The ESRII-conference 2023

For the seventh time, the European Society Reasearch on Internet Interventions (ESRII) organizes a joint European conference 7th ESRII 2023 was held in Amsterdam on 31 August -1. September. UngMeistring and Forhelse participated broadly with both articles and posters.

In the beautiful surroundings of the library Openbare Bibliotheek Amsterdam (OBA), researchers gathered from all over Europe to be inspired, share experiences and network. This year’s theme was “United in Diversity”. ESRII is a conference with the aim of promoting evidence-based knowledge and research around Internet interventions with a focus on behavior and mental health. VU University Amsterdam, Faculty of Clinical Psychology hosted this year’s gathering. The conference presented 8 keynote lectures, 67 poster presentations and 19 parallel tracks with more than 80 different contributions.

From the researchcentre Forhelse participated:

The PhD student in UngMeistring Guri-Elise Holgersen, with the poster: “A personalised digital treatment for adolescents with eating disorder – qualitative results and a pilot study protocol.”

The PhD student in UngMeistring Maren Helene Rinke Storetvedt, with the poster “Young ADHD: A qualitative study with focus on adolescents´ needs, wishes and barriers related to ADHD and a digital intervention.”

Post doc Smiti Kahlon with the Anxiety app Modi “Feasibility and preliminary clinical effects of a novel mobile application targeting anxiety in adolescents.”

Henning Monsen from Solli DPS with the poster “eMeistring Health and Works. A feasibility study of a transdiagnostic treatment for people on sick-leave caused by common mental disorders.”

The PhD student Beate Standal held a post titled: “Healthcare Workers’ Construction of the Patient: A Qualitative Study of the Use of Digital Mental Health Interventions in Specialized Mental Health Care.”

Center leader at Forhelse Tine Nordgreen was among the key note speakers with the post: “Never sell the bear`s skin before someone has killed the beast.”

Some photos from the eventful days.

The PhD student Beate Standal presents to a packed room.

From left: Post doc Smiti Kahlon and the PhD students Guri-Elise Holgersen and Maren Helene Rinke Storetvedt displayed posters from their studies on applications for anxiety, eating disorders and ADHD.

Henning Monsen presented records from eMeistring. Here, the audience also had the opportunity to try their hand at the program.

The Center manager Tine Nordgreen held a keynote presentation on the first day of the conference. She talked about experiences gained in the projects so far, and also what will be important to take into further research.

Thanks to ESRII for a great and inspiring conference!

Publication of the results of the UngSpotlight study

Postdoc Smiti Kahlon has been working on her doctorate in recent years, entitled the UngSpotlight Project, a VR programme for young people with performance anxiety (public speaking anxiety). The results of the study have now been published in Frontiers in Virtual Reality.

Presentation anxiety is one of the most common fears among adolescents. It is assumed that around 30 % experience presentation anxiety to such an extent that it affects their school life, and even more adolescents avoid situations in which they are asked to present themselves in public. This way, they do not get the opportunity to show their full potential at school. The aim of the study is to investigate whether VR therapy (gamified virtual realityexposure) can help adolescents manage presentation anxiety so that they have an easier school day.

The study is a randomised controlled trial in 100 adolescents. The adolescents were either assigned VR therapy, an online training programme or a combination of these. Both interventions were purely self-help and were carried out at home after school. The main findings from the study show that VR therapy has an effect compared to the group that did not receive the therapy. No group differences were shown between VR therapy and the online training programme.

Both training programmes are freely available for use. The VR application can be downloaded from the Oculus Quest Store and is called UngSpotlight VR. The web-based training programme UngSpotlight will be launched via the Directorate for Health and Social Affairs this autumn.

Read the publication here:

Forhelse at Arendal Week

On 17 August, Forhelse SFI participated in a debate at Arendal Week under the auspices of E-Health in Norway (EHiN). The theme was “Innovation against social inequality and loneliness”. Here it was discussed how we should proceed with the digitisation of society in a way that includes everyone.

As many as 600 000 inhabitants are digitally illiterate. Therefore, this is an important topic to focus on. The debate participants shed light on the topic well due to their various backgrounds, which led to an exciting conversation with different points of view. Some of the topics that were brought up were: who are the lonely people, innovation through volunteerism, affected family members and friends, the digital benefits of health platforms and other topics.

Participants in the debate:

Henriette Lauvhaug Nybakke, PhD candidate, Norwegian Center for E-health Research and Forhelse SFI
Beate Standal, PhD candidate, Department of Global Public Health and Primary Care, UiB and Forhelse SFI
Julia Németh, Innovation and Public Affairs HelsaMi, Helseplattformen
Ole-Marius Minde Johnsen, national head of Mental Helse
Stian Omdalsmoen, municipal council member and mayoral candidate, Municipality of Froland (Progress Party)
Anita Vatland, head, Pårørendealliansen
Trude Andresen, chief municipal executive for the Municipality of Drammen
Moderator: Sunniva Balstad, Writer and competence manager, EHiN

Follow the link to see footage of an exciting and important debate:

From the left; Sunniva Balstad, Trude Andresen, Beate Standal, Ole-Marius Minde Johnsen, Anita Vatland, Julia Németh , Henriette Lauvhaug Nybakke and Stian Omdalsmoen. Photo: Emilie Gjengedal Vatnøy/Mental Health

Beate Standal represented Forhelse SFI and University of Bergen, Photo: Henriette Lauvhaug Nybakke

Publication of the results of the RestDep study

Postdoc Sunniva Brurok Myklebost has been working on the RestDep Project in recent years. The results of the work have now been published in the journal Frontiers in Psychology.

Difficulties with cognitive functioning such as concentration, memory and executive functions, are common after depression. Good cognitive function is important for functioning well in working life and psychosocially. Relapses of depression are also related to cognitive difficulties. It is therefore important that this patient group receives the treatment and therapy it needs. The fact that RestDep can be delivered digitally can make treatment available to a large group of people who have been depressed.

The main finding of the study shows that the web-based therapy programme can be linked to long-term improvement in cognitive difficulties, but the effect on depression symptoms is more uncertain. Participants who did not relapse from depression after 2 years benefited more from the digital therapy than those who relapsed.

Read the publication here:

Digital access for the youngest

Just before the summer, the Research Center participated in a workshop on digital ID for youth. The workshop was organized by the Norwegian Digitalisation Agency and was held at their premises in beautiful surroundings in Leikanger. The goal of the gathering was to make access to digital ID better for our youngest citizens.

Today, young people can access health services via Norway’s digital identification application, BankID. This provides a high level of security, but requires parental consent and can be a challenging process. MinID is a security level lower, and is something the youth can obtain themselves. MinID functions as a digital ID that says something about who you are, but does not give access to programs that handle sensitive data, such as health data. The workshop demonstrated how demanding it can be to create MinID on your own as a 13-year-old. The goal of the Norwegian Digitalisation Agency is to adapt the use so that young people are not dependent on help from their parents/guardians. Making electronic ID available to the youngest is an important step away from digital exclusion, facilitating so that as many people as possible have access to the health services that exist and are essential for the implementation of the services. For programmes developed by UngMeiring, among others, there will be a need for a high level of security.

The workshop was attended by representatives from: Bufdir, Municipality of Bergen, Municipality of Oslo, Norwegian Health Network, Western Norway Regional Health Authority, Directorate for eHealth, Digdir and the Directorate for Health and Social Affairs. Kristin Hogstad Bruvik (project manager for UngMeistring) and Robin Gulseth (consultant at the Research Center) participated from the Research Center. The gathering resulted in a number of measures that the Norwegian Digitalisation Agency will implement during 2023 with high priority.

UngMeistring and the Research Center would like to thank the Norwegian Digitalisation Agency for an engaging and important gathering and look forward to following the process.

One year with UngMeistring

In April 2022, the four-year project UngMeistring started in earnest. The project will develop and research the effect of 8 digital self-help and therapist-guided programs for children and adolescents with ADHD, anxiety, depression and eating disorders. What has happened since inception?

During the year, UngMeistring has laid a good foundation for the next few years with initial brainstorming sessions and great insight into the various diagnostic packages. All the packages are well underway, except for depression which we are waiting a bit to start up. Preliminary interviews have been conducted with users and therapists to identify needs. This insight forms the basis for the PhD candidates’ first article. Based on this work, the project is now in the development phase of the programs. The content production team is well underway and works closely with professionals and developers to find the best solutions together.

Work package leader Lisbeth Sandtorv, designer Thea Stangeby and content producer Ingvild Skage work with visual style in the ADHD programme.

In May, the stage was also set for the first user tests in Helse Bergen and Helse Fonna. The purpose of this round was to test the concept, design and overall theme of the programmes for ADHD and eating disorders. Engaged young people gave good feedback that will be an important contribution to the road ahead. We find that this way of working provides appropriate feedback and understanding of the group. Close cooperation with a focus on user involvement is essential to reach precisely the given target group, and can lead to a greater extent that the program is actually used and implemented as desired. In Helse Stavanger, the project group also works very well with insight and user testing in the program for anxiety.

We look forward to the continuation of this exciting work.

Work package leader Esther Espestt and designer Thea Stangeby conducted user tests with young people in May. The young people gave input on visual style, content and their own thoughts on how a digital treatment can be made.

I Helse Stavanger jobber prosjektgruppen også svært godt med innsikt og brukertesting i programmet for angst. Prosjektgruppen består av arbeidspakkeleder Lars Ravn Øhlckers som er rådgiver ved Klinikk PH barn, unge og rusavhengige i Helse Stavanger, samt psykologstudentene Majen Bjerke og Pia Rygg Hauge. De har også med seg en rekke fagpersoner i referansegruppen, samt en klasse med ungdommer som har psykologi valgfag. Teamet i Stavanger har jobbet godt med innsikt og konsept, og har sammen med et designbyrå utformet første prototype som de har testet på ungdom.

I arbeidspakken H6 IKT- og Pasientsikkerhet har vi jobbet sammen med DigiUng og Digitaliseringsdirektoratet for å utforske hvordan man kan gjøre tilgjengeligheten til MinID for ungdom 13-15 enklere. Vi håper dette kan bidra til at flere tar i bruk digitale tjenester, og at det etter hvert også vil bli enklere å få tilgang til høyeste sikkerhetsnivå for de yngste i befolkningen.

Til venstre ser du psykologstudent Majen Bjerke fra prosjektgruppen H4 Angst som har etablert samarbeid med psykologisklassen ved Stavanger Katedralskole. Disse har fått undervisning om angst, deltatt i fokusgruppeintervju, og vil bidra med

Join us at the lecture with Professor Nick Titov

On Monday 4 September, the stage is set for a lecture with the theme “Service delivery models for digital interventions – Research and lessons learned from primary and secondary healthcare services”. The lunch lecture will be held by Professor Nick Titov, who has extensive experience in research and development of digital health services. The lecture is mostly relevant for managers, project staff and employees in digital patient care.

Professor Titov is based at Macquarie University in Australia, and has developed MindSpot and PORTS (Practitioner Online Referral and Treatment Service). Titov has been pioneering the field of digital healthcare since 2006 and, together with Professor Blake Dear, has conducted more than 80 clinical trials of digital mental health treatments. Professor Titov’s research and clinical work puts the spotlight on developing strategies to reduce various barriers to psychological treatments.

The lecture is held in Bikuben, Haukeland University Hospital. September 4 at 11:30-12:30. There will be light refreshments, and the event is free.

Click here to register

We look forward to the lecture!

Welcome!

Meet PhD candidate Maren Helene Rinke Storetvedt

One of UngMeistring’s two doctoral degrees is Maren Helene Rinke Storetvedt. She will research the development and effect of online and game-based coping programs for children and adolescents with ADHD. This week we have taken a closer look at what she will be working on and researching over the next few years.

UngMestring is a project that will develop digital treatment and self-help programs for children and adolescents with ADHD, anxiety, depression or eating disorders. The goal is to increase access to evidence-based mental health services for children and adolescents between the ages of 13 and 18. The project started in 2022 and will last for 4 years. You can read more about UngMeistring here.

-Why did you want to be a part of UngMeistring?

-I had heard positive things about the research centre’s work with digital health services and was very interested in working in this field. It is very rewarding to be part of a research environment that works to develop and evaluate health services. For me, it is important that what I work with is useful, and it is very motivating to conduct research that young people will benefit from,” says Storetvedt.

Storetvedt has a bachelor’s degree in social education and a master’s degree in health promotion and health psychology. She also has experience from project work with participation routines at system level in the knowledge centre in Bergen Municipality. She brings this experience into her work, which she is already well underway. Storetvedt is now involved in the insight phase of the development. She has interviewed adolescents with ADHD to identify what they want and can benefit from in a digital mastery programme.

“This has been an educational and rewarding process. The young people have contributed with a lot of valuable insight and I look forward to meeting them again later in the development, says Storetvedt enthusiastically.

The user in focus

In order to succeed in developing good digital mental health services, collaboration between researchers, clinicians, users, developers and more is required. As a social educator, Storetvedt is passionate about user involvement and believes that it is important to work for real participation in service development.

“User involvement is central to ensuring that we deliver good and relevant solutions that are actually used. In the project, I will use a user-centered framework called “Person-based approach” (PBA) that combines theory and evidence with mapping of users’ needs and psychological context,” says Storetvedt.

I am concerned that everyone should have equal access to healthcare. We know that there are social inequalities in the use of health services, and it is therefore essential that the digital health services are designed and made available in a way that is socially cohesive.
PhD student Maren Helene Rinke Storetvedt.

– What challenges do you encounter along the way?

“Digital solutions are here to stay, and therefore it is important to ensure that we can offer safe, knowledge-based solutions that are available to anyone who wants to make use of them. One challenge we have in the project is digital login. We must therefore think about how the solution will be delivered safely. This applies in particular to young people who are under the age of majority under health law and therefore cannot log on to digital solutions with BankID.

“A PhD programme is challenging in itself, and I think it will be important to remind myself that the PhD is a research education, and that I have to tolerate feeling a little bit of imposter syndrome from time to time. In Forhelse, I have many good colleagues who cheer, support and guide me, and I am sure that this will make it easier to overcome the challenges that come with a PhD course.

Digital treatment of cognitive difficulties after depression

Sunniva Brurok Myklebost defends her PhD degree on the 19.1.2023, with her thesis “Residual cognitive symptoms after depression: Person-based development and evaluation of an internet-delivered cognitive enhancement intervention”.

Cognitive difficulties are common forms of difficulties after depression, also called residual symptoms. They are characterised by difficulties with attention, memory and management functions, which affect daily life and can contribute to the relapse of depression. Despite depression being one of the most common mental disorders, there is a lack of clinical interventions to treat residual cognitive symptoms. Digital interventions can therefore be a solution to increase accessibility to treatment.

The thesis consists of two studies. The first study deals with the development of a digital intervention for residual cognitive symptoms and includes interviews with previously depressed people, where the purpose is to investigate their cognitive difficulties and need for treatment of these. The results show that previously depressed people experience cognitive difficulties in the aftermath of depression and that they need information about residual cognitive symptoms, coping strategies for worry, strategies to increase acceptance and compensation of symptoms through therapist support. Digital interventions for previously depressed people should promote motivation, gradually provide access to information and should be adapted to the degree of residual symptoms.

The second study is a pilot study where we examined the effect of a digital program for adults who have been depressed and report cognitive residual symptoms. The findings show a significant decrease in cognitive residual symptoms and rumination after completion, as well as at follow-up after six months. In addition, the findings show that a shorter duration of previous depression and a high degree of expected treatment effect have an impact on the reduction of cognitive difficulties after six months. The results from the thesis are promising and show that digital interventions can be used to treat cognitive residual symptoms after depression, which can contribute to increased function and reduce the risk of relapse.

Myklebost has Tine Nordgreen as her main supervisor and professor at UiB, Åsa Hammar, as co-supervisor.

The public defence will be held at Alrek Health Cluster at 10:30 am and is open to anyone interested. Trial lecture 09.15 – 10.00 at the same place with the given topic: “Methodological challenges and possible solutions in clinical trials targeting cognition in depression.”

All are welcome!

Kick-off for the EU PIECES Project

On 22-23 June, a kick-off was arranged in Barcelona for the EU PIECES Project, in which Bergen Health Trust/Haukeland University Hospital joined as partners. The project aims to develop, evaluate and make available a methodological implementation tool specifically aimed at cancer prevention.

Given the high and increasing global burden of cancer, successful implementation of cancer prevention programmes is essential. Many evidence-based programmes often face challenges when implemented in real-world settings. The PIECES Project aims to overcome these challenges and lay the foundation for successful cancer prevention initiatives on a global scale.

The PIECES Project will provide a digital tool that contributes to the identification, selection and adaptation of cancer prevention programmes. It will also support the development of evidence-based implementation strategies that take into account local barriers and contexts. The tool contains a comprehensive collection of cancer prevention programmes focusing on six risk factors for cancer: tobacco, alcohol, UV radiation, HPV, nutrition and physical activity. The tool will also include theory of behaviour change, as well as implementation support.

Funded by the European Union

The ambitious project is funded by the European Union under the Horizon Europe Research and Innovation Programme with more than MEUR 7.7 (MNOK 90.5). The project consists of a consortium of 15 partners from ten different countries with broad sociocultural backgrounds. The countries in question have a combined population of about 77.7 million inhabitants, providing an ideal natural laboratory for research and improving the scale-up and implementation of cancer prevention programmes.

To ensure the success of the project, a multicenter case study will be conducted to evaluate and optimise implementation results. Using various sociological theories, the method (Realist Evaluation) will provide insight into the processes that lead to these results.

Researcher Robin Kenter and research assistant Hanne Karoline Hinderaker at Forhelse SFI at HBE/HUH contribute to the project with research on implementation strategies, evaluation of the effects of different strategies and development of the implementation tool. They will collaborate with Amsterdam UMC Trimbos-Institute, IDIBELL and Institute Catala d’Oncologia.

We look forward to the results and impact of the PIECES Project, as it has the potential to increase the effectiveness of cancer prevention measures and improve public health at a European level.