Integrating online communities and social networks with computerised treatment for insomnia: a qualitative study of service user and primary health care professional perspectives

Siriwardena, A. Niroshan and Middlemass, Jo and Davy, Zowie and Cavanagh, Kate and Linehan, Conor and Morgan, Kevin and Lawson, Shaun (2012) Integrating online communities and social networks with computerised treatment for insomnia: a qualitative study of service user and primary health care professional perspectives. In: SAPC 41st Annual Scientific Meeting, 3-4 October 2012, Scottish Exhibition and Conference Centre, Glasgow, UK. (Unpublished)

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Integrating online communities and social networks with computerised treatment for insomnia: a qualitative study of service user and primary health care professional perspectives
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Abstract

The problem: Insomnia is the most commonly reported psychological complaint in Britain. Although hypnotic drugs are widely used for treatment of insomnia, they are only licensed short term and adverse effects are common. Cognitive Behavioural Therapy for insomnia (CBT-I), which is effective and safe long term, is recommended first line but is not widely used nor available, in part because of the lack of trained providers. In response to this, Computerised Cognitive Behavioural Therapy (CCBT) has been advocated. Existing CCBT programmes can suffer from poor rates of uptake, adherence and completion. We aimed to investigate patients and practitioners’ views on how CCBT for insomnia (CCBT-I) could be improved by incorporating features of modern technology including social networking functions.
The approach: We used a qualitative design and the theory of planned behaviour to underpin the study. Interviews and focus groups were held with adult service users and health professionals using a topic guide designed to elicit participants’ beliefs, intentions and controlling factors that might facilitate or create barriers to the uptake and adherence to CCBT-I. We explored the data using thematic analysis supported by Nvivo.
Findings: We interviewed 23 health professionals and 28 patients. We identified multi-faceted issues focused on meta-themes of trust and functionality which were perceived to increase likelihood of successful uptake and adherence. Trust and confidence would be increased if CCBT-I was perceived to be evidence-based and accredited; when referral was from a trusted professional within a supervised package of care; and when online support and follow-up were provided. Interaction with other users, by integrating CCBT-I with social networking, was perceived to provide mutual support but concerns from people with sleep problems included apprehension about online ‘strangers’ and concerns from practitioners included information security. Asynchronous communication such as posting a note, commenting on a forum or adding to a thread was considered safer than engaging in real-time on-line communication. To improve functionality patients wanted mobile applications; access in short periods; self-assessment of insomnia and its causes; more personalised information on sleep; an interactive approach; and contact with other users to be moderated or overseen.
Consequences: Although previous qualitative studies have looked at CCBT uptake and adherence, none have looked at insomnia exclusively or explored the feasibility, advantages and drawbacks of online communication between participants. Improving uptake and adherence to online programmes for insomnia requires attention to design features which are focused on trust and functionality. Although computerised therapies for insomnia would allow more people to access treatment, some would not be suitable for online therapies because of lack of online access or poor computer literacy. The results of the study are being used the development of a novel platform for CCBT for insomnia and other health conditions.

Item Type:Conference or Workshop Item (Presentation)
Additional Information:The problem: Insomnia is the most commonly reported psychological complaint in Britain. Although hypnotic drugs are widely used for treatment of insomnia, they are only licensed short term and adverse effects are common. Cognitive Behavioural Therapy for insomnia (CBT-I), which is effective and safe long term, is recommended first line but is not widely used nor available, in part because of the lack of trained providers. In response to this, Computerised Cognitive Behavioural Therapy (CCBT) has been advocated. Existing CCBT programmes can suffer from poor rates of uptake, adherence and completion. We aimed to investigate patients and practitioners’ views on how CCBT for insomnia (CCBT-I) could be improved by incorporating features of modern technology including social networking functions. The approach: We used a qualitative design and the theory of planned behaviour to underpin the study. Interviews and focus groups were held with adult service users and health professionals using a topic guide designed to elicit participants’ beliefs, intentions and controlling factors that might facilitate or create barriers to the uptake and adherence to CCBT-I. We explored the data using thematic analysis supported by Nvivo. Findings: We interviewed 23 health professionals and 28 patients. We identified multi-faceted issues focused on meta-themes of trust and functionality which were perceived to increase likelihood of successful uptake and adherence. Trust and confidence would be increased if CCBT-I was perceived to be evidence-based and accredited; when referral was from a trusted professional within a supervised package of care; and when online support and follow-up were provided. Interaction with other users, by integrating CCBT-I with social networking, was perceived to provide mutual support but concerns from people with sleep problems included apprehension about online ‘strangers’ and concerns from practitioners included information security. Asynchronous communication such as posting a note, commenting on a forum or adding to a thread was considered safer than engaging in real-time on-line communication. To improve functionality patients wanted mobile applications; access in short periods; self-assessment of insomnia and its causes; more personalised information on sleep; an interactive approach; and contact with other users to be moderated or overseen. Consequences: Although previous qualitative studies have looked at CCBT uptake and adherence, none have looked at insomnia exclusively or explored the feasibility, advantages and drawbacks of online communication between participants. Improving uptake and adherence to online programmes for insomnia requires attention to design features which are focused on trust and functionality. Although computerised therapies for insomnia would allow more people to access treatment, some would not be suitable for online therapies because of lack of online access or poor computer literacy. The results of the study are being used the development of a novel platform for CCBT for insomnia and other health conditions.
Keywords:insomnia, Cognitive Behavioural Therapy for Insomnia, computertised cognitive behavioural therapy, social networks, online communities, qualitative study, interprofessional working
Subjects:B Subjects allied to Medicine > B230 Pharmacy
B Subjects allied to Medicine > B714 Practice Nursing
A Medicine and Dentistry > A300 Clinical Medicine
B Subjects allied to Medicine > B760 Mental Health Nursing
Divisions:College of Social Science > School of Health & Social Care
College of Science > School of Computer Science
ID Code:6457
Deposited By: Niro Siriwardena
Deposited On:07 Oct 2012 11:10
Last Modified:02 Sep 2014 09:08

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