PDF(Pubmed)
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.
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.
摘要：
背景：家庭老年人是抑郁症的高危人群。然而,他们中的许多人在获得证据支持的心理健康治疗方面面临障碍。数字心理健康干预措施可能会改善治疗机会，但很少有基于网络的干预措施明确针对老年人的抑郁症。
目的：本文描述了Empower@Home的开发过程，一种基于认知行为疗法的针对居家老年人抑郁症的网络干预措施，并报告可用性研究的结果。
方法：Empower@Home是与社区机构合作开发的，利益相关者，和老年人，以用户为中心的设计原则。通过二次数据分析评估用户需求，来自行政数据的人口和健康概况，以及对社区合作伙伴的访谈和调查。对10名老年人进行了比较可用性评估，以评估Empower@Home与2个类似程序的可用性。对4个最终用户进行了现场测试，以检测其他可用性问题。
结果：来自社区合作伙伴的反馈和建议严重影响了Empower@Home的内容和设计。发言包括9次会议，包括心理教育和通过短片介绍认知行为治疗技能和工具，会期练习,一个动画故事情节，和每周一次的课外家庭练习。印刷工作簿伴随着基于网络的课程。在比较可用性测试中(N=10)，Empower@Home获得的系统可用性量表得分为78分（SD7.4），显着高于2个比较程序（t9=3.28；P=.005和t9=2.78；P=.011）。大多数参与者,80%(n=8)，首选Empower@Home而不是比较器。在纵向现场试验(n=4)中，所有参与者都表示喜欢该计划程序,并且对执行与计划相关的任务充满信心.单主题线图显示，随着时间的推移，他们的抑郁评分总体呈下降趋势，为干预措施的潜在影响提供了一个令人鼓舞的迹象。
结论：与社区利益相关者合作，并在设计过程中仔细考虑潜在的实施问题，可以提高可用性，引人入胜，和有效的数字心理健康干预措施。
目的：本文描述了Empower@Home的开发过程，一种基于认知行为疗法的针对居家老年人抑郁症的网络干预措施，并报告可用性研究的结果。
方法：Empower@Home是与社区机构合作开发的，利益相关者，和老年人，以用户为中心的设计原则。通过二次数据分析评估用户需求，来自行政数据的人口和健康概况，以及对社区合作伙伴的访谈和调查。对10名老年人进行了比较可用性评估，以评估Empower@Home与2个类似程序的可用性。对4个最终用户进行了现场测试，以检测其他可用性问题。
结果：来自社区合作伙伴的反馈和建议严重影响了Empower@Home的内容和设计。发言包括9次会议，包括心理教育和通过短片介绍认知行为治疗技能和工具，会期练习,一个动画故事情节，和每周一次的课外家庭练习。印刷工作簿伴随着基于网络的课程。在比较可用性测试中(N=10)，Empower@Home获得的系统可用性量表得分为78分（SD7.4），显着高于2个比较程序（t9=3.28；P=.005和t9=2.78；P=.011）。大多数参与者,80%(n=8)，首选Empower@Home而不是比较器。在纵向现场试验(n=4)中，所有参与者都表示喜欢该计划程序,并且对执行与计划相关的任务充满信心.单主题线图显示，随着时间的推移，他们的抑郁评分总体呈下降趋势，为干预措施的潜在影响提供了一个令人鼓舞的迹象。
结论：与社区利益相关者合作，并在设计过程中仔细考虑潜在的实施问题，可以提高可用性，引人入胜，和有效的数字心理健康干预措施。
