Reducing suicidal ideation among Turkish migrants in the Netherlands and in the UK: the feasibility of a randomised controlled trial of a guided online intervention
Abstract Background The evidence for the effectiveness of e-mental health interventions among ethnic minorities is still preliminary. This mixed methods study investigates the feasibility of a culturally adapted, guided online intervention with the intention to understand how it works and for whom t...
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | Pilot and Feasibility Studies |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40814-021-00772-9 |
| _version_ | 1818615904034881536 |
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| author | Ozlem Eylem Annemieke van Straten Leonore de Wit Shanaya Rathod Kamaldeep Bhui Ad J. F. M. Kerkhof |
| author_facet | Ozlem Eylem Annemieke van Straten Leonore de Wit Shanaya Rathod Kamaldeep Bhui Ad J. F. M. Kerkhof |
| author_sort | Ozlem Eylem |
| collection | DOAJ |
| description | Abstract Background The evidence for the effectiveness of e-mental health interventions among ethnic minorities is still preliminary. This mixed methods study investigates the feasibility of a culturally adapted, guided online intervention with the intention to understand how it works and for whom to inform refinement. It also examines its likely effectiveness in reducing suicidal ideation when compared with the treatment as usual. Methods Turkish migrants with mild to moderate suicidal thoughts were recruited from the general population using social media and newspaper advertisements. The intervention group obtained direct access to a 6-week guided online intervention while participants in the waiting list condition had to wait for 6 weeks. The intervention is based on an existing online intervention and was culturally adapted. Participants in both conditions completed baseline, post-test, and follow-up questionnaires on suicidal ideation (primary outcome), depression, worrying, hopelessness, suicide attempt and self-harm, acculturation, quality of life, and usability. In addition, participants were interviewed to examine the feasibility and mechanisms of action in more depth. The responses were analysed by inductive thematic analysis. Results Eighty-five people signed up via the study website, and we included 18 (10 intervention, 8 waitlist control). While the therapeutic benefits were emphasised (e.g. feeling connected with the intervention), the feasibility was judged to be low. The main reasons given were not having severe suicidal thoughts and not being represented by the culturally adapted intervention. No suicide attempts were recorded during the study. The suicidal ideation, depression, and hopelessness scores were improved in both groups. Conclusion Although intended to be a definitive trial, the current study became a feasibility study with process evaluation to understand the components and how they operate. The online intervention was not superior to the control condition. Future studies need to attend the implementation issues raised including measures of stigma, acculturation, and careful cultural adaptations alongside more attention to coaching and relational support. They should also consider how to improve engagement alongside selection of those who are motivated to use online interventions and offer alternatives for those who are not. Trial registration Netherlands Trial Register, NTR5028 . Registered on 1 March 2015 |
| first_indexed | 2024-12-16T16:41:19Z |
| format | Article |
| id | doaj.art-fe0997d52bff497696d7a5dfa0c316ef |
| institution | Directory Open Access Journal |
| issn | 2055-5784 |
| language | English |
| last_indexed | 2024-12-16T16:41:19Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Pilot and Feasibility Studies |
| spelling | doaj.art-fe0997d52bff497696d7a5dfa0c316ef2022-12-21T22:24:19ZengBMCPilot and Feasibility Studies2055-57842021-01-017111810.1186/s40814-021-00772-9Reducing suicidal ideation among Turkish migrants in the Netherlands and in the UK: the feasibility of a randomised controlled trial of a guided online interventionOzlem Eylem0Annemieke van Straten1Leonore de Wit2Shanaya Rathod3Kamaldeep Bhui4Ad J. F. M. Kerkhof5Department of Clinical Psychology, Vrije Universiteit AmsterdamDepartment of Clinical Psychology, Vrije Universiteit AmsterdamDepartment of Clinical Psychology, Vrije Universiteit AmsterdamSouthern Health NHS Foundation TrustCentre for Psychiatry, Wolfson Institute of Preventive MedicineDepartment of Clinical Psychology, Vrije Universiteit AmsterdamAbstract Background The evidence for the effectiveness of e-mental health interventions among ethnic minorities is still preliminary. This mixed methods study investigates the feasibility of a culturally adapted, guided online intervention with the intention to understand how it works and for whom to inform refinement. It also examines its likely effectiveness in reducing suicidal ideation when compared with the treatment as usual. Methods Turkish migrants with mild to moderate suicidal thoughts were recruited from the general population using social media and newspaper advertisements. The intervention group obtained direct access to a 6-week guided online intervention while participants in the waiting list condition had to wait for 6 weeks. The intervention is based on an existing online intervention and was culturally adapted. Participants in both conditions completed baseline, post-test, and follow-up questionnaires on suicidal ideation (primary outcome), depression, worrying, hopelessness, suicide attempt and self-harm, acculturation, quality of life, and usability. In addition, participants were interviewed to examine the feasibility and mechanisms of action in more depth. The responses were analysed by inductive thematic analysis. Results Eighty-five people signed up via the study website, and we included 18 (10 intervention, 8 waitlist control). While the therapeutic benefits were emphasised (e.g. feeling connected with the intervention), the feasibility was judged to be low. The main reasons given were not having severe suicidal thoughts and not being represented by the culturally adapted intervention. No suicide attempts were recorded during the study. The suicidal ideation, depression, and hopelessness scores were improved in both groups. Conclusion Although intended to be a definitive trial, the current study became a feasibility study with process evaluation to understand the components and how they operate. The online intervention was not superior to the control condition. Future studies need to attend the implementation issues raised including measures of stigma, acculturation, and careful cultural adaptations alongside more attention to coaching and relational support. They should also consider how to improve engagement alongside selection of those who are motivated to use online interventions and offer alternatives for those who are not. Trial registration Netherlands Trial Register, NTR5028 . Registered on 1 March 2015https://doi.org/10.1186/s40814-021-00772-9e-mental healthCultural adaptationSuicidal ideationTurkish migrantsFeasibilityRCT |
| spellingShingle | Ozlem Eylem Annemieke van Straten Leonore de Wit Shanaya Rathod Kamaldeep Bhui Ad J. F. M. Kerkhof Reducing suicidal ideation among Turkish migrants in the Netherlands and in the UK: the feasibility of a randomised controlled trial of a guided online intervention Pilot and Feasibility Studies e-mental health Cultural adaptation Suicidal ideation Turkish migrants Feasibility RCT |
| title | Reducing suicidal ideation among Turkish migrants in the Netherlands and in the UK: the feasibility of a randomised controlled trial of a guided online intervention |
| title_full | Reducing suicidal ideation among Turkish migrants in the Netherlands and in the UK: the feasibility of a randomised controlled trial of a guided online intervention |
| title_fullStr | Reducing suicidal ideation among Turkish migrants in the Netherlands and in the UK: the feasibility of a randomised controlled trial of a guided online intervention |
| title_full_unstemmed | Reducing suicidal ideation among Turkish migrants in the Netherlands and in the UK: the feasibility of a randomised controlled trial of a guided online intervention |
| title_short | Reducing suicidal ideation among Turkish migrants in the Netherlands and in the UK: the feasibility of a randomised controlled trial of a guided online intervention |
| title_sort | reducing suicidal ideation among turkish migrants in the netherlands and in the uk the feasibility of a randomised controlled trial of a guided online intervention |
| topic | e-mental health Cultural adaptation Suicidal ideation Turkish migrants Feasibility RCT |
| url | https://doi.org/10.1186/s40814-021-00772-9 |
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