TY -的盟Donkin Liesje AU - Hickie,伊恩·B非盟-克里斯滕森海伦AU -奈史密斯,Sharon L AU - Neal,布鲁斯AU -安乐乡,尼科尔·L AU - Glozier尼克PY - 2013 DA - 2013/10/17 TI -反思用法和剂量反应关系的结果在一个在线干预抑郁症:随机对照试验乔- J地中海互联网Res SP - e231六世- 15 - 10 KW -坚持KW -互联网KW -电子健康KW -抑郁KW -病人的依从性AB -背景:现在有大量证据表明，基于网络的干预可以有效地改变行为并成功地治疗心理障碍。然而，对使用对干预结果的影响的兴趣是最近才发展起来的。到目前为止，干预的持久性或完成度是最常见的使用指标，但这并不能充分描述用户的在线行为。分析使用的替代测量方法及其与结果的关系可能有助于了解干预使用者可能需要多少干预才能从该计划中获得临床显著益处。目的:本研究的目的是确定哪些使用指标(如果有的话)与在线抑郁症治疗试验的结果相关。心血管风险E-couch抑郁结局(CREDO)是一项随机对照试验，评估了基于认知行为疗法和人际疗法的无指导网络项目(E-couch)对抑郁症和心血管疾病患者的治疗效果。总共有280名参与试验的参与者开始了该项目，分为12个模块，包含文本和活动页面。使用数据(例如，登录的数量、完成的模块、在线花费的时间和完成的活动)由程序接口自动捕获。我们估计了这些指标和复合指标与患者健康问卷(PHQ-9)抑郁评分≥5分的临床显著改善结果的相关性。 Results: In all, 214/280 (76.4%) participants provided outcome data at the end of the 12-week period and were included in the analysis. Of these, 94 (43.9%) participants obtained clinically significant improvement. Participants logged into the program an average of 18.7 times (SD 8.3) with most (62.1%, 133/214) completing all 12 modules. Average time spent online per log-in was 17.3 minutes (SD 10.5). Participants completed an average of 9 of 18 activities available within the program. In a multivariate regression model, only the number of activities completed per log-in was associated with a clinically significant outcome (OR 2.82, 95% CI 1.05-7.59). The final model predicted 7.4% of variance in outcome. Curve estimates indicated that significant logarithmic (P=.009) and linear (P=.002) relationships existed between activities completed per log-in and clinically significant change. Conclusions: Only one objective measure of usage was independently associated with better outcome of a Web-based intervention of known effectiveness. The 4 usage metrics retained in the final step of the regression accounted for little outcome variance. Medium level users appeared to have little additional benefit compared to low users indicating that assumptions of a linear relationship between use and outcome may be too simplistic and further models and variables need to be explored to adequately understand the relationship. Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12610000085077; http://www.anzctr.org.au/ACTRN12610000085077.aspx (Archived by WebCite at http://www.webcitation.org/6K9FQtKBn). SN - 14388871 UR - //www.mybigtv.com/2013/10/e231/ UR - https://doi.org/10.2196/jmir.2771 UR - http://www.ncbi.nlm.nih.gov/pubmed/24135213 DO - 10.2196/jmir.2771 ID - info:doi/10.2196/jmir.2771 ER -