Evidence map›Paper›PMID 35948866›Full record

Trial reportBMC primary care2022

Comparing a ses-sensitive and an all-ses implementation strategy to improve participation rates of patients with a lower socioeconomic background in a web-based intervention for depressive complaints: a cluster randomised trial in primary care.

Stephanie S Leone, Odile Smeets, Suzanne Lokman, Brigitte Boon, Agnes van der Poel, Tessa Van Doesum, Laura Shields-Zeeman, Jeannet Kramer, Filip Smit

Open access · goldAbstract readPragmatic Clinical TrialRandomized Controlled Trial
In one paragraph

Trial report in BMC primary care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 42% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. [Socioeconomic status and cecal adenocarcinoma mortality risk: an American population-based analysis].Nan fang yi ke da xue xue bao = Journal of Southern Medical University · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Stephanie S LeoneDepartment of Mental Health & Prevention, Trimbos Institute: Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands. sleone@trimbos.nl.ORCID 0000-0002-9081-0538
Odile SmeetsAcademy Het Dorp, Arnhem, The Netherlands.
Suzanne LokmanTranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
Brigitte BoonAcademy Het Dorp, Arnhem, The Netherlands.
Agnes van der PoelAcademy Het Dorp, Arnhem, The Netherlands.
Tessa Van DoesumDepartment of Mental Health & Prevention, Trimbos Institute: Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands.
Laura Shields-ZeemanDepartment of Mental Health & Prevention, Trimbos Institute: Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands.
Jeannet KramerDepartment of Mental Health & Prevention, Trimbos Institute: Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands.
Filip SmitDepartment of Mental Health & Prevention, Trimbos Institute: Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands.
Trimbos Institute · NLTilburg University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDepression is a major public health concern, which is most pronounced in population segments with a lower social-economic status (SES). E-health interventions for depressive complaints are proven to be effective, but their reach needs to be improved, especially among people with a lower socioeconomic status (SES). Implementing e-health interventions in the primary care setting with SES-sensitive guidance from General Practice nurses (GP nurses) may be a useful strategy to increase the reach of e-health in lower SES groups. We implemented an evidence-based online intervention that targets depressive complaints in primary care.

methodsA pragmatic cluster-randomised trial was conducted in two parallel groups where a SES sensitive (SES-sens) implementation strategy with additional face-to-face guidance by GP nurses was compared to an all-SES implementation strategy. The primary outcome was the percentage of lower SES participants in either condition. Participation was defined as completing at least 1 face-to-face session and 2 online exercises. Participation rates were evaluated using logistic mixed modelling.

resultsIn both conditions, the participation rates of lower SES participants were quite high, but were notably lower in the SES-sens implementation condition (44%) than in the all-SES implementation condition (58%). This unexpected outcome remained statistically significant even after adjusting for potential confounders between the conditions (Odds Ratio 0.43, 95%-CI 0.22 to 0.81). Less guidance was provided by the GP nurses in the SES-sens group, contrary to the implementation instructions.

conclusionsFrom a public health point of view, it is good news that a substantial number of primary care patients with a lower SES level used the implemented e-health intervention. It is also positive that an all-SES implementation strategy performed well, and even outperformed a SES-sensitive strategy. However, this was an unexpected finding, warranting further research into tailoring implementation strategies of e-health interventions towards specific target groups in the primary care setting.

trial registrationNetherlands Trial Register, identifier: NL6595 , registered on 12 November 2017.

Indexed as

Internet-Based InterventionExerciseHumansNetherlandsPrimary Health CareSocial ClassDepressionE-healthImplementationLower socio-economic statusPrimary Care

Identifiers

PMID35948866
PMCPMC9367024
OpenAlexW4291002569

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.