A Web-Based Stratified Stepped Care Mental Health Platform (TourHeart): Semistructured Interviews With Stakeholders

JMIR Hum Factors. 2022 May 13;9(2):e35057. doi: 10.2196/35057.

Abstract

Background: TourHeart, a web-based stratified stepped care mental health platform, is a one-stop solution that integrates psychoeducation and other well-being promotional tools for mental health promotion and mental illness prevention and evidence-based, low-intensity psychological interventions for the treatment of people with anxiety and depressive symptoms. Instead of focusing only on symptom reduction, the platform aims to be person-centered and recovery-oriented, and continual feedback from stakeholders is sought. Understanding the perspectives of users and service providers enables platform developers to fine-tune both the design and content of the services for enhanced service personalization and personal recovery.

Objective: This qualitative study evaluated a web-based mental health platform by incorporating the perspectives of both users and service providers who administered the platform and provided coaching services. The platform included both web-based and offline services targeting adults along the mental health spectrum based on the two-continua model of mental health and mental illness.

Methods: Interview questions were designed based on the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework (RE-AIM). Views on offline services, the design of the web-based platform, user experience, and the contents of the platform were explored using semistructured interviews. A total of 27 service users and 22 service providers were recruited using purposive criterion sampling. A hybrid thematic analysis was performed to identify salient aspects of users' and providers' experiences with and views of the platform.

Results: Totally, 3 broad themes (namely, the quality of the platform, drivers for platform use, and coaching services) emerged from the interview data that highlighted users' views of and experiences with the web-based platform. The platform's general esthetics, operations, and contents were found to be critical features and drivers for continued use. Although coaching services were indispensable, participants preferred the autonomy and anonymity associated with web-based mental health services.

Conclusions: This study highlights the importance of web-based mental health services being easy to navigate and understand, being user-centric, and providing adequate guidance in self-help. It also confirms existing design standards and recommendations and suggests that more rigorous, iterative user experience research and robust evaluation should be conducted in the future adaptation of web-based stratified stepped care services, so that they can be more personalized and better promote personal recovery.

Keywords: eHealth; engagement; mental health; mental well-being; psychological intervention; recovery; stepped care.