Health e-cards as a means of encouraging help seeking for depression among young adults: randomized controlled trial

J Med Internet Res. 2009 Oct 22;11(4):e42. doi: 10.2196/jmir.1294.

Abstract

Background: There is a need to identify interventions that increase help seeking for depression among young adults.

Objective: The aim was to evaluate a brief depression information intervention employing health e-cards (personalized emails containing links to health information presented on a Web page).

Methods: A randomized controlled trial was carried out with 348 19- to 24-year-olds drawn from the community. Participants were randomized to receive one of three conditions, all of which delivered a short series of health e-cards. Two active conditions involved the delivery of depression information designed to increase help-seeking behavior and intentions and to improve beliefs and knowledge associated with help seeking. A control arm delivered information about general health issues unrelated to depression. The primary outcome was help-seeking behavior. Secondary outcomes were help-seeking intentions; beliefs about the efficacy of depression treatments and help sources; ability to recognize depression; knowledge of the help-seeking process; and depressive symptoms. The study's primary focus was outcomes relating to formal help seeking (consultation with a general practitioner or mental health professional) but also targeted behaviors, intentions, and beliefs relating to informal help seeking.

Results: Relative to the control condition, depression health e-cards were not associated with an increase in formal help-seeking behavior, nor were they associated with improved beliefs about depression treatments; ability to recognize depression; knowledge of the help-seeking process; or depressive symptoms. Depression e-cards were associated with improved beliefs about the overall efficacy of formal help sources (z = 2.4, P = .02). At post-intervention, participants in all conditions, relative to pre-intervention, were more likely to have higher intentions of seeking help for depression from a formal help source (t(641) = 5.8, P < .001) and were more likely to rate interpersonal psychotherapy as being helpful (z = 2.0, P = .047). Depression e-cards were not associated with any significant changes in informal help-seeking behavior, intentions, or beliefs.

Conclusions: The study found no evidence that providing depression information in the form of brief e-cards encourages help seeking for depression among young adults. Involvement in the study may have been associated with increased help-seeking intentions among participants in all conditions, suggesting that mechanisms other than depression information may increase help seeking.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Attitude to Health
  • Cost of Illness
  • Counseling
  • Depression / therapy*
  • Depressive Disorder / therapy*
  • Disease Progression
  • Electronic Health Records / statistics & numerical data*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Patient Acceptance of Health Care*
  • Psychiatry
  • Psychology, Clinical
  • Psychotherapy
  • Stress, Psychological / diagnosis
  • Surveys and Questionnaires
  • Treatment Outcome
  • Young Adult