Digital Intervention Barriers Scale-7 (DIBS-7): Development, Evaluation, and Preliminary Validation

Giovanni Ramos; Amanda Kay Montoya; Hayley Renee Hammons; Danielle Smith; Denise April Chavira; Leslie Rose Rith-Najarian

doi:10.2196/40509

Digital Intervention Barriers Scale-7 (DIBS-7): Development, Evaluation, and Preliminary Validation

JMIR Form Res. 2023 Apr 6:7:e40509. doi: 10.2196/40509.

Authors

Giovanni Ramos¹, Amanda Kay Montoya¹, Hayley Renee Hammons¹, Danielle Smith¹, Denise April Chavira¹, Leslie Rose Rith-Najarian²

Affiliations

¹ Department of Psychology, University of California, Los Angeles, Los Angeles, CA, United States.
² Department of Psychology, Harvard University, Cambridge, MA, United States.

PMID: 37023417
PMCID: PMC10131680
DOI: 10.2196/40509

Abstract

Background: The translation of mental health services into digital formats, deemed digital mental health interventions (DMHIs), has the potential to address long-standing obstacles to accessing care. However, DMHIs have barriers of their own that impact enrollment, adherence, and attrition in these programs. Unlike in traditional face-to-face therapy, there is a paucity of standardized and validated measures of barriers in DMHIs.

Objective: In this study, we describe the preliminary development and evaluation of such a scale, the Digital Intervention Barriers Scale-7 (DIBS-7).

Methods: Following an iterative QUAN → QUAL mixed methods approach, item generation was guided by qualitative analysis of feedback from participants (n=259) who completed a DMHI trial for anxiety and depression and identified barriers related to self-motivation, ease of use, acceptability, and comprehension of tasks. Item refinement was achieved through DMHI expert review. A final item pool was administered to 559 treatment completers (mean age 23.02 years; 438/559, 78.4% female; 374/559, 69.9% racially or ethnically minoritized). Exploratory factor analyses and confirmatory factor analyses were estimated to determine the psychometric properties of the measure. Finally, criterion-related validity was examined by estimating partial correlations between the DIBS-7 mean score and constructs related to treatment engagement in DMHIs.

Results: Statistical analyses estimated a 7-item unidimensional scale with high internal consistency (α=.82, ω=0.89). Preliminary criterion-related validity was supported by significant partial correlations between the DIBS-7 mean score and treatment expectations (pr=-0.25), number of modules with activity (pr=-0.55), number of weekly check-ins (pr=-0.28), and treatment satisfaction (pr=-0.71).

Conclusions: Overall, these results provide preliminary support for the use of the DIBS-7 as a potentially useful short scale for clinicians and researchers interested in measuring an important variable often associated with treatment adherence and outcomes in DMHIs.

Keywords: barriers; development; digital mental health intervention; measure; psychometrics; scale; validation.

©Giovanni Ramos, Amanda Kay Montoya, Hayley Renee Hammons, Danielle Smith, Denise April Chavira, Leslie Rose Rith-Najarian. Originally published in JMIR Formative Research (https://formative.jmir.org), 06.04.2023.