Dorota Reis

Reliability and Validity of Assessing User Satisfaction With Web-Based Health Interventions

Background The perspective of users should be taken into account in the evaluation of Web-based health interventions. Assessing the users’ satisfaction with the intervention they receive could enhance the evidence for the intervention effects. Thus, there is a need for valid and reliable measures to assess satisfaction with Web-based health interventions. Objective The objective of this study was to analyze the reliability, factorial structure, and construct validity of the Client Satisfaction Questionnaire adapted to Internet-based interventions (CSQ-I). Methods The psychometric quality of the CSQ-I was analyzed in user samples from 2 separate randomized controlled trials evaluating Web-based health interventions, one from a depression prevention intervention (sample 1, N=174) and the other from a stress management intervention (sample 2, N=111). At first, the underlying measurement model of the CSQ-I was analyzed to determine the internal consistency. The factorial structure of the scale and the measurement invariance across groups were tested by multigroup confirmatory factor analyses. Additionally, the construct validity of the scale was examined by comparing satisfaction scores with the primary clinical outcome. Results Multigroup confirmatory analyses on the scale yielded a one-factorial structure with a good fit (root-mean-square error of approximation =.09, comparative fit index =.96, standardized root-mean-square residual =.05) that showed partial strong invariance across the 2 samples. The scale showed very good reliability, indicated by McDonald omegas of .95 in sample 1 and .93 in sample 2. Significant correlations with change in depressive symptoms (r=−.35, P<.001) and perceived stress (r=−.48, P<.001) demonstrated the construct validity of the scale. Conclusions The proven internal consistency, factorial structure, and construct validity of the CSQ-I indicate a good overall psychometric quality of the measure to assess the user’s general satisfaction with Web-based interventions for depression and stress management. Multigroup analyses indicate its robustness across different samples. Thus, the CSQ-I seems to be a suitable measure to consider the user’s perspective in the overall evaluation of Web-based health interventions.

Dimensions of coping in chronic pain patients: Factor analysis and cross-validation of the German version of the Coping Strategies Questionnaire (CSQ-D).

PURPOSE The Coping Strategies Questionnaire (CSQ) by Rosenstiel and Keefe (1983) is one of the most widely used measures of coping strategies in pain patients, although its construct and factorial validity is dissatisfying. Verra, Angst, Lehmann, and Aeschlimann (2006) translated the full measure, which assesses eight different coping strategies, into German (CSQ-D). Our aim was to identify stable latent dimensions and present a shorter and more valid version of the CSQ-D. METHODS A principal axes factor analysis (PFA) and a confirmatory factor analysis (CFA) were performed for specification and cross-validation of the new model. Thus, two independent samples of patients with fibromyalgia-like symptoms (n = 321, n = 162) completed questionnaire batteries that included the CSQ-D and measures of fibromyalgia (FM) impact, pain, depression, and anxiety. RESULTS The most interpretable result appeared to be a six-factor model with an acceptable fit. The first four factors, (1) Catastrophizing, (2) Ignoring Pain, (3) Diversion, and (4) Reinterpreting Pain, resemble the original scales by Rosenstiel and Keefe (1983). The Praying or Hoping scale split up into distinct (5) Praying and (6) Hoping dimensions. Except Praying, all coping strategies were significantly associated with measures of psychological health outcomes, pain, overall FM impact, or social support. CONCLUSIONS The new short form, called CSQ-DS, is a valid and reliable instrument, composed of 26 items and assessing six coping strategies. Future investigations are recommended to further prove both the external and construct validity of the CSQ-DS.

Time pressure with state vigour and state absorption: are they non-linearly related?

ABSTRACT On the basis of activation theory and the challenge-hindrance demands model, this study was conducted to clarify the functional form (linear vs. curvilinear) of the within-persons relations of time pressure with vigour and absorption. Further, we investigated whether these relations would be moderated by time-varying job control. A total of 52 full-time employees (44% female) participated in the study, which included two assessments per day over the course of 2 work weeks. Our analyses confirmed an inverted U-shaped within-persons association between state time pressure and state vigour and a moderator effect of job control on the curvilinear relation. By contrast, state time pressure and state absorption displayed only a positive linear relation. This study demonstrates that within-persons high levels of time pressure may impair employees’ energy levels but still promote their absorption at work.

The German Version of the Perceived Stress Scale (PSS-10): Evaluation of Dimensionality, Validity, and Measurement Invariance With Exploratory and Confirmatory Bifactor Modeling:

The Perceived Stress Scale (PSS) is a popular instrument for measuring the degree to which individuals appraise situations in their lives as excessively uncontrollable and overloaded. Despite its widespread use (e.g., for evaluating intervention effects in stress management studies), there is still no agreement on its factor structure. Hence, the aim of the present study was to examine the dimensionality, measurement invariance (i.e., across gender, samples, and time), reliability, and validity of the PSS. Data from 11,939 German adults (73% women) were used to establish an exploratory bifactor model for the PSS with one general and two specific factors and to cross-validate this model in a confirmatory bifactor model. The model displayed strong measurement invariance across gender and was replicated in Study 2 in data derived from six randomized controlled trials investigating a web-based stress management training. In Study 2 (overall N = 1,862), we found strong temporal invariance. Also, our analyses of concurrent and predictive validity showed associations with depressive symptoms, anxiety, and insomnia severity for the three latent PSS factors. These results show the implications of the bifactor structure of the PSS that might be of consequence in empirical research.

Turning Good Intentions Into Actions by Using the Health Action Process Approach to Predict Adherence to Internet-Based Depression Prevention: Secondary Analysis of a Randomized Controlled Trial

Background Many individuals engaging in Internet-based interventions fail to complete these treatments as intended. The processes responsible for treatment adherence in Internet-based interventions are still poorly understood. Objective The aim of this study was to investigate to what extent adherence in an Internet-based intervention can be predicted by motivational and volitional factors outlined in the health action process approach (HAPA). Methods This study investigated motivational and volitional factors included in HAPA in a randomized controlled trial to predict treatment adherence of N=101 individuals with subclinical depression in the intervention group of a depression prevention intervention (GET.ON Mood Enhancer). Adherence was operationalized as the number of completed treatment modules. Using longitudinal structural equation modeling, HAPA variables (motivational, maintenance, and recovery self-efficacy, outcome expectancies, intention, and planning) were assessed at baseline and their associations with adherence 7 weeks later. Results Planning predicted adherence. Better planning was, in turn, associated with higher levels of maintenance self-efficacy, and the latter significantly affected treatment adherence via planning. The other hypothesized direct associations were not significant. In total, the HAPA variables accounted for 14% of variance in treatment adherence. Conclusions Planning emerged as the strongest predictor of treatment adherence in highly motivated participants in an Internet-based intervention out of all HAPA variables investigated. Findings are in line with the hypothesis that planning facilitates the translation of good intentions into actions. The findings imply that systematically fostering planning skills and maintenance self-efficacy prior to or during Internet-based interventions would help participants to successfully complete these treatments. Trial Registration German Clinical Trials Register DRKS00005973; https://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00005973 (Archived by WebCite at http://www.webcitation.org/6uxCy64sy).

Sleep Characteristics, Sleep Problems, and Associations to Quality of Life among Psychotherapists

Sleep problems, especially insomnia, are a common complaint among adults. International studies have shown prevalence rates between 4.7 and 36.2% for sleep difficulties in general, whereas 13.1–28.1% report insomnia symptoms. Sleep problems are associated with lower social and academic performance and can have a severe impact on psychological and physical health. Psychotherapists are suppliers within the public health system. The goal of this study was to outline sleep characteristics, prevalence of sleep problems, insomnia, and associations of quality of life among psychotherapists. A total of 774 psychotherapists (74.7% women; mean age 46 years) participated in the study. Sleep characteristics, sleep problems, well-being, life satisfaction and workload, as well as specific job demands, were assessed via a questionnaire. Analyses revealed that more than 4.2% of the surveyed psychotherapists have difficulties falling asleep, 12.7% often wake up in the night, and 26.6% feel tired, and 3.4% think that their interrupted sleep affects work performance. About 44.1% of them suffer from symptoms of insomnia. Path models showed that insomnia is significantly related to well-being and life satisfaction.