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Manning Hutson M, Hosking SM, Mantalvanos S, Berk M, Pasco J, Dunning T. What Injured Workers With Complex Claims Look For in Online Communities: Netnographic Analysis. J Med Internet Res 2022; 24:e17180. [PMID: 35389358 PMCID: PMC9030974 DOI: 10.2196/17180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 06/15/2021] [Accepted: 07/27/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Improved understanding of social constructs around injury may help insurance case managers to understand how best to support people after injury. OBJECTIVE This study sought to explore what people who sustain work-related injuries may seek from online communities. The study highlights potential opportunities for improved engagement with insurance case management practice. METHODS An observational netnographic analysis was undertaken on anonymous, publicly available messages posted on Australian message boards. All research data were drawn from anonymous, online communities. A person (author SM) with experience of making a claim through an Australian workers' compensation system and online engagement was involved in study conception, design, and analysis. Data were analyzed using NVivo12 in an iterative, multistage process including coding, journaling, and member checking. A total of 141 people were engaged in discussion across 47 threads housed on 4 Australian forums. RESULTS In this qualitative study, themes emerged from the data, describing how injured workers use online communities to help make decisions, get support, and solve problems. The key motivators for action and engagement were seeking information, connection, or justice. Establishment of relationships was a key mediator of each of these parameters. CONCLUSIONS Some work-related injuries may involve medical and medicolegal complexity as well as changed lifestyle and routine during convalescence and recovery. The mechanism used by some injured workers to seek information and problem solve suggests a capacity for self-management and self-care after work-related injury. Netnography provides information on a community that may not regularly engage with research because of the complexity of their situation and their vulnerability.
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Affiliation(s)
| | | | | | - Michael Berk
- School of Medicine, Deakin University, Geelong, Australia
- Pain Train, Geelong, Australia
- Barwon Health, Geelong, Australia
| | - Julie Pasco
- School of Medicine, Deakin University, Geelong, Australia
- Barwon Health, Geelong, Australia
- Department of Medicine - Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Trisha Dunning
- Barwon Health, Geelong, Australia
- Centre for Quality and Patient Safety Research, Barwon Health Partnership, School of Nursing and Midwifery, Deakin University, Geelong, Australia
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Sana: A Gamified Rehabilitation Management System for Anterior Cruciate Ligament Reconstruction Recovery. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10144868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The anterior cruciate ligament (ACL) provides stabilization support for the back and forth motion of the knee joint. ACL ruptures account for 50% of all sports-related knee injuries with approximately 76.6% of them requiring reconstructive surgery, necessitating long-term patient rehabilitation. Compliance with rehabilitation management programs, following ACL reconstruction, is fundamental for the successful restoration of the knee’s kinematics and reducing the risk of secondary osteoarthritis. Existing recovery programs are often paper-based and require patients to perform exercises at home, unsupervised, resulting in a low level of self-efficacy; by promoting self-efficacy in home-based settings, rehabilitation outcomes can improve. This paper reports the design development of the Sana system, a mobile and wearable application that adopts behavioral design principles and gamification theory to improve long-term post-operative outcomes for ACL reconstruction recovery. A feasibility study was conducted from 15 October 2019–13 May 2020, employing the double diamond framework and a human-centered design approach (BS EN ISO 9241-210: 2019). Eighteen participants were recruited, including eight domain experts (in fields such as user experience design, human factors, and physiotherapy), and ten representative users who had undergone long-term rehabilitation for musculoskeletal injuries.
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Michalak EE, Morton E, Barnes SJ, Hole R, Murray G. Supporting Self-Management in Bipolar Disorder: Mixed-Methods Knowledge Translation Study. JMIR Ment Health 2019; 6:e13493. [PMID: 30985287 PMCID: PMC6487350 DOI: 10.2196/13493] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 02/19/2019] [Accepted: 02/22/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Self-management is increasingly recognized as an important method through which individuals with bipolar disorder (BD) may cope with symptoms and improve quality of life. Digital health technologies have strong potential as a method to support the application of evidence-informed self-management strategies in BD. Little is known, however, about how to most effectively maximize user engagement with digital platforms. OBJECTIVE The aims of this study were (1) to create an innovative Web-based Bipolar Wellness Centre, (2) to conduct a mixed-methods (ie, quantitative and qualitative) evaluation to assess the impact of different sorts of engagement (ie, knowledge translation [KT]), and (3) to support engagement with the self-management information in the Bipolar Wellness Centre. METHODS The project was implemented in 2 phases. In phase 1, community-based participatory research and user-centered design methods were used to develop a website (Bipolar Wellness Centre) housing evidence-informed tools and strategies for self-management of BD. In phase 2, a mixed-methods evaluation was conducted to explore the potential impact of 4 KT strategies (Web-based webinars, Web-based videos, Web-based one-to-one Living Library peer support, and in-person workshops). Quantitative assessments occurred at 2 time points-preintervention and 3 weeks postintervention. Purposive sampling was used to recruit a subsample of participants for the qualitative interviews, ensuring each KT modality was represented, and interviews occurred approximately 3 weeks postintervention. RESULTS A total of 94 participants were included in the quantitative analysis. Responses to evaluative questions about engagement were broadly positive. When averaged across the 4 KT strategies, significant improvements were observed on the Bipolar Recovery Questionnaire (F1,77=5.887; P=.02) and Quality of Life in Bipolar Disorder (F1,77=8.212; P=.005). Nonsignificant improvements in positive affect and negative affect were also observed. The sole difference that emerged between KT strategies related to the Chronic Disease Self-Efficacy measure, which decreased after participation in the webinar and video arms but increased after the Living Library and workshop arms. A subsample of 43 participants was included in the qualitative analyses, with the majority of participants describing positive experiences with the 4 KT strategies; peer contact was emphasized as a benefit across all strategies. Infrequent negative experiences were reported in relation to the webinar and video strategies, and included technical difficulties, the academic tone of webinars, and feeling unable to relate to the actor in the videos. CONCLUSIONS This study adds incremental evidence to a growing literature that suggests digital health technologies can provide effective support for self-management for people with BD. The finding that KT strategies could differentially impact chronic disease self-efficacy (hypothesized as being a product of differences in degree of peer contact) warrants further exploration. Implications of the findings for the development of evidence-informed apps for BD are discussed in this paper.
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Affiliation(s)
- Erin E Michalak
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Emma Morton
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Steven J Barnes
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Rachelle Hole
- School of Social Work, University of British Columbia, Okanagan, BC, Canada
| | | | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
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Gliddon E, Cosgrove V, Berk L, Lauder S, Mohebbi M, Grimm D, Dodd S, Coulson C, Raju K, Suppes T, Berk M. A randomized controlled trial of MoodSwings 2.0: An internet-based self-management program for bipolar disorder. Bipolar Disord 2019; 21:28-39. [PMID: 29931798 DOI: 10.1111/bdi.12669] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES MoodSwings 2.0 is an online self-guided intervention for bipolar disorder that includes educational modules, interactive tools, and discussion forums. The primary aim of the study was to determine if participation in MoodSwings 2.0 would result in decreased symptoms of depression and mania compared to the control condition. Secondary aims were to identify improvements in core depression symptoms, quality of life, medication adherence, functioning, and time to relapse. METHODS This was a three-arm randomized controlled trial that compared two intervention arms against a peer support control group (forum). A total of 304 adults aged 21 to 65 years with a diagnosis of bipolar disorder were assigned to a forum-only control group (Group 1; n = 102), a forum plus modules treatment group (Group 2; n = 102), or a forum, modules, and tools treatment group (Group 3; n = 100), in addition to usual care. RESULTS There was a significant intervention impact showing improvement on the primary outcome of depression for Group 2 compared to Group 1 (P = .05) with effect sizes (Cohen's d) ranging from 0.17 to 0.43. There was also a significant intervention impact showing improvement on the secondary outcome of core depression for Group 2 (P = .02) and Group 3 (P = .05), but worse physical functioning for Group 3 (P = .01), compared to Group 1. CONCLUSIONS This study provides evidence of the efficacy of internet-based psychoeducation interventions for bipolar disorder in reducing depressive symptoms. Further investigation is needed to assess effectiveness in a public program.
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Affiliation(s)
- Emma Gliddon
- IMPACT Strategic Research Centre, Barwon Health, Deakin University, Geelong, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Victoria Cosgrove
- Bipolar and Depression Research Program, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Lesley Berk
- IMPACT Strategic Research Centre, Barwon Health, Deakin University, Geelong, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia.,School of Population Health, University of Melbourne, Parkville, Australia
| | - Sue Lauder
- Department of Psychiatry, University of Melbourne, Parkville, Australia.,Faculty of Health, School of Health Sciences and Psychology, Federation University Australia, Ballarat, Australia
| | - Mohammadreza Mohebbi
- IMPACT Strategic Research Centre, Barwon Health, Deakin University, Geelong, Australia.,Deakin Biostatistics Unit, Deakin University, Geelong, Australia
| | - David Grimm
- Bipolar and Depression Research Program, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Systems Psychology Lab, Georgia Institute of Technology, Atlanta, GA, USA
| | - Seetal Dodd
- IMPACT Strategic Research Centre, Barwon Health, Deakin University, Geelong, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia.,Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia
| | - Carolyn Coulson
- IMPACT Strategic Research Centre, Barwon Health, Deakin University, Geelong, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Karishma Raju
- Bipolar and Depression Research Program, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Trisha Suppes
- Bipolar and Depression Research Program, VA Palo Alto Health Care System, Palo Alto, CA, USA.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael Berk
- IMPACT Strategic Research Centre, Barwon Health, Deakin University, Geelong, Australia.,Department of Psychiatry, University of Melbourne, Parkville, Australia.,Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,Florey Institute for Neuroscience and Mental Health, Parkville, Australia
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Murray G. What Would Digital Early Intervention for Bipolar Disorder Look Like? Theoretical and Translational Considerations for Future Therapies. Front Psychiatry 2019; 10:599. [PMID: 31507467 PMCID: PMC6715769 DOI: 10.3389/fpsyt.2019.00599] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 07/29/2019] [Indexed: 12/19/2022] Open
Abstract
There are growing calls for the development of early intervention/preventive interventions for young people identified to be at risk of bipolar disorder (BD), and digital delivery appears to be a strong candidate delivery method. To date, no such interventions exist, and the aim of this perspective paper is to advance the literature by reviewing theoretical issues related to early intervention in BD and introducing a framework for design of feasible, acceptable, and effective online psychosocial interventions for this population. It is concluded that, by adopting an appropriate transdiagnostic and humanistic framework, and recognizing emerging tenets of digital psychotherapy development, testable online interventions for young people at risk of BD are within reach.
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Affiliation(s)
- Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Melbourne, VIC, Australia
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Fletcher K, Foley F, Murray G. Web-Based Self-Management Programs for Bipolar Disorder: Insights From the Online, Recovery-Oriented Bipolar Individualised Tool Project. J Med Internet Res 2018; 20:e11160. [PMID: 30355553 PMCID: PMC6231852 DOI: 10.2196/11160] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/25/2018] [Accepted: 08/17/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a complex, relapsing mood disorder characterized by considerable morbidity and mortality. Web-based self-management interventions provide marked opportunities for several chronic mental health conditions. However, Web-based self-management programs targeting BD are underrepresented compared with programs targeting other psychiatric conditions. OBJECTIVE This paper aims at facilitating future research in the area of self-management of BD and draws insights from the development of one such intervention-the Online, Recovery-Oriented Bipolar Individualised Tool (ORBIT)-that is aimed at improving the quality of life of people with BD. METHODS We have discussed the opportunities and challenges in developing an engaging, evidence-based, safe intervention within the context of the following three nested domains: (1) intervention development; (2) scientific testing of the intervention; and (3) ethical framework including risk management. RESULTS We gained the following insights across the three abovementioned overlapping domains: Web-based interventions can be optimized through (1) codesign with consumers with lived experience to ensure relevance and appropriateness to the target audience; (2) novel content development processes that iteratively combine evidence-based information with lived experience perspectives, capitalizing on multimedia (eg, videos) that the digital health space provides; and (3) incorporating Web-based communities to connect end users and promote constructive engagement by access to a Web-based coach. CONCLUSIONS Self-management is effective in BD, even for those on the more severe end of the spectrum. While there are challenges to be aware of, guided self-management programs, such as those offered by the ORBIT project, which are specifically developed for Web-based delivery provide highly accessible, engaging, and potentially provocative treatments for chronically ill populations who may otherwise have never engaged with treatment. Key questions about engagement, effectiveness, and cost-effectiveness will be answered by the ORBIT project over the next 18 months.
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Affiliation(s)
- Kathryn Fletcher
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Fiona Foley
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Greg Murray
- Centre for Mental Health, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
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Brown M, O'Neill N, van Woerden H, Eslambolchilar P, Jones M, John A. Gamification and Adherence to Web-Based Mental Health Interventions: A Systematic Review. JMIR Ment Health 2016; 3:e39. [PMID: 27558893 PMCID: PMC5014987 DOI: 10.2196/mental.5710] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 06/06/2016] [Accepted: 07/11/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Adherence to effective Web-based interventions for common mental disorders (CMDs) and well-being remains a critical issue, with clear potential to increase effectiveness. Continued identification and examination of "active" technological components within Web-based interventions has been called for. Gamification is the use of game design elements and features in nongame contexts. Health and lifestyle interventions have implemented a variety of game features in their design in an effort to encourage engagement and increase program adherence. The potential influence of gamification on program adherence has not been examined in the context of Web-based interventions designed to manage CMDs and well-being. OBJECTIVE This study seeks to review the literature to examine whether gaming features predict or influence reported rates of program adherence in Web-based interventions designed to manage CMDs and well-being. METHODS A systematic review was conducted of peer-reviewed randomized controlled trials (RCTs) designed to manage CMDs or well-being and incorporated gamification features. Seven electronic databases were searched. RESULTS A total of 61 RCTs met the inclusion criteria and 47 different intervention programs were identified. The majority were designed to manage depression using cognitive behavioral therapy. Eight of 10 popular gamification features reviewed were in use. The majority of studies utilized only one gamification feature (n=58) with a maximum of three features. The most commonly used feature was story/theme. Levels and game leaders were not used in this context. No studies explicitly examined the role of gamification features on program adherence. Usage data were not commonly reported. Interventions intended to be 10 weeks in duration had higher mean adherence than those intended to be 6 or 8 weeks in duration. CONCLUSIONS Gamification features have been incorporated into the design of interventions designed to treat CMD and well-being. Further research is needed to improve understanding of gamification features on adherence and engagement in order to inform the design of future Web-based health interventions in which adherence to treatment is of concern. Conclusions were limited by varied reporting of adherence and usage data.
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Affiliation(s)
- Menna Brown
- Swansea University, Medical School, Swansea, United Kingdom.
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