Table 3.
Summary of randomized trials using online crowdsourcing methods for recruitment, intervention delivery, and data collection in people with serious mental illness
| Studya | Origin | Designa | Sample | Recruitment | How
was diagnosis confirmed?c |
Study Duration |
Intervention | Comparison | Outcome Measuresd |
Results | Attritione | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Nb | % Male |
Strategy | Assessed for Eligibility (N) |
% | Reasons | |||||||||
| Jones et al (2014) [39] |
UK | RCT | 39 | 3 | Online advertisements through a national bipolar foundation, foundation meetings, newsletters, email blasts |
54 | Self-reported diagnosis of bipolar disorder (100%); score >9 on MDQ |
10 weeks | Web-based self- directed parenting intervention for bipolar parents (n=19) |
Waitlist control (n=20) |
Symptom
and parenting measures: MDQ; CES-D; ISS; SDQ; PS |
Significant improvement in child behavior and perceived parenting measures |
39 | Lost contact; dropout significantly greater in control group |
| Kaplan et al (2014) [41] |
US | RCT | 60 | 0 | Websites, e- news lists, organizational listservs |
378 | Mood disorder (87%) or schizophrenia spectrum disorder (13%) confirmed by doctor or therapist through release of information form |
3 months | Web-based parenting education and peer support listserv for mothers with SMI (n=31) |
Online healthy lifestyle facts and education (n=29) |
Symptom
and parenting measures: PSCS; HFPI; FCI; MOS |
Improved parenting and coping skills; decreased parental stress; no improvement in efficacy or support |
22 | Other illness, preference for face- to-face support, too busy |
| Kaplan et al (2011) [42] |
US | RCT | 300 | 34 | Websites targeting people with mental illness, e-news lists |
952 | Schizophrenia spectrum disorder (22%); mood disorders (78%) confirmed by doctor or therapist through release of information form |
12 months | Internet peer support via a listserv (n=101) or experimental Internet peer support via a bulletin board (n=99) |
Waitlist control (n=100) |
Measures of recovery, quality of life, empowerment, social support and distress: RAS; QOL; ES; MOS; HSCL; OGQ |
No differences between groups. Greater participation in Internet peer support resulted in higher levels of distress |
17 | Too many emails; content of the postings; poor fit; preference for face- to-face support; difficulty using the online format; lost website address; forgot login |
| Lauder et al (2015) [37] |
AU | RCT | 156 | 25 | Clinician referral, advertising via conferences and consumer and professional forums, online optimization strategies |
158 | Bipolar disorder (100%) confirmed by telephone clinical interview |
12 months | MoodSwings online program with moderated discussion board for coping and relapse prevention (n=78) |
MoodSwings- Plus online program with moderated discussion board and additional CBT-based elements (n=78) |
Measures of characteristics of bipolar disorder: ASRM; MADRS; Relapse; SCID; MOS; IPC; MARS; EGAM; GSEVDEP; GSEVMANIA; GPF; GQOL |
Reduced
mood symptoms, improvements in functionality, quality of life and medication adherence in both groups; Moodswings- Plus had greater improvements |
81 | Did not commence the program; computer problems; too busy; distressed by questionnaires; unknown. |
| Proudfoot et al (2012) [38] |
AU | RCT | 419 | 30 | Advertisements posted in online depression and bipolar disorder community, mental health organizations, and print media advertisements |
660 | Diagnosis of bipolar disorder (100%) within past 12 months confirmed using cut-off score on MSQ-27; current treated for bipolar disorder |
6 months | Online Bipolar Education Program (BEP) (n=139) or BEP enhanced with email support from peers who are successfully managing their illness (n=134) |
Attentional control with basic facts about bipolar disorder delivered online (n=134) |
Brief IPQ; GADS; WSAS; RSE; SWLS; MHLC; perceived stigma; daily mood ratings |
Increased perceptions of control, decreased perceptions of stigmatization, improvements in anxiety and depression across both groups |
36 | Did not complete intervention; lost contact. Higher adherence to BEP enhanced with peer support compared to BEP alone. Females and participants over age 30 showed greatest adherence |
| Simon et al (2011) [43] |
US | RCT | 118 | 28 | Email announcements through the Depression and Bipolar Support Alliance, advertisements online and in mental health clinics |
118 (No participants who chose to enroll were excluded) |
Bipolar disorder (100%) |
3 weeks | MyRecoveryPlan online education program supported with online peer coaching (n=64) |
Control
group received MyRecovery Plan only (n=54) |
Program retention |
Peer coaching increased program use (38% vs. 9% in control group) |
75 | Not specified |
| Todd et al (2014) [40] |
UK | RCT | 122 | 28 | Online advertisements and presentations at mental health organizations |
240 | Self-reported diagnosis of bipolar disorder (100%) confirmed using MDQ, and described using SCID |
6 months | Living with Bipolar (LWB) web-based self-management intervention and motivational email support (n=61) |
Wait-list control group (n=61) |
QoLBD-Brief; WHOQoL- BREF; BRQ; ISS; SASS; SMAI |
Feasibility demonstrated by high retention. LWB improved quality of life, wellbeing, depression, recovery, and social function compared to control |
14 | Lack of
time; bereavement; divorce; holiday; physical or mental health concerns |
RCT, randomized controlled trial
All participants were adults with SMI, defined as schizophrenia spectrum disorders (e.g., schizophrenia or schizoaffective disorder) or mood disorders (e.g., bipolar disorder or affective disorders).
MDQ, Mood Disorder Questionnaire; MSQ-27, Mood Swings Questionnaire; SCID, Structured Clinical Interview for DSM;
MDQ, Mood Disorder Questionnaire; CES-D, Center for Epidemiological Studies – Depression Scale; ISS, Internal States Scale; SDQ, Strengths and Difficulties Questionnaire; PS, Parenting Scale; PSCS, Parenting Sense of Competence Scale; HFPI, Healthy Families Parenting Inventory; FCI, Family Coping Inventory; MOS, Medical Outcomes Study Social Support Survey; RAS, Recovery Assessment Scale; QOL, Lehmans’ Quality of Life Interview; ES, Empowerment Scale; HSCL, Hopkins Symptoms Checklist; OGQ, Online Group Questionnaire; ASRM, Altman Self-Rating Mania Scale; MADRS, Montgomery-Asberg Depression Rating Scale Self-Assessment; SCID, Structured Clinical Interview for DSM; IPC, Levenson’s Internal, Powerful Others and Chance Locus of Control scale; MARS, Medication Adherence Rating Scale; EGAM, Exploratory Global Assessment Measures; GSEVDEP, Global measure of Severity of Depression; GSEVMANIA, Global measure of Severity of Mania; GPF, Global Measure of Psychosocial Functioning; GQOL, Global measure of Quality of Life; Brief IPQ, Brief Illness Perception Questionnaire; GADS, Goldberg Anxiety and Depression Scale; WSAS, Work and Social Adjustment Scale; RSE, Rosenberg Self-Esteem Scale; SWLS, Satisfaction With Life Scale; MHLC, Multidimensional Health Locus of Control; QoLBD-Brief, Quality of Life in Bipolar Disorder Scale Brief Version; WHOQoL-BREF, World Health Organisation Quality of Life assessment tool brief version; BRQ, Bipolar Recovery Questionnaire; ISS, Internal States Scale; SASS, Social Adaptation Self-Evaluation Scale;
Attrition rates are based on the number of enrolled participants who dropped out during the study. We do not report attrition based on the number of invited participants.