Are Organizational EHealth Interventions Becoming More Effective at Addressing Employee Mental Health; A Systematic Review and Meta-Analysis (Preprint)

Acceptability of Tele-mental Health Services Among Users: A Systematic Review and Meta-analysis

BACKGROUND

Mental disorders are currently a global public health concern, particularly after the coronavirus disease 2019 (COVID-19) pandemic. Mental health services gradually transitioned to teleservices, employing various methods like texting and videoconferencing. This meta-analysis aimed mainly to quantify the acceptability of tele-mental health services among both beneficiaries and providers. Secondary objectives included quantifying the usability of and satisfaction with these services.

METHODS

We conducted a systematic search of the following databases PubMed Central, SAGE, Google Scholar, Scopus, Web of Science, PubMed Medline, and EBSCO according to Preferred Reporting Items of the Systematic Reviews and Meta-Analysis (PRISMA) guidelines until December 2022.

RESULTS

Out of 3366 search results, 39 studies fully met the inclusion criteria. The pooled acceptability of tele-mental health services among beneficiaries was [71.0% with a 95% confidence interval (CI) of 63.0 - 78.5%, I2 = 98%]. Using meta-regression, four key factors contributed to this heterogeneity (R2 = 99.75%), namely, year of publication, type of mental disorder, participant category, and the quality of included studies. While acceptability among providers was [66.0% (95%CI, 52.0 - 78.0%), I2 = 95%]. The pooled usability of tele-mental health services among participants was [66.0% (95%CI, 50.0 - 80.0%), I2 = 83%]. Subgroup analysis revealed statistically significant results (p = 0.003), indicating that usability was higher among beneficiaries compared to providers.

CONCLUSIONS

The study highlighted a high acceptability of tele-mental health services. These findings suggest a promising outlook for the integration and adoption of tele-mental health services and emphasize the importance of considering user perspectives and addressing provider-specific challenges to enhance overall service delivery and effectiveness.

Practical pathway for the management of depression in the workplace: a Canadian perspective

Major depressive disorder (MDD) and other mental health issues pose a substantial burden on the workforce. Approximately half a million Canadians will not be at work in any week because of a mental health disorder, and more than twice that number will work at a reduced level of productivity (presenteeism). Although it is important to determine whether work plays a role in a mental health condition, at initial presentation, patients should be diagnosed and treated per appropriate clinical guidelines. However, it is also important for patient care to determine the various causes or triggers including work-related factors. Clearly identifying the stressors associated with the mental health disorder can help clinicians to assess functional limitations, develop an appropriate care plan, and interact more effectively with worker's compensation and disability programs, as well as employers. There is currently no widely accepted tool to definitively identify MDD as work-related, but the presence of certain patient and work characteristics may help. This paper seeks to review the evidence specific to depression in the workplace, and provide practical tips to help clinicians to identify and treat work-related MDD, as well as navigate disability issues.

Impacts of COVID-19 on Stress in Middle School Teachers and Staff in Minnesota: An Exploratory Study Using Random Forest Analysis

While the COVID-19 pandemic has negatively impacted many occupations, teachers and school staff have faced unique challenges related to remote and hybrid teaching, less contact with students, and general uncertainty. This study aimed to measure the associations between specific impacts of the COVID-19 pandemic and stress levels in Minnesota educators. A total of 296 teachers and staff members from eight middle schools completed online surveys between May and July of 2020. The Epidemic Pandemic Impacts Inventory (EPII) measured the effects of the COVID-19 pandemic according to nine domains (i.e., Economic, Home Life). The Kessler-6 scale measured non-specific stress (range: 0-24), with higher scores indicating greater levels of stress. Random forest analysis determined which items of the EPII were predictive of stress. The average Kessler-6 score was 6.8, indicating moderate stress. Three EPII items explained the largest amount of variation in the Kessler-6 score: increase in mental health problems or symptoms, hard time making the transition to working from home, and increase in sleep problems or poor sleep quality. These findings indicate potential areas for intervention to reduce employee stress in the event of future disruptions to in-person teaching or other major transitions during dynamic times.

The Role of Human and Organizational Factors in the Pursuit of One Digital Health

OBJECTIVE

This paper surveys a subset of the 2022 human and organizational factor (HOF) literature to provide guidance on building a One Digital Health ecosystem.

METHODS

We searched a subset of journals in PubMed/Medline for studies with "human factors" or "organization" in the title or abstract. Papers published in 2022 were eligible for inclusion in the survey. Selected papers were categorized into structural and behavioural aspects to understand digital health enabled interactions across micro, meso, and macro systems.

RESULTS

Our survey of the 2022 HOF literature showed that while we continue to make meaningful progress at digital health enabled interactions across systems levels, there are still challenges that must be overcome. For example, we must continue to grow the breadth of HOF research beyond individual users and systems to assist with the scale up of digital health systems across and beyond organizations. We summarize the findings by providing five HOF considerations to help build a One Digital Health ecosystem.

CONCLUSION

One Digital Health challenges us to improve coordination, communication, and collaboration between the health, environmental and veterinary sectors. Doing so requires us to develop both the structural and behavioural capacity of digital health systems at the organizational level and beyond so that we can develop more robust and integrated systems across health, environmental and veterinary sectors. The HOF community has much to offer and must play a leading role in designing a One Digital Health ecosystem.

Online mental health training program for male-dominated organisations: a pre-post pilot study assessing feasibility, usability, and preliminary effectiveness

PURPOSE

The emergence of digital health interventions for mental ill-health in the workplace is expansive. Digital interventions delivered in male-dominated settings are less so. This pilot study aimed to assess the usability, feasibility, acceptability, and preliminary effects of an online intervention in a male-dominated organization. We focus on male-dominated as mental ill-health is frequently unrecognized and underdiagnosed among males.

METHODS

Unwind, a 7-week internet-based program with stress-management components, was tested in a pre-post pilot study. Unwind gets users to identify and understand their stress triggers and assists them to develop adaptive ways to manage these and their stress. Participants were Australian adults employed in a mining company. Follow-up assessment occurred 8 weeks after baseline. The primary outcome measure was change in stress symptoms, with secondary outcomes; change in depression, anxiety, insomnia, well-being, and alcohol use. User feedback and program data were analyzed to assess usability, engagement, and intervention adherence.

RESULTS

Eligible participants n = 87 showed significant reductions in stress (g = 0.46, p < 0.001), depression (g = 0.47, p < 0.001), anxiety (g = 0.50, p < 0.001), insomnia (g = 0.44, p < 0.001), and well-being (g = 0.32, p = 0.004) post-intervention. Significant improvements were observed in both well and unwell (mental ill-health) and male and female participants. There was no gender effect on outcomes. A dose-response was observed as the number of modules used was related positively to improvement in anxiety (F_1,86 = 5.735, p = 0.019; R² = 0.25). Overall users rated Unwind as useful and engaging.

CONCLUSION

This study presents evidence base that Unwind is a feasible and acceptable approach to reducing employees' mental health-related symptoms in typically difficult-to-reach male-dominated industries. Unwind is feasible for larger scale delivery within male-dominated industries.