Browsing by Author "McCall, Hugh"
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Item Open AccessDoes Persuasive Design Predict Efficacy In Unguided iCBT? A Meta-Regression Analysis(Faculty of Graduate Studies and Research, University of Regina, 2020-08) McCall, Hugh; Hadjistavropoulos, Heather; Asmundson, Gordon; Sharpe, Donald; Olthuis, JanineMental health disorders such as depression and anxiety are leading contributors to the global disease burden. However, a large proportion of people with mental health disorders remain untreated, often due to a lack of nearby services, logistic barriers (e.g., work schedules), stigma, the cost of treatment, and other barriers. Internet-delivered cognitive behavioural therapy (iCBT) without therapist guidance represents a promising solution to this problem, as it is cost-effective, convenient for users, and possible to implement on a large scale. Various persuasive design elements—features or design principles intended to make interventions more engaging—have been proposed and implemented to improve adherence and outcomes among users of unguided iCBT. However, no review to date has determined the extent to which persuasive design elements predict the efficacy of unguided iCBT interventions. The present study consisted of a systematic review, meta-analysis, and meta-regression of unguided iCBT interventions for depression and anxiety. A search of five databases and a hand search yielded a total of 41 articles describing 45 comparisons (N = 10,301) of iCBT conditions and control conditions. The meta-analyses revealed a small to moderate weighted mean effect size (Hedges’ g = 0.29) for unguided iCBT for depression and a moderate effect size (Hedges’ g = 0.48) for unguided iCBT for anxiety. Meta-regression analyses indicated that greater use of persuasive design predicted greater efficacy in unguided iCBT for depression but not anxiety. However, this research was exploratory in nature, and further research will be required to clarify the role of persuasive design in unguided iCBT and its relationship to treatment outcomes. Item Open AccessHow have public safety personnel seeking digital mental healthcare been affected by the COVID-19 pandemic? An exploratory mixed methods study(Multidisciplinary Digital Publishing Institute, 2020-12-13) McCall, Hugh; Beahm, Janine; Landry, Caeleigh; Huang, Ziyin; Carleton, R. Nicholas; Hadjistavropoulos, HeatherPublic safety personnel (PSP) experience unique occupational stressors and suffer from high rates of mental health problems. The COVID-19 pandemic has impacted virtually all aspects of human life around the world and has introduced additional occupational stressors for PSP. The objective of this study was to explore how PSP, especially those seeking digital mental health services, have been affected by the pandemic. Our research unit, PSPNET, provides internet-delivered cognitive behavioral therapy to PSP in the Canadian province of Saskatchewan. When the pandemic spread to Saskatchewan, PSPNET began inquiring about the impact of the pandemic on prospective clients during the eligibility screening process. We used content analysis to analyze data from telephone screening interviews (n = 56) and descriptive statistics to analyze data from a questionnaire concerning the impacts of COVID-19 (n = 41). The results showed that most PSP reported facing several novel emotional challenges (e.g., social isolation, boredom, anger, and fear) and logistical challenges (e.g., related to childcare, finances, work, and access to mental healthcare). Most participants indicated they felt at least somewhat afraid of contracting COVID-19 but felt more afraid of their families contracting the virus than themselves. However, few participants reported severe challenges of any kind, and many (40%) indicated that they had not been significantly negatively impacted by the pandemic. Overall, the results suggest that PSP are not expressing significant concern at this time in meeting the novel challenges posed by COVID-19. Continued research will be required to monitor how diverse PSP populations and treatment outcomes are affected by the pandemic as the situation evolves. Item Open AccessInternet-delivered cognitive behavioural therapy for symptoms of PTSD among public safety personnel: Initial outcomes of an open cohort preference trial of transdiagnostic and disorder-specific therapy(Elsevier, 2023-09-09) McCall, Hugh; Dear, Blake, F.; Landry, Caeleigh; Beahm, Janine D.; Gregory, Julia; Titov, Nickolai; Carleton, R. Nicholas; Hadjistavropoulos, Heather D.Public safety personnel (PSP) face high rates of mental health problems and many barriers to care. Initial outcomes of transdiagnostic internet-delivered cognitive behavioural therapy (ICBT) tailored for PSP are promising, but prior research has not evaluated outcomes of PTSD-specific ICBT among PSP or PSP's preferences for transdiagnostic or PTSD-specific ICBT. The current paper presents the initial outcomes (N = 150) of a mixed-methods observational study designed to (a) investigate preferences for transdiagnostic or PTSD-specific ICBT among PSP with elevated symptoms of PTSD and/or a primary concern with PTSD symptoms and (b) explore potential differences in client engagement, satisfaction, and symptom changes between the two forms of ICBT. PSP completed questionnaires before and after their preferred ICBT program. Mixed-methods analyses included generalized estimating equations, descriptive statistics, and inductive conventional qualitative content analysis. More clients (n = 85; 57 %) selected transdiagnostic ICBT than PTSD-specific ICBT (n = 65; 43 %), but the difference in the number of clients who selected each course was not statistically significant. Clients in both ICBT programs reported similar and favorable treatment satisfaction (e.g., 98 % would recommend the course to a friend), treatment engagement (i.e., 69 % accessed at least four of the five lessons), and pre-post improvement in symptoms (e.g., Hedges' g = 0.81 for reduction in PTSD symptom). Transdiagnostic ICBT resulted in greater reductions in symptoms of panic disorder than PTSD-specific ICBT. Qualitative analyses showed similarities across the ICBT programs in client feedback. The current study provides further evidence supporting the use and outcomes of ICBT for PSP in both transdiagnostic and disorder-specific formats. Implications for the literatures on PSP mental health and ICBT, as well as practical recommendations, are discussed.