Evaluation of a web-based decision aid for depression: a mixed-methods study

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Zacharias, Bradley D.
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Decision aids are intended to inform and empower healthcare consumers in their treatment decisions in an increasingly complex decision-making context where there are often numerous evidence-based treatment options across which to navigate risk/benefit tradeoffs. Evidence-based depression treatments now span several modalities including pharmacological and psychosocial approaches. Given a complex decision-making task, there is the need for consumer decision aids containing sufficient high quality evidence-based information presented in a balanced way in order to navigate options and make informed, values-congruent decisions. Of concern is the relative lack of decision support materials targeted toward adolescents and young adults (18-25 years of age), especially given high incidence rates of mental health problems and lower rates of treatment seeking. The purpose of this study was to examine young adults’ evaluations of the content of a new web-based depression treatment decision aid. The project involved a sequential exploratory mixed-methods design, consisting of a qualitative study followed by a quantitative study. Study 1 involved collection and framework analysis of interview data from a sample of 10 young adults with a history of depression treatment. Results are reported in terms of participants’ familiarity as well as approval for the clarity, amount, balance, trustworthiness, completeness, and helpfulness of the information. Participants also made numerous suggestions for improvement. These suggestions were vetted and many were incorporated into a revised decision aid which was then quantitatively evaluated in Study 2 by 175 Introductory Psychology students. Study 2 variables included participant ratings of the amount, clarity, balance, trustworthiness, and helpfulness of the information. Associations across sociodemographics, evaluative ratings, and time spent on topics were explored. The findings have implications regarding strategies to develop high quality, consumer sensitive information to facilitate informed decision making in young adults. Given that the Internet is increasingly used to search for health information, combined with research indicating acceptability of health websites by young adults, the availability of these materials on the Web may be particularly helpful to support decision-making about treatment for depression for this group.
Decison, Aids