Journal article
Web-Based Cognitive Behavioral Therapy for Depression Among Homebound Older Adults: Development and Usability Study
JMIR aging, Vol.6(1), p.e47691
09/19/2023
DOI: 10.2196/47691
PMID: 37725423
Abstract
Background: Homebound older adults are a high-risk group for depression. However, many of them face barriers to accessing evidence-supported mental health treatments. Digital mental health interventions can potentially improve treatment access, but few web-based interventions are explicitly tailored for depression in older adults.Objective: This paper describes the development process of Empower@Home, a web-delivered intervention for depression in homebound older adults that is based on cognitive behavioral therapy, and reports on the outcomes of usability studies. Methods: Empower@Home was developed in collaboration with community agencies, stakeholders, and older adults, guided by user-centered design principles. User needs were assessed through secondary data analysis, demographic and health profiles from administrative data, and interviews and surveys of community partners. A comparative usability evaluation was conducted with 10 older adults to assess the usability of Empower@Home compared to 2 similar programs. Field testing was conducted with 4 end users to detect additional usability issues.Results: Feedback and recommendations from community partners heavily influenced the content and design of Empower@Home. The intervention consists of 9 sessions, including psychoeducation and an introduction to cognitive behavioral therapy skills and tools through short video clips, in-session exercises, an animated storyline, and weekly out-of-session home practice. A printed workbook accompanies the web-based lessons. In comparative usability testing (N=10), Empower@Home received a System Usability Scale score of 78 (SD 7.4), which was significantly higher than the 2 comparator programs (t9=3.28; P=.005 and t9=2.78; P=.011). Most participants, 80% (n=8), preferred Empower@Home over the comparators. In the longitudinal field test (n=4), all participants reported liking the program procedures and feeling confident in performing program-related tasks. The single-subject line graph showed an overall downward trend in their depression scores over time, offering an encouraging indication of the intervention's potential effects.Conclusions: Collaboration with community stakeholders and careful consideration of potential implementation issues during the design process can result in more usable, engaging, and effective digital mental health interventions.
Details
- Title: Subtitle
- Web-Based Cognitive Behavioral Therapy for Depression Among Homebound Older Adults: Development and Usability Study
- Creators
- Xiaoling Xiang - University of MichiganJay Kayser - University of MichiganSamson Ash - University of MichiganChuxuan Zheng - University of MichiganYihang Sun - Columbia UniversityAddie Weaver - University of MichiganRuth Dunkle - University of MichiganJames A. Blackburn - University of MichiganAlex Halavanau - Stanford UniversityJia Xue - University of TorontoJoseph A. Himle - University of Michigan
- Resource Type
- Journal article
- Publication Details
- JMIR aging, Vol.6(1), p.e47691
- DOI
- 10.2196/47691
- PMID
- 37725423
- NLM abbreviation
- JMIR Aging
- ISSN
- 2561-7605
- eISSN
- 2561-7605
- Publisher
- Jmir Publications, Inc
- Number of pages
- 14
- Grant note
- Michigan Health Endowment Fund
- Language
- English
- Date published
- 09/19/2023
- Academic Unit
- School of Social Work
- Record Identifier
- 9985223624302771
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