Evaluating discussion board engagement in the MoodSwings online self-help program for bipolar disorder: protocol for an observational prospective cohort study

BMC Psychiatry, Oct 2015

Background Online, self-guided programs exist for a wide range of mental health conditions, including bipolar disorder, and discussion boards are often part of these interventions. The impact engagement with these discussion boards has on the psychosocial well-being of users is largely unknown. More specifically we need to clarify the influence of the type and level of engagement on outcomes. The primary aim of this exploratory study is to determine if there is a relationship between different types (active, passive or none) and levels (high, mid and low) of discussion board engagement and improvement in outcome measures from baseline to follow up, with a focus on self-reported social support, stigma, quality of life and levels of depression and mania. The secondary aim of this study is to identify any differences in demographic variables among discussion users. Methods/design The present study is a sub-study of the MoodSwings 2.0 3-arm randomised controlled trial (discussion board only (arm 1), discussion board plus psychoeducation (arm 2), discussion board, psychoeducation plus cognitive behavioural therapy-based tools (arm 3)). Discussion engagement will be measured via online participant activity monitoring. Assessments include online self-report as well as blinded phone interviews at baseline, 3, 6, 9 and 12 months follow up. Discussion The results of this study will help to inform future programs about whether or not discussion boards are a beneficial inclusion in online self-help interventions. It will also help to determine if motivating users to actively engage in online discussion is necessary, and if so, what level of engagement is optimal to produce the most benefit. Future programs may benefit through being able to identify those most likely to poorly engage, based on demographic variables, so motivational strategies can be targeted accordingly. Trial registration ClinicalTrials.gov NCT02118623 registered April 15 2014 and NCT02106078 registered May 16 2013.

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Evaluating discussion board engagement in the MoodSwings online self-help program for bipolar disorder: protocol for an observational prospective cohort study

Gliddon et al. BMC Psychiatry Evaluating discussion board engagement in the MoodSwings online self-help program for bipolar disorder: protocol for an observational prospective cohort study Emma Gliddon 0 1 Sue Lauder 0 2 Lesley Berk 0 5 6 Victoria Cosgrove 3 4 David Grimm 4 Seetal Dodd 0 1 Trisha Suppes 3 4 Michael Berk 0 1 6 7 0 The Department of Psychiatry, The University of Melbourne , Parkville , Australia 1 IMPACT Strategic Research Centre, Deakin University , Geelong , Australia 2 The Collaborative Research Network, Federation University , Ballarat , Australia 3 Stanford University School of Medicine , Stanford, California , USA 4 VA Palo Alto Health Care System , Palo Alto, California , USA 5 School of Psychology, Deakin University , Burwood , Australia 6 Orygen - The National Centre of Excellence in Youth Mental Health , Parkville , Australia 7 Florey Institute for Neuroscience and Mental Health , Parkville , Australia Background: Online, self-guided programs exist for a wide range of mental health conditions, including bipolar disorder, and discussion boards are often part of these interventions. The impact engagement with these discussion boards has on the psychosocial well-being of users is largely unknown. More specifically we need to clarify the influence of the type and level of engagement on outcomes. The primary aim of this exploratory study is to determine if there is a relationship between different types (active, passive or none) and levels (high, mid and low) of discussion board engagement and improvement in outcome measures from baseline to follow up, with a focus on self-reported social support, stigma, quality of life and levels of depression and mania. The secondary aim of this study is to identify any differences in demographic variables among discussion users. Methods/design: The present study is a sub-study of the MoodSwings 2.0 3-arm randomised controlled trial (discussion board only (arm 1), discussion board plus psychoeducation (arm 2), discussion board, psychoeducation plus cognitive behavioural therapy-based tools (arm 3)). Discussion engagement will be measured via online participant activity monitoring. Assessments include online self-report as well as blinded phone interviews at baseline, 3, 6, 9 and 12 months follow up. Discussion: The results of this study will help to inform future programs about whether or not discussion boards are a beneficial inclusion in online self-help interventions. It will also help to determine if motivating users to actively engage in online discussion is necessary, and if so, what level of engagement is optimal to produce the most benefit. Future programs may benefit through being able to identify those most likely to poorly engage, based on demographic variables, so motivational strategies can be targeted accordingly. Bipolar disorder; Internet; Online; Support group; Mental health - May 16 2013 (NCT02106078) ACTRN12614000409673, U1111-1155-4445, 1R34MH091384, 1R34MH091284 Contact for public queries Emma Gliddon, BAppSci(Psych), BSci(Hons) Contact for scientific queries Prof Michael Berk, FFPsych, PhD Primary registry and trial identifying number Source(s) of monetary or material support Countries of recruitment Health condition(s) or problem(s) studied National Institute of Mental Health University of Melbourne VA Palo Alto Health Care System Moderated discussion board Date of first enrolment Observational prospective cohort design Intervention model: Single group Internet-Based Interventions for Bipolar Disorder (MoodSwings 2) Sub-study of a Randomized Trial of Internet-Based Interventions for Bipolar Disorder - Current diagnosis of bipolar I disorder, bipolar II disorder, or bipolar disorder not otherwise specified (NOS) verified with the Structured Clinical Interview for the Diagnostic Manual for Mental Disorders (SCID) mood disorders module. - Access to a computer with internet access. - Able to speak and read English proficiently. - Some degree of medical supervision of bipolar disorder (sees a health professional at least twice a year to discuss symptoms and treatment needs). - Local access to emergency care. - Current psychosis, as assessed in screening phone interview with the SCID psychotic screening module. - Acutely suicidal (defined as having a Hamilton Rating Scale for Depression [HAM-D] item 3 scores of = 3) - Current mania, assessed using the SCID mood disorder module. Medical Outcomes Study Social Support Survey (MOS-SSS) [Time Frame: Change from Baseline to 3 months, 6 months, 9 months and 12 months] Inventory of Stigma Experiences [Time Frame: Change from Baseline to 3 months, 6 months, 9 months and 12 months] Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) [Time Frame: Change from Baseline to 3 months, 6 months, 9 months and 12 months] Montgomery-Asberg Depression Rating Scale (MADRS) [Time Frame: Change from Baseline to 3 months, 6 months, 9 months and 12 months] Young Mania Rating Scale (YM (...truncated)


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Emma Gliddon, Sue Lauder, Lesley Berk, Victoria Cosgrove, David Grimm, Seetal Dodd, Trisha Suppes, Michael Berk. Evaluating discussion board engagement in the MoodSwings online self-help program for bipolar disorder: protocol for an observational prospective cohort study, BMC Psychiatry, 2015, pp. 243, 15, DOI: 10.1186/s12888-015-0630-7