A Systematic Review of Predictors of, and Reasons for, Adherence to Online Psychological Interventions
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A key issue regarding the provision of psychological therapy in a self-guided online format is low rates of adherence. The aim of this systematic review was to assess both quantitative and qualitative data on the predictors of adherence, as well as participant reported reasons for adhering or not adhering to online psychological interventions.
Database searches of PsycINFO, Medline, and CINAHL identified 1721 potentially relevant articles published between 1 January 2000 and 25 November 2015. A further 34 potentially relevant articles were retrieved from reference lists. Articles that reported predictors of, or reasons for, adherence to an online psychological intervention were included.
A total of 36 studies met the inclusion criteria. Predictors assessed included demographic, psychological, characteristics of presenting problem, and intervention/computer-related predictors. Evidence suggested that female gender, higher treatment expectancy, sufficient time, and personalized intervention content each predicted higher adherence. Age, baseline symptom severity, and control group allocation had mixed findings. The majority of assessed variables however, did not predict adherence.
Few clear predictors of adherence emerged overall, and most results were either mixed or too preliminary to draw conclusions. More research of predictors associated with adherence to online interventions is warranted.
KeywordsTreatment adherence Self-help Online Psychological Intervention
Our thanks to the members of the Flinders Centre for Innovation in Cancer Survivorship Group, Dr. Emma Kemp and Prof. Bogda Koczwara, for assisting Ms. Binnion during her Masters candidature and for providing feedback on early drafts of this manuscript.
Compliance with Ethical Standards
This work was conducted as part of a larger clinical trial, supported by the National Health and Medical Research Council (grant number 1042942).
Declaration of Conflicting Interests
Author Lisa Beatty has received research grants from the National Health and Medical Research Council (grant number 1042942). Author Claire Binnion declares that she has no conflict of interest.
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