Beyond Efficacy- Eliciting Preference for Face-to-face and Internet-based Psychotherapy Among People with Depression

NCT05449561 | Completed

• 1 other identifier: SBRE(R)-21-043
• Study Type: observational
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to strengthen the evidence base of clients' preferences of psychotherapy and to close the described literature gaps so as to inform public health resource reallocation and implementation of psychological services. The investigators aim to address the following research questions:

1. 1.Which psychological service attributes exert the most influence on the service use decisions?
2. 2.Can respondents be represented by latent classes on the basis of similar preference profiles?
3. 3.Which attributes exert the most influence on the service utilization decisions of each latent class?
4. 4.Will people with depression adopt Internet-based psychotherapy considering the long waiting time and high cost of conventional face-to-face psychotherapy?
5. 5.to examine the relative importance of a series of characteristics of psychological services (e.g., delivery modality, waiting time, out-of-pocket service fee, anonymity and referral methods) on the choices of psychological service using DCE.
6. 6.to identify segments of people with depression with different service preferences using latent class model, because the relative weighting of service preferences may vary with demographic (e.g., gender, age, socioeconomic status, depression severity) and psychological characteristics (e.g., help seeking stigma); and
7. 7.since DCEs need to be translated into improved services to be truly useful, and with reference to emerging interest in the development of digital mental health service for people with depression to solve the issue of long waiting time and cost in face-to-face psychotherapy, using a series of statistical simulations, we aim to estimate the percentage of people with depression in each latent class segment who would use psychotherapy with pre-defined treatment attributes packages.

Conditions

Depression

Keywords

mental well-being; depression; Internet-based Psychotherapy; Client-Centered Services; Discrete Choice Experiment (DCE)

Outcome Measures

Primary Outcomes (4)

• Depression

  Patient Health Questionnaire (PHQ9) (Kroenke, Spitzer, \& Williams, 2001). It is a 9-item measure to access the severity of depression. PHQ-9 has been validated and used widely in the general population for screening and measuring depression severity. Scores of 5, 10, 15, and 20 denote mild, moderate, moderately severe, and severe level of depression respectively (range: 0-27).

  at baseline

• Help-seeking Self-Stigma

  Self-Stigma of Seeking Help Scale (SSOSH-10). To understand how stigma may influence choices and preference of psychological service, SSOSH-10 will be used to assess respondents' level of help seeking stigma. The scale scores on a 5-point Likert-type scale, with 1= totally disagree and 5 = totally agree (scores range from 10 to 50). The higher the mean score, the higher the self-stigma of seeking help.

  at baseline

• Attitudes towards Psychological Online Interventions

  Attitudes towards Psychological Online Interventions Questionnaire (APOI). It is a 16-item measure to assess respondent's attitudes towards psychological online interventions. It scores on a 5-point Likert scale with 1=totally agree to 5=totally disagree.

  at baseline

• Potential attributes and their influence on respondent's choice of psychotherapies

  1 set of questions with different attributes that influence respondent's choice of psychotherapy will be asked. We plan to include (1) Treatment Modality, (2) Effectiveness, (3) Referral, (4) Anonymity, (5) Waiting Time and (6) Out-Of-Pocket Cost as attributes. We will also ask another 60 participants with depressive symptoms to rank attributes from 1 ("most important") to 9 ("least important"). The 6 highest ranked attributes will be selected for the questions.

  baseline (During qualitative interview)

Study Arms (1)

Discrete Choice qualitative interview

We will invite at least 20 participants with at least mild level of depressive symptoms to participate in individual interviews. The interviews will be in semi-structured format. Upon provision of informed consent and completion of demographics survey, we will ask respondents a single question of what matters to them when considering the use of psychotherapy, with adequate probes during the conversation. This will ensure uniformity of the topics to be discussed, and the level of digression allowed.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

A variety of online and offline approaches to recruit a diverse sample of people with depression. Participants will be recruited using both online and offline approaches, including social/digital media and print media advertisement, forums, mutual support groups for people with depression, Integrated Community Centers for Mental Wellness, primary health clinics. Quota sampling on gender, age, and socioeconomic status will be adopted. The inclusion criteria include: (1) aged 18 years old or above (2) with at least mild to moderate depressive symptoms (defined as having a cut-off score of 10 or above based on the Patient Health Questionnaire-9 (PHQ-9)) (3) able to read and understand Chinese. Exclusion criteria include: (1) self-reported DSM-5 diagnosis of current manic episodes, post-traumatic stress disorder, substance use disorders, and psychotic disorders (2) actively suicidal as assessed by P4-suicidality screener.

You may qualify if:

• Participants aged 18 years old or above
• With at least mild to moderate depressive symptoms (defined as having a cut-off score of 10 or above based on the Patient Health Questionnaire-9 (PHQ-9))
• Able to read and understand Chinese

You may not qualify if:

• Self-reported DSM-5 diagnosis of current manic episodes, post-traumatic stress disorder, substance use disorders, and psychotic disorders
• Actively suicidal as assessed by P4-suicidality screener

Sponsors & Collaborators

• Chinese University of Hong Kong: lead

Study Sites (1)

Department of Psychology

Hong Kong, Hong Kong

Location

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MeSH Terms

Conditions

Depression; Psychological Well-Being

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior; Personal Satisfaction

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: June 29, 2022
• First Posted: July 8, 2022
• Study Start: July 26, 2022
• Primary Completion: July 26, 2023
• Study Completion: July 26, 2023
• Last Updated: February 13, 2025

Record last verified: 2025-02

Locations

HK (1)