@Article{info:doi/10.2196/34769,
author="Batterham, Philip J
and Gulliver, Amelia
and Kurz, Ella
and Farrer, Louise M
and Vis, Christiaan
and Schuurmans, Josien
and Calear, Alison L",
title="The Effect of Dissemination Pathways on Uptake and Relative Costs for a Transdiagnostic, Self-guided Internet Intervention for Reducing Depression, Anxiety, and Suicidal Ideation: Comparative Implementation Study",
journal="J Med Internet Res",
year="2022",
month="May",
day="6",
volume="24",
number="5",
pages="e34769",
keywords="implementation; mental health; adherence; uptake; internet",
abstract="Background: Self-guided web-based programs are effective; however, inadequate implementation of these programs limits their potential to provide effective and low-cost treatment for common mental health problems at scale. There is a lack of research examining optimal methods for the dissemination of web-based programs in the community. Objective: This study aimed to compare the uptake, reach, relative costs, and adherence associated with 3 community-based pathways for delivering a low-intensity web-based transdiagnostic mental health program. The 3 dissemination pathways were social media advertising, advertising in general practice, and advertising in pharmacies. Methods: Participants were recruited on the web, from general practices, or from community pharmacies; completed a screener for psychological distress; and were offered the 4-week FitMindKit program---a 12-module psychotherapeutic intervention. Uptake was defined as the number of participants who enrolled in the web-based program; reach was defined as the rate of uptake per exposure; and costs were calculated based on staff time, equipment, and advertising. Adherence was assessed as the number of modules of FitMindKit completed by the participants. Results: Uptake comprised 1014 participants who were recruited through the 3 dissemination pathways: on the web (991/1014, 97.73{\%}), in general practice (16/1014, 1.58{\%}), and in pharmacy (7/1014, 0.69{\%}). Reach was highest for social media: 1 in every 50 people exposed to web-based advertising took up the intervention compared with 1 in every 441 in general practitioner clinics and 1 in every 1708 in pharmacies. The dissemination cost was US {\$}4.87 per user on social media, US {\$}557 per user for general practitioner clinics, and US {\$}1272 per user for pharmacy dissemination. No significant differences in adherence were observed between the conditions, whereas all pathways showed an underrepresentation of men and linguistic diversity. Conclusions: The web-based dissemination pathway was the most efficient and cost-effective for delivering a self-guided internet-based mental health program to people in the community. More research is needed to identify how best to engage men and those with culturally diverse backgrounds in web-based interventions. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12618001688279; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376113 ",
issn="1438-8871",
doi="10.2196/34769",
url="https://www.jmir.org/2022/5/e34769",
url="https://doi.org/10.2196/34769",
url="http://www.ncbi.nlm.nih.gov/pubmed/35522458"
}