@Article{信息:doi 10.2196 / / jmir。4493，作者=“Zarski, ana - carlotta和Lehr, Dirk和Berking, Matthias和Riper, Heleen和Cuijpers, Pim和Ebert, David Daniel”，标题=“坚持基于互联网的移动支持的压力管理:来自三个随机对照试验的个人参与者数据的汇总分析”，期刊=“J Med Internet Res”，年=“2016”，月=“6”，日=“29”，卷=“18”，数=“6”，页=“e146”，关键词=“指导”;治疗依从性;预测因子;网络干预;工作压力;背景:不坚持治疗是互联网干预中普遍存在的问题。来自卫生保健专业人员的指导已被发现可以提高对一系列身体和精神障碍的互联网干预的治疗依从率。评价不同强度的不同指导格式是重要的，特别是在提高效力和成本效益方面。识别不依从的预测因素可以使互联网干预措施更好地适应参与者的需求，特别是有停止治疗风险的参与者。 Objective: The goal of this study was to investigate the influence of different guidance formats (content-focused guidance, adherence-focused guidance, and administrative guidance) on adherence and to identify predictors of nonadherence in an Internet-based mobile-supported stress management intervention (ie, GET.ON Stress) for employees. Methods: The data from the groups who received the intervention were pooled from three randomized controlled trials (RCTs) that evaluated the efficacy of the same Internet-based mobile-supported stress management intervention (N=395). The RCTs only differed in terms of the guidance format (content-focused guidance vs waitlist control, adherence-focused guidance vs waitlist control, administrative guidance vs waitlist control). Adherence was defined by the number of completed treatment modules (0-7). An ANOVA was performed to compare the adherence rates from the different guidance formats. Multiple hierarchical linear regression analysis was conducted to evaluate predictors of nonadherence, which included gender, age, education, symptom-related factors, and hope for improvement. Results: In all, 70.5{\%} (93/132) of the content-focused guidance sample, 68.9{\%} (91/132) of the adherence-focused guidance sample, and 42.0{\%} (55/131) of the participants in the administrative guidance sample completed all treatment modules. Guidance had a significant effect on treatment adherence (F2,392=11.64, P<.001; $\omega$2=.05). Participants in the content-focused guidance (mean 5.70, SD 2.32) and adherence-focused guidance samples (mean 5.58, SD 2.33) completed significantly more modules than participants in the administrative guidance sample (mean 4.36, SD 2.78; t223=4.53, P<.001; r=.29). Content-focused guidance was not significantly associated with higher adherence compared to adherence-focused guidance (t262=0.42, P=.67; r=.03). The effect size of r=.03 (95{\%} CI --0.09 to 0.15) did not pass the equivalence margin of r=.20 and the upper bound of the 95{\%} CI lay below the predefined margin, indicating equivalence between adherence-focused guidance and content-focused guidance. Beyond the influence of guidance, none of the predictors significantly predicted nonadherence. Conclusions: Guidance has been shown to be an influential factor in promoting adherence to an Internet-based mobile-supported stress management intervention. Adherence-focused guidance, which included email reminders and feedback on demand, was equivalent to content-focused guidance with regular feedback while requiring only approximately a quarter of the coaching resources. This could be a promising discovery in terms of cost-effectiveness. However, even after considering guidance, sociodemographic, and symptom-related characteristics, most interindividual differences in nonadherence remain unexplained. Clinical Trial: DRKS00004749; http://drks-neu.uniklinik-freiburg.de/drks{\_}web/navigate.do?navigationId=trial.HTML{\&}TRIAL {\_}ID=DRKS00004749 (Archived by WebCite at http://www.webcitation.org/6QiDk9Zn8); DRKS00005112; http://drks-neu.uniklinik-freiburg. de/drks{\_}web/navigate.do?navigationId=trial.HTML{\&}TRIAL{\_}ID=DRKS00005112 (Archived by WebCite at http://www.webcitation.org/6QiDysvev); DRKS00005384; http://drks-neu.uniklinik-freiburg.de/ drks{\_}web/navigate.do?navigationId=trial.HTML{\&}TRIAL{\_}ID=DRKS00005384 (Archived by WebCite at http://www.webcitation.org/6QiE0xcpE) ", issn="1438-8871", doi="10.2196/jmir.4493", url="//www.mybigtv.com/2016/6/e146/", url="https://doi.org/10.2196/jmir.4493", url="http://www.ncbi.nlm.nih.gov/pubmed/27357528" }