Table 2.

Design principles resulting from the evidence synthesis.

Evidence synthesis	Resulting design principle
Barriers to accessing face-to-face mental health and well-being services in rural areas include cost, time, stigma, a lack of anonymity in country towns, a general lack of understanding of mental health issues, and the lack of availability of services [5,16,52-58].	Web-based resources may help to address barriers to the access and availability of services.
Barriers to help seeking for mental health issues among farmers include the desire for control, self-reliance, tendency to minimize the problem, and resignation [14,37]. Farmers prefer anonymous self-help books or internet resources [59].	Self-help resources align with farmers’ desire for control, self-reliance, and anonymity.
Farmers are often isolated and perceive a lack of understanding of rural issues from outsiders [6,38]. Many farmers report difficulty understanding health care professionals [14] and that health care professionals do not understand them and their way of life [6,53]. However, there is a high level of community trust within rural Australia [39], suggesting that a resource designed by farmers and for farmers may be considered credible.	Having a clear farming focus and co-designing alongside farmers is needed to ensure relevance and acceptability.
Managing uncertainty is a key challenge resulting from drought and a stressor that many farmers do not feel equipped to manage [6]. They are generally already good at solving problems, so they are less likely to benefit from assistance with that.	Uncertainty about the future is a key stressor that farmers need help with managing.
Information provision and educational resources alone are not enough to change key behaviors and thought processes [60]. Evidence-based behavior change techniques (eg, modeling, self-monitoring, and goal setting) should be built into web-based interventions to maximize the effect [33,61].	An interactive, engaging resource is needed.
Farmers who adopt acceptance as a coping strategy and do not engage in behavioral disengagement (giving up) are less likely to experience distress when faced with significant stressors during drought [40].	Acceptance is an effective coping strategy for farmers in this context.
ACTa is a transdiagnostic, evidence-based psychotherapeutic approach that can foster acceptance and committed action (opposite of giving up) and improve well-being in a nonpathologizing way [62]. ACT may be used to address a range of psychological disorders and promote general well-being in nonclinical samples [62-64], including via web-based interventions [64,65]. It is particularly suited to contexts where the stressor must be accepted or cannot be fixed [66].	ACT may be an appropriate therapeutic model for this context.
Strategies to improve intervention adherence and effectiveness must also be included (eg, tunneling, personalization, and reminders) [33,67-69].	Issues relating to web-based intervention adherence need to be addressed.

^aACT: acceptance and commitment therapy.