Using online media to encourage help-seeking for depression

Abstract

Clinical depression has been prevalent in international health statistics but people are often found to be reluctant to seek help when they encounter depression. This thesis built and evaluated a mental health promotion campaign to encourage help-seeking through first forming a behavioral model to conceptualize the interplays of various factors in shaping one’s help-seeking intention and behavior for depression in Hong Kong.

The thesis began with in-depth illness narrative qualitative interviews with 18 participants through purposive sampling from the general public of Hong Kong. Through the interview results and close reference to the theory of planned behavior (TPB), a behavioral model was drafted highlighting impacts of view on depression, help-seeking and other factors had on individual’s help-seeking intention and behavior. Followed by that, 70 quantitative questionnaires completed by members of the general public were then done through snowball sampling to validate the model. 16 items were then retained in the model that uses attitude towards help-seeking, subjective norm and perceived behavioral control to explain individual’s help-seeking intention and behavior. At the same time, the interviews and questionnaires found that participants seem to have a limited view of treatment options and have diverse views of the symptoms of depression, both of which profoundly affect their motivation to seek help. The role of family and friends and a holistic approach to mental health education were found to be particularly important for encouraging help-seeking behavior in future campaigns concerning depression.

The content for this mental health promotion campaign was then designed into 4-weeks of email campaign material according to the factors mentioned in the model to encourage help-seeking for depression built and validated in the previous stages. The participant recruitment for the media campaign was done through the social media Facebook through two paid advertisements. A total of 5,405 clicks were gained through the Facebook advertisements and these Facebook users were then directed to a Survey Monkey email registration site to the campaign. 383 people registered their emails in the site with 199 of them completed the pre-test and joined the 4-week campaign. The 199 participants were randomly divided in two groups with one receiving the campaign material and another group receiving information from tradition leaflet issued by the Hospital Authority in Hong Kong. Pre-test and post-test were done before and after the campaign to measure the difference in help-seeking intention after reading the two sets of material respectively. As a result, 116 participants completed the campaign and the post-test. With a post-test only design, no significant change has been found in primary outcomes including attitude, subjective norm and perceived behavioral control, but significant change has been found in secondary outcome, which participants were found to have better mental health literacy after the campaign. This thesis has shown the practicality and effectiveness of using online media and theory-guided material for mental health promotion campaigns. It is important for future studies to take advantage of the popularity of online media and conduct primitive and evaluative research on these campaigns.