背景:技术改善了青年心理干预的可及性。生态瞬时干预(EMI)是一种数字干预,旨在干预日常生活,以增强泛化性和生态有效性,并能够在最需要的时刻进行干预。确定使用生态瞬时干预措施的工作机制可能会产生改善干预措施的见解。
方法:本研究调查了生态瞬时干预的使用和可接受性的工作机制,叫SELFIE,针对暴露于童年创伤的青少年的自尊,并评估这些使用和可接受性机制在什么情况下发挥作用或不发挥作用。一个现实主义的评估方法被用于开发初始程序理论(数据:专家访谈和利益相关者焦点小组),并随后进行测试(数据:对参与者的15次采访,一个有治疗师的焦点小组,汇报问卷),精炼它们。
结果:SELFIE干预是通过智能手机应用程序提供的,能够持续提供干预,从而提高可访问性和可行性。当他们的个人智能手机提供干预时,这增强了隐私感,减少了参与应用程序的犹豫,导致信息披露和积极参与。Further,智能手机应用程序促进了日常生活中的技能实践,支持在不同情况下重复练习,从而实现效果的普遍性。缓冲技术故障对于减少其可能的负面影响似乎很重要。
结论:这项研究增强了我们对EMIs可能的工作机制的理解,例如持续的可用性支持增加的可访问性和可行性,在这种情况下,个人智能手机的使用是一种便利的环境。特此,目前的研究有助于在这一领域相对有限的研究。为了让这个领域向前发展,使用机制,需要了解EMIs的可接受性。强烈建议在特定目标机制的EMI功效试验的同时,进行了过程评估,以调查使用的工作机制。
背景:当前论文报道了SELFIE试验(荷兰试验注册NL7129(NTR7475))中的现实性评估。
BACKGROUND: Technology improves accessibility of psychological interventions for youth. An ecological momentary intervention (EMI) is a digital intervention geared toward intervening in daily life to enhance the generalizability and ecological validity, and to be able to intervene in moments most needed. Identifying working mechanisms of the use of ecological momentary interventions might generate insights to improve interventions.
METHODS: The present study investigates the working mechanisms of the use and acceptability of an ecological momentary intervention, named SELFIE, targeting self-esteem in youth exposed to childhood trauma, and evaluates under what circumstances these mechanisms of use and acceptability do or do not come into play. A realist evaluation approach was used for developing initial program theories (data: expert interviews and a stakeholders focus group), and subsequently testing (data: 15 interviews with participants, a focus group with therapists, debriefing questionnaire), and refining them.
RESULTS: The SELFIE intervention is offered through a smartphone application enabling constant availability of the intervention and thereby increasing accessibility and feasibility. When the intervention was offered on their personal smartphone, this enhanced a sense of privacy and less hesitance in engaging with the app, leading to increased disclosure and active participation. Further, the smartphone application facilitates the practice of skills in daily life, supporting the repeated practice of exercises in different situations leading to the generalizability of the effect. Buffering against technical malfunction seemed important to decrease its possible negative effects.
CONCLUSIONS: This study enhanced our understanding of possible working mechanisms in EMIs, such as the constant availability supporting increased accessibility and feasibility, for which the use of the personal smartphone was experienced as a facilitating context. Hereby, the current study contributes to relatively limited research in this field. For the field to move forward, mechanisms of use, and acceptability of EMIs need to be understood. It is strongly recommended that alongside efficacy trials of an EMI on specific target mechanisms, a process evaluation is conducted investigating the working mechanisms of use.
BACKGROUND: The current paper reports on a realist evaluation within the SELFIE trial (Netherlands Trial Register NL7129 (NTR7475)).