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      Evaluation Methods for Assessing Users’ Psychological Experiences of Web-Based Psychosocial Interventions: A Systematic Review

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          Abstract

          Background

          The use of Web-based interventions to deliver mental health and behavior change programs is increasingly popular. They are cost-effective, accessible, and generally effective. Often these interventions concern psychologically sensitive and challenging issues, such as depression or anxiety. The process by which a person receives and experiences therapy is important to understanding therapeutic process and outcomes. While the experience of the patient or client in traditional face-to-face therapy has been evaluated in a number of ways, there appeared to be a gap in the evaluation of patient experiences of therapeutic interventions delivered online. Evaluation of Web-based artifacts has focused either on evaluation of experience from a computer Web-design perspective through usability testing or on evaluation of treatment effectiveness. Neither of these methods focuses on the psychological experience of the person while engaged in the therapeutic process.

          Objective

          This study aimed to investigate what methods, if any, have been used to evaluate the in situ psychological experience of users of Web-based self-help psychosocial interventions.

          Methods

          A systematic literature review was undertaken of interdisciplinary databases with a focus on health and computer sciences. Studies that met a predetermined search protocol were included.

          Results

          Among 21 studies identified that examined psychological experience of the user, only 1 study collected user experience in situ. The most common method of understanding users’ experience was through semistructured interviews conducted posttreatment or questionnaires administrated at the end of an intervention session. The questionnaires were usually based on standardized tools used to assess user experience with traditional face-to-face treatment.

          Conclusions

          There is a lack of methods specified in the literature to evaluate the interface between Web-based mental health or behavior change artifacts and users. Main limitations in the research were the nascency of the topic and cross-disciplinary nature of the field. There is a need to develop and deliver methods of understanding users’ psychological experiences while using an intervention.

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          Most cited references48

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          Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review.

          To identify underlying patterns in the alliance literature, an empirical review of the many existing studies that relate alliance to outcome was conducted. After an exhaustive literature review, the data from 79 studies (58 published, 21 unpublished) were aggregated using meta-analytic procedures. The results of the meta-analysis indicate that the overall relation of therapeutic alliance with outcome is moderate, but consistent, regardless of many of the variables that have been posited to influence this relationship. For patient, therapist, and observer ratings, the various alliance scales have adequate reliability. Across most alliance scales, there seems to be no difference in the ability of raters to predict outcome. Moreover, the relation of alliance and outcome does not appear to be influenced by other moderator variables, such as the type of outcome measure used in the study, the type of outcome rater, the time of alliance assessment, the type of alliance rater, the type of treatment provided, or the publication status of the study.
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            The qualitative interview in IS research: Examining the craft

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              Using Evidence-Based Internet Interventions to Reduce Health Disparities Worldwide

              Health disparities are a persistent problem worldwide. A major obstacle to reducing health disparities is reliance on “consumable interventions,” that is, interventions that, once used, cannot be used again. To reduce health disparities, interventions are required that can be used again and again without losing their therapeutic power, that can reach people even if local health care systems do not provide them with needed health care, and that can be shared globally without taking resources away from the populations where the interventions were developed. This paper presents the argument that automated self-help evidence-based Internet interventions meet the above criteria and can contribute to the reduction of health disparities worldwide. Proof-of-concept studies show that evidence-based Internet interventions can reach hundreds of thousands of people worldwide and could be used in public sector settings to augment existing offerings and provide services not currently available (such as prevention interventions). This paper presents a framework for systematically filling in a matrix composed of columns representing common health problems and rows representing languages. To bring the benefits of evidence-based Internet interventions to the underserved, public sector clinics should establish eHealth resource centers, through which patients could be screened online for common disorders and provided with evidence-based Internet intervention services not currently available at the clinics. These resources should be available in the patients’ languages, in formats that do not require literacy, and that can be accessed with mobile devices. Such evidence-based Internet interventions should then be shared with public sector clinics as well as individuals anywhere in the world. Finally, this paper addresses sustainability and describes a continuum of evidence-based Internet interventions to share nationally and across the world. This approach to expanding health service delivery will significantly contribute to a reduction of health disparities worldwide, adding to the often-quoted slogan, “Think globally, act locally,” a third line: “Share globally.”
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                Author and article information

                Contributors
                Journal
                J Med Internet Res
                J. Med. Internet Res
                JMIR
                Journal of Medical Internet Research
                JMIR Publications (Toronto, Canada )
                1439-4456
                1438-8871
                June 2016
                30 June 2016
                : 18
                : 6
                : e181
                Affiliations
                [1] 1Centre for Interdisciplinary Trauma Research Department of Psychology Auckland University of Technology AucklandNew Zealand
                [2] 2Auckland University of Technology AucklandNew Zealand
                [3] 3Auckland University of Technology School of Computer and Mathematical Sciences AucklandNew Zealand
                [4] 4Auckland University of Technology Department of Computer Science AucklandNew Zealand
                [5] 5Centre for Interdisciplinary Trauma Research School of Clinical Sciences Auckland University of Technology AucklandNew Zealand
                Author notes
                Corresponding Author: Jacqueline Susan Feather jackie.feather@ 123456aut.ac.nz
                Author information
                http://orcid.org/0000-0002-3448-0191
                http://orcid.org/0000-0003-3933-5986
                http://orcid.org/0000-0002-4908-7771
                http://orcid.org/0000-0002-6236-1560
                http://orcid.org/0000-0003-2812-047X
                http://orcid.org/0000-0003-3453-023X
                Article
                v18i6e181
                10.2196/jmir.5455
                4945819
                27363519
                42726741-b6bf-4801-b5c1-f169469f6cba
                ©Jacqueline Susan Feather, Moira Howson, Linda Ritchie, Philip D Carter, David Tudor Parry, Jane Koziol-McLain. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 30.06.2016.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

                History
                : 17 December 2015
                : 24 January 2016
                : 3 May 2016
                : 24 May 2016
                Categories
                Original Paper
                Original Paper

                Medicine
                ehealth,medical informatics applications,web browser,web-based,usability,computer systems,psychology, clinical,usability testing,ehealth evaluation

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