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Background: Participants for efficacy studies on Internet-based interventions (IBI) are recruited through self-selected convenience sampling or targeted external invitations. Comparisons are necessary to determine how recruitment strategies influence sample composition. Such comparisons consequently yield potential for evaluating which conditions are more probable to fulfill IBI's promise to be an effective treatment option for underserved populations. Methods: A comparison of sociodemographic and clinical characteristics of differently recruited participants in an IBI for mild to moderate depression was made: (1) individuals on sick leave due to an affective disorder who were informed about the IBI by their health insurance (n= 308) and (2) individuals who self-selected to participate (e.g., after seeing information on the IBI in print media; n= 699). Results: Compared to the self-selected group, the externally selected group was older, less educated, spent less time on the Internet, had a less positive attitude towards IBI, and comprised more men. Groups did not differ in initial symptom severity, in-treatment symptom change, or previous psychotherapeutic experiences. Conclusions: The results indicate that larger shares of underserved subpopulations (e.g., less educated, older, male, less internet-savvy) begin an IBI treatment when the insurer informs them about the IBI. Recruitment source does not influence efficacy. [ABSTRACT FROM AUTHOR]

Hintergrund: In Wirksamkeitsstudien zu internetbasierten Interventionen (IBI) werden Teilnehmende entweder durch Selbstselektion oder gezielte Ansprache rekrutiert. Vergleiche zwischen unterschiedlichen Rekrutierungsstrategien ermöglichen zu ermitteln, wie der Zugang zur Intervention die Stichprobenzusammensetzung beeinflusst. Gleichzeitig kann überprüft werden, unter welchen Bedingungen das Versprechen der IBI, ein wirksames Behandlungsangebot für eigentlich unterversorgte Populationen zu sein, eher eingehalten wird. Methode: Soziodemografische und klinische Eigenschaften unterschiedlich rekrutierter Teilnehmender an einer IBI für leicht- bis mittelgradige Depression wurden miteinander verglichen: (1) Personen, die extern nach Krankschreibung aufgrund einer affektiven Störung von ihrer Krankenkasse über die Teilnahmemöglichkeit informiert wurden (n = 308); (2) Personen, die selbstselektiert (z.B. durch Printmedien) auf eine Teilnahmemöglichkeit aufmerksam wurden (n = 699). Ergebnisse: Verglichen mit der selbstselektierten Gruppe wies die extern selektierte Gruppe vor Interventionsbeginn einen größeren Männeranteil auf, war älter, hatte ein geringeres Bildungsniveau, verbrachte weniger Zeit im Internet und hatte eine weniger positive Einstellung gegenüber IBI. Kein Unterschied bestand hinsichtlich initialer Symptomschwere, psychotherapeutischer Vorerfahrungen und Symptomreduktion während der Intervention. Schlussfolgerungen: Die Ergebnisse weisen darauf hin, dass eigentlich unterversorgte Personen (z.B. weniger Bildung, höheres Alter, männlich, weniger internetaffin) in größerer Zahl in IBI rekrutiert werden können, wenn eine gezielte, externe Information über das Behandlungsangebot erfolgt. Die Rekrutierungsart beeinflusst dabei nicht die erzielbare Symptomreduktion. [ABSTRACT FROM AUTHOR]

Background: Even though there is an increasing number of studies on the efficacy of Internet-based interventions (IBI) for depression, experimental trials on the benefits of added guidance by clinicians are scarce and inconsistent. This study compared the efficacy of semistandardized feedback provided by psychologists with fully standardized feedback in IBI.Methods: Participants with mild-to-moderate depression (n = 1,089, 66% female) from the client pool of a health insurance company participated in a cognitive-behavioral IBI targeting depression over 6 weeks. Individuals were randomized to weekly semistandardized e-mail feedback from psychologists (individual counseling; IC) or to automated, standardized feedback where a psychologist could be contacted on demand (CoD). The contents and tasks were identical across conditions. The primary outcome was depression; secondary outcomes included anxiety, rumination, and well-being. Outcomes were assessed before and after the intervention and 3, 6, and 12 months later. Changes in outcomes were evaluated using latent change score modeling.Results: Both interventions yielded large pre-post effects on depression (Beck Depression Inventory-II: dIC = 1.53, dCoD = 1.37; Patient Health Questionnaire-9: dIC = 1.20, dCoD = 1.04), as well as significant improvements of all other outcome measures. The effects remained significant after 3, 6, and 12 months. The groups differed with regard to attrition (IC: 17.3%, CoD: 25.8%, p = 0.001). Between-group effects were statistically nonsignificant across outcomes and measurement occasions.Conclusion: Adding semistandardized guidance in IBI for depression did not prove to be more effective than fully standardized feedback on primary and secondary outcomes, but it had positive effects on attrition. [ABSTRACT FROM AUTHOR]