment entailed inviting students to complete a stress test (ie, screening and feedback) on their mobile phones. After completing the stress test, all participants were invited to complete a follow-up questionnaire and take part in telephone interviews.

Results:A total of 149 high school students completed the stress test, of which 68 completed the questionnaire. There were 67 free-text comments distributed across the items. The majority of participants (55/68, 81%) stated that they coped with stress better or in the same way after engaging in the stress test, due to time management, dialogue with others, and self-refection. A total of 4 out of 68 participants (6%)—3 female students (75%) and 1 male student (25%)—took part in telephone interviews. Three main themes were identified from the interview data: perceptions about stress, design features, and intervention features.

Conclusions:Stress was described by the students as a condition caused by high demands set by oneself and the social environment that impacted their physical health, personal relationships, school performance, and emotional well-being. Participants claimed that mHealth interventions need to be clearly tailored to a young age group, be evidence based, and offer varied types of support, such as information about stress, exercises to help organize tasks, self-assessment, coping tools, and recommendations of other useful websites, literature, blogs, self-help books, or role models. Mobile phones seemed to be a feasible and acceptable platform for the delivery of an intervention.

Place, publisher, year, edition, pages
Toronto, ON, Canada: J M I R Publications, Inc., 2020
Keywords
mental health, stress, high school students, intervention, mHealth
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-173649 (URN)10.2196/17044 (DOI)000780472700004 ()32673268 (PubMedID)2-s2.0-85097608662 (Scopus ID)
Available from: 2021-03-01 Created: 2021-03-01 Last updated: 2022-09-02Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-5913-2903

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