TY - JOUR AU - Zarski, ana - carlotta AU - Lehr, Dirk AU - Berking, Matthias AU - Riper, Heleen AU - Cuijpers, Pim AU - Ebert, David Daniel PY - 2016 DA - 2016/06/29 TI -坚持基于互联网的移动支持的压力管理:三个随机对照试验个体参与者数据的汇总分析[J] Med Internet Res SP - e146 VL - 18 IS - 6 KW -指导KW -治疗依从性KW -预测因子KW -互联网干预KW -工作压力KW -压力管理AB -背景:不遵守治疗是互联网干预中普遍存在的问题。来自卫生保健专业人员的指导已被发现可以提高对一系列身体和精神障碍的互联网干预的治疗依从率。评价不同强度的不同指导格式是重要的，特别是在提高效力和成本效益方面。识别不依从的预测因素可以使互联网干预措施更好地适应参与者的需求，特别是有停止治疗风险的参与者。目的:本研究的目的是调查不同的指导格式(以内容为中心的指导、以坚持为中心的指导和行政指导)对依从性的影响，并确定基于互联网的移动支持压力管理干预(即GET)中不遵守的预测因素。(关于压力)。方法:接受干预组的数据来自三个随机对照试验(rct)，这些试验评估了基于互联网的移动支持的压力管理干预的效果(N=395)。随机对照试验仅在指导格式方面有所不同(以内容为中心的指导vs候补名单控制，以坚持为中心的指导vs候补名单控制，行政指导vs候补名单控制)。依从性由完成治疗模块的数量来定义(0-7)。采用方差分析比较不同指导格式的依从率。 Multiple hierarchical linear regression analysis was conducted to evaluate predictors of nonadherence, which included gender, age, education, symptom-related factors, and hope for improvement. Results: In all, 70.5% (93/132) of the content-focused guidance sample, 68.9% (91/132) of the adherence-focused guidance sample, and 42.0% (55/131) of the participants in the administrative guidance sample completed all treatment modules. Guidance had a significant effect on treatment adherence (F2,392=11.64, P<.001; ω2=.05). Participants in the content-focused guidance (mean 5.70, SD 2.32) and adherence-focused guidance samples (mean 5.58, SD 2.33) completed significantly more modules than participants in the administrative guidance sample (mean 4.36, SD 2.78; t223=4.53, P<.001; r=.29). Content-focused guidance was not significantly associated with higher adherence compared to adherence-focused guidance (t262=0.42, P=.67; r=.03). The effect size of r=.03 (95% CI –0.09 to 0.15) did not pass the equivalence margin of r=.20 and the upper bound of the 95% CI lay below the predefined margin, indicating equivalence between adherence-focused guidance and content-focused guidance. Beyond the influence of guidance, none of the predictors significantly predicted nonadherence. Conclusions: Guidance has been shown to be an influential factor in promoting adherence to an Internet-based mobile-supported stress management intervention. Adherence-focused guidance, which included email reminders and feedback on demand, was equivalent to content-focused guidance with regular feedback while requiring only approximately a quarter of the coaching resources. This could be a promising discovery in terms of cost-effectiveness. However, even after considering guidance, sociodemographic, and symptom-related characteristics, most interindividual differences in nonadherence remain unexplained. Clinical Trial: DRKS00004749; http://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL _ID=DRKS00004749 (Archived by WebCite at http://www.webcitation.org/6QiDk9Zn8); DRKS00005112; http://drks-neu.uniklinik-freiburg. de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005112 (Archived by WebCite at http://www.webcitation.org/6QiDysvev); DRKS00005384; http://drks-neu.uniklinik-freiburg.de/ drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005384 (Archived by WebCite at http://www.webcitation.org/6QiE0xcpE) SN - 1438-8871 UR - //www.mybigtv.com/2016/6/e146/ UR - https://doi.org/10.2196/jmir.4493 UR - http://www.ncbi.nlm.nih.gov/pubmed/27357528 DO - 10.2196/jmir.4493 ID - info:doi/10.2196/jmir.4493 ER -