Abstract:
BACKGROUND:Posttraumatic stress disorder (PTSD) develops in 10-20% of injury patients. We developed a novel, self-guided Internet-based intervention (called Trauma TIPS) based on techniques from cognitive behavioral therapy (CBT) to prevent the onset of PTSD symptoms. OBJECTIVE:To determine whether Trauma TIPS is effective in preventing the onset of PTSD symptoms in injury patients. METHODS:Adult, level 1 trauma center patients were randomly assigned to receive the fully automated Trauma TIPS Internet intervention (n=151) or to receive no early intervention (n=149). Trauma TIPS consisted of psychoeducation, in vivo exposure, and stress management techniques. Both groups were free to use care as usual (nonprotocolized talks with hospital staff). PTSD symptom severity was assessed at 1, 3, 6, and 12 months post injury with a clinical interview (Clinician-Administered PTSD Scale) by blinded trained interviewers and self-report instrument (Impact of Event Scale-Revised). Secondary outcomes were acute anxiety and arousal (assessed online), self-reported depressive and anxiety symptoms (Hospital Anxiety and Depression Scale), and mental health care utilization. Intervention usage was documented. RESULTS:The mean number of intervention logins was 1.7, SD 2.5, median 1, interquartile range (IQR) 1-2. Thirty-four patients in the intervention group did not log in (22.5%), 63 (41.7%) logged in once, and 54 (35.8%) logged in multiple times (mean 3.6, SD 3.5, median 3, IQR 2-4). On clinician-assessed and self-reported PTSD symptoms, both the intervention and control group showed a significant decrease over time (P<.001) without significant differences in trend. PTSD at 12 months was diagnosed in 4.7% of controls and 4.4% of intervention group patients. There were no group differences on anxiety or depressive symptoms over time. Post hoc analyses using latent growth mixture modeling showed a significant decrease in PTSD symptoms in a subgroup of patients with severe initial symptoms (n=20) (P<.001). CONCLUSIONS:Our results do not support the efficacy of the Trauma TIPS Internet-based early intervention in the prevention of PTSD symptoms for an unselected population of injury patients. Moreover, uptake was relatively low since one-fifth of individuals did not log in to the intervention. Future research should therefore focus on innovative strategies to increase intervention usage, for example, adding gameplay, embedding it in a blended care context, and targeting high-risk individuals who are more likely to benefit from the intervention. TRIAL REGISTRATION:International Standard Randomized Controlled Trial Number (ISRCTN): 57754429; http://www.controlled-trials.com/ISRCTN57754429 (Archived by WebCite at http://webcitation.org/6FeJtJJyD).
journal_name
J Med Internet Resjournal_title
Journal of medical Internet researchauthors
Mouthaan J,Sijbrandij M,de Vries GJ,Reitsma JB,van de Schoot R,Goslings JC,Luitse JS,Bakker FC,Gersons BP,Olff Mdoi
10.2196/jmir.2460subject
Has Abstractpub_date
2013-08-13 00:00:00pages
e165issue
8eissn
1439-4456issn
1438-8871pii
v15i8e165journal_volume
15pub_type
杂志文章,随机对照试验abstract:BACKGROUND:The health risk assessment (HRA) is a type of health promotion program frequently offered at the workplace. Insight into the underlying determinants of participation is needed to evaluate and implement these interventions. OBJECTIVE:To analyze whether individual characteristics including demographics, healt...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.2387
更新日期:2013-08-09 00:00:00
abstract::Digital health is an advancing phenomenon in modern health care systems. Currently, numerous stakeholders in various countries are evaluating the potential benefits of digital health solutions at the individual, population, and/or organizational levels. Additionally, driving factors are being created from the customer...
journal_title:Journal of medical Internet research
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更新日期:2018-05-18 00:00:00
abstract:BACKGROUND:An understanding of the factors that predict retention and website use are critical to the development of effective Web-based weight loss interventions. However, poor retention (dropout attrition) and website utilization (nonusage attrition) are major inhibitors to the effectiveness of Web-based programs. O...
journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/jmir.1640
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abstract:BACKGROUND:Internet-based interventions using cognitive behavioral approaches can be effective in promoting self-management of chronic pain conditions. Web-based programs delivered via smartphones are increasingly used to support the self-management of various health disorders, but research on smartphone interventions ...
journal_title:Journal of medical Internet research
pub_type: 杂志文章,随机对照试验
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更新日期:2013-01-07 00:00:00
abstract:BACKGROUND:Demand for mental health services, especially for clinical high-risk and early psychosis, has increased, creating a need for new solutions to increase access to and quality of care. Smartphones and mobile technology are potential tools to support coordinated specialty care for early psychosis, given their po...
journal_title:Journal of medical Internet research
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abstract:BACKGROUND:E-liquid is one of the main components in electronic nicotine delivery systems (ENDS). ENDS review comments could serve as an early warning on use patterns and even function to serve as an indicator of problems or adverse events pertaining to the use of specific e-liquids-much like types of responses tracked...
journal_title:Journal of medical Internet research
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abstract:BACKGROUND:The increasing incidence of inflammatory bowel disease (IBD) has imposed heavy financial burdens for Chinese patients; however, data about their financial status and access to health care are still lacking. This information is important for informing patients with IBD about disease treatment budgets and heal...
journal_title:Journal of medical Internet research
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abstract:BACKGROUND:Worldwide nearly 3 million people die from chronic obstructive pulmonary disease (COPD) every year. Integrated disease management (IDM) improves quality of life for COPD patients and can reduce hospitalization. Self-management of COPD through eHealth is an effective method to improve IDM and clinical outcome...
journal_title:Journal of medical Internet research
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journal_title:Journal of medical Internet research
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journal_title:Journal of medical Internet research
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journal_title:Journal of medical Internet research
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journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
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journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
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更新日期:2010-06-16 00:00:00
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journal_title:Journal of medical Internet research
pub_type: 杂志文章
doi:10.2196/11087
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journal_title:Journal of medical Internet research
pub_type: 杂志文章,评审
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journal_title:Journal of medical Internet research
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journal_title:Journal of medical Internet research
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更新日期:2012-01-18 00:00:00
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journal_title:Journal of medical Internet research
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pub_type: 社论
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journal_title:Journal of medical Internet research
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journal_title:Journal of medical Internet research
pub_type: 杂志文章,随机对照试验
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更新日期:2012-12-17 00:00:00
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journal_title:Journal of medical Internet research
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journal_title:Journal of medical Internet research
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journal_title:Journal of medical Internet research
pub_type: 杂志文章
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journal_title:Journal of medical Internet research
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journal_title:Journal of medical Internet research
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更新日期:2018-04-18 00:00:00
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