Reach, uptake, and psychological outcomes of two publicly funded internet-based cognitive behavioural therapy programs in Ontario, Canada: an observational study.

Background: Access to traditional mental health services in Canada remains limited, prompting exploration into digital alternatives. The Government of Ontario initiated access to two internet-based cognitive behavioral therapy (iCBT) programs, LifeWorks AbilitiCBT and MindBeacon TAiCBT, for adults w...

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Publicado en:International Journal of Mental Health Systems Vol. 18; no. 1; pp. 1 - 15
Autores principales: Khan, Bilal Noreen, Liu, Rebecca H., Chu, Cherry, Bolea-Alamañac, Blanca, Nguyen, Megan, Thapar, Serena, Fanaieyan, Roz, Leon-Carlyle, Marisa, Tadrous, Mina, Kurdyak, Paul, O'Riordan, Anne, Keresteci, Maggie, Bhattacharyya, Onil
Formato: research tables/charts Journal Article
Publicado: BioMed Central 11/7/2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 11/7/2024
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        atl: Reach, uptake, and psychological outcomes of two publicly funded internet-based cognitive behavioural therapy programs in Ontario, Canada: an observational study.
      aug:
        au:
          Khan, Bilal Noreen
          Liu, Rebecca H.
          Chu, Cherry
          Bolea-Alamañac, Blanca
          Nguyen, Megan
          Thapar, Serena
          Fanaieyan, Roz
          Leon-Carlyle, Marisa
          Tadrous, Mina
          Kurdyak, Paul
          O'Riordan, Anne
          Keresteci, Maggie
          Bhattacharyya, Onil
        affil: https://ror.org/03cw63y62 Women's College Hospital, 76 Grenville St, M5S 1B2, Toronto, ON, Canada
      sug:
        subj:
          Cognitive Therapy
          Internet-Based Intervention
          Program Evaluation
          Mental Health Services Ontario
          Mental Disorders Therapy
          Financing, Government
          Government Programs Ontario
          Treatment Outcomes
          Human
          Nonexperimental Studies
          Ontario
          Secondary Analysis
          Retrospective Design
          Text Messaging
          Anxiety
          Depression
          Questionnaires
          Female
          Male
          Adolescence
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Descriptive Statistics
          Race Factors
          Ethnic Groups
          Pretest-Posttest Design
          Funding Source
          White Persons
          Urban Population
          Recovery
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: Background: Access to traditional mental health services in Canada remains limited, prompting exploration into digital alternatives. The Government of Ontario initiated access to two internet-based cognitive behavioral therapy (iCBT) programs, LifeWorks AbilitiCBT and MindBeacon TAiCBT, for adults with mental health issues. Methods: An uncontrolled observational study utilizing secondary retrospective program data was conducted to evaluate the reach, uptake, and psychological symptom changes among participants engaging with either iCBT program. Results: Between May 2020 and September 2021, 56,769 individuals enrolled in LifeWorks AbilitiCBT, and 73,356 in MindBeacon TAiCBT. However, substantial exclusions were made: 56% of LifeWorks participants and 68% of MindBeacon participants were ineligible or failed to initiate treatment. Consequently, 25,154 LifeWorks participants and 23,795 MindBeacon participants were included in the analysis. Of these, 22% of LifeWorks and 26% of MindBeacon participants completed over 75% of iCBT treatment. On average, LifeWorks participants received 13 ± SD 7.1 therapist messages and sent 5 ± SD 10.3 messages, while MindBeacon participants received 25 ± SD 20.7 therapist messages and sent 13 ± SD 16.4 messages. LifeWorks included synchronous therapist contact averaging 1.4 ± SD 1.9 h per participant, while MindBeacon was purely asynchronous. Baseline severity of anxiety (37%) and depression symptoms (22%) was higher for LifeWorks participants compared to MindBeacon participants (24% and 10%, respectively). Clinically significant changes in anxiety and depression scores were observed: 22% of LifeWorks and 31% of MindBeacon participants exhibited reliable recovery in PHQ-9 scores, while 26% of LifeWorks and 25% of MindBeacon participants demonstrated reliable recovery in GAD-7 scores. Conclusion: In conclusion, iCBT programs show promise for engaged participants with varying levels of severity in anxiety and depression symptoms. Future iterations of iCBT should consider adopting a broad entry criterion to iCBT programming to increase accessibility, especially for those with severe symptoms, alongside integrated intake care pathways, and potential payment structure adjustments for iCBT service providers. Taken all together, these factors could temper high dropout rates post-intake assessment. This evaluation underscores the potential and value of digital mental health interventions for individuals with mild to severe anxiety or depression symptoms, emphasizing the importance of addressing participant dropout.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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