Norway’s first digital treatment for patients with IBS (irritable bowel syndrome)

Mage-tarm skolen

The case has been published by Helse Bergen 01.12.23

Mage-tarmskolen, which is SFI’s partner in Forhelse, offers Norway’s first digital treatment for patients with IBS (irritable bowel syndrome). Doctors in primary and specialist healthcare throughout Helse Vest refer patients to this treatment, and can now show good results. Over 90% of ISB patients are satisfied with the treatment and find the digital gastrointestinal school useful.

Forhelse SFI (Center for Research-Driven Innovation) in Health Bergen, has contributed to the development of the treatment offer. The digital platform has been developed by Forhelse SFI partners CheckWare AS and Section for e-Health.

There is no curative treatment for IBS, but through school the patients have learned various tools that reduce their ailments. IBS causes problems such as abdominal pain, constipation, bloated stomach and intestines, and diarrhea. The disease is often made worse by stress and certain foods. The condition is common and affects approximately 15 out of 100 in the population. – Many of these patients are worried to leave the house because of their ailments. Now they can sit at home and learn how to better cope with the disease, says Birgitte Berentsen Jacobsen, associate professor and general manager of the National Competence Service for Functional Gastrointestinal Diseases. (Nasjonal kompetansetjeneste for funksjonelle mage-tarmsykdommer).

Increased quality of life. More than 700 patients in Helse Bergen’s catchment area have undergone the treatment from 2020-2023. The average age of the participants is 38 years (77% women and 23% men).

The results show that three months after starting treatment, a total of 55% of the patients responded very well. The number of patients in the remission/mild IBS group increased from 11% to 44%, and the number of patients with severe IBS decreased from 42% to 8%. After 6 months, 21% of patients reported stable improvement of IBS symptoms.

Read more about the study on Helse Bergen’s website.

 Read more at HelseBergen.no

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.

Thanks to ESRII for a great and inspiring conference!

Important discussions for the development of digital health tools

Forhelse SFI held a joint meeting for partners and researchers on 21 and 22 November in Bergen. The meeting discussed the progress and status of our ongoing projects in the development of new digital health tools.

Mamma Mia is an example of a tool already in use in 31 municipalities, at 44 public health clinics and by 182 employees in Norway. The project was presented by RBUP East & South, Regional Center For Child & Adolescent Mental Health, and runs from 2020 to 2025. The programme will help prevent and reduce depression among pregnant women from week 21 and after childbirth up to 6 months.

The results of the research show some major challenges for the implementation of digital tools in the health services. It is time-consuming for healthcare personnel to adopt new methods in an already busy working day. However, the good benefits experienced by ¼ of the participants who experienced depression (25% of all participants experienced depression), the tool is well received by this patient group.

The participants of the seminar contributed with good presentations and discussions during the meetings. Important topics addressed were the use of early method development, implementation of the tools and their challenges, cost assessments at all levels, supervised versus unsupervised software, effectiveness of digital tools for patients and for health personnel, and achievement of benefits.

In order to help with the ever-increasing need for health services, the use of digital tools must become “the norm” in our health services. Dissemination to users will also be an important task in the future. Nevertheless, its use should be based on voluntary participation.

We still have room for improvement in the impact of research projects on health services. Unfortunately, a large proportion of today’s IT projects within the health sector have not been implemented. We must acquire new knowledge, train users and create new attitudes in society.

The benefits related to improved quality of life for patient groups can be considerable, but we must avoid that new digital tools create additional work for health personnel who already have much to do at work.

The Director of Forhelse SFI Tine Nordgreen.

Thank you to all participants who represented Amsterdam UMC (Public and Occupational Health), Oslo University Hospital, Vestfold Hospital, St. Olavs Hospital, WNRHA ICT, RBUP East and South, Municipality of Bergen (Agency for Children and Families), Knowledge Centre for the Municipality of Bergen, Gastrointestinal School the Bergen Health Trust, University of Bergen, eMestring from Bergen Health Trust, National Centre for eHealth Research, Lifekeys and Youwell.

Linn Støme, Special advisor at the University Hospital of Oslo.

Presentations at the SFI event:

Vidar Halsteinli, St. Olavs Hospital, and Kristian Kidholm, Odense University Hospital – Introduction to the involvement of health personnel in digital health interventions.

Tine Nordgreen, Director of the Forhelse Center – From self-guided to therapist-guided from the perspective of effectiveness. WP1

Vidar Halsteinli, St. Olavs hospital. –From self-guided to therapist-guided from a cost perspective. WP2

Linn Støme, Oslo University Hospital –From self-guided to therapist-guided, early perspectives within Health Technology Assessment. WP3.

Cristiaan Vis, Amsterdam UMC — Public and Occupational Health. –From self-guided to therapist-guided from a perspective of implementation. WP4.

Filip Drozd, Silje Marie Haga and Zareen Abbas Khan, RBUP East and South. –Mamma Mia and the involvement of health professionals.

Kristian Kidholm, Odense University Hospital –The effects of Telemedicine, a blind spot in Research.

Kari Lupsa Helvik, Youwell. –What is the commercial potential of guided intervention versus interventions delivered via internet?

Åsne Halskau, Forhelse Center coordinator. –What is an SFI? Work plan and budget 2024. Reporting to the Research Council of Norway.

Vidar Halsteinli, St. Olavs Hospital. –Implementation of eMastery – at what cost? Mamma Mia. WP2.

Tine Nordgreen, Director of the Forhelse Center. –My ADHD adult, from an unguided to guided programme.  

PIECES tailors digital tools in cancer prevention

PIECES deltakere i Amsterdam

On 2 and 3 November, UMC Amsterdam and Trimbos organized a workshop for the partners in the PIECES Project, with participants from different nations. The agenda for the workshop was to test and design an advanced implementation tool for primary cancer prevention (PCP-IT).

The project has now reached a milestone

The workshop marked a significant milestone in the ongoing efforts of the PIECES consortium. Our goal is to reduce the global burden of cancer by implementing behavioural change tools regarding six cancer risk factors. The risk factors are: tobacco smoking and exposure to secondhand smoke, unhealthy diet, little physical activity, alcohol consumption, UV exposure and infection with human papilloma virus (HPV).

The main focus of the meeting was on testing and improving the PCP-IT tool’s ability to streamline the process of selecting and adapting existing evidence-based cancer prevention programmes, adapted to specific local environments and populations.

The tool will have a wide application in cancer prevention

Examples of the application of PCP IT tools are Volkswagen, which will implement a change behaviour for its employees, partners in the EU want tools for initiating smoking cessation campaigns, the NHS in Scotland (Scotland’s national health information services) wants to reduce secondhand smoke, and Australia wants to adopt an app that leads to increased use of sunscreen.

Tailor-made and effective tools

ThePCP-IT tool has the potential to be a transformational resource in the field, as it helps stakeholders identify changes from previously used prevention programmes (both online and offline), and also adapt to the unique environments in which the tool will be implemented. This critical step lays the foundation for tailored and effective strategies in cancer prevention.

In the Amsterdam workshop, two new modules in the implementation tool were piloted. The work used cases and examples of existing interventions that address risk factors for cancer. This helped test the tool’s usability.

Researcher and projectleader Robin Kenter and researchassistant Hanne Karoline Hinderaker.

Haukeland University Hospital is developing a repository

Researcher and project manager Robin Kenter and research consultant Hanne Karoline Hinderaker participated from Haukeland University Hospital. The hospital is responsible for developing a repository of factors influencing the implementation of the cancer prevention programme. The repository will be available through the PCP-IT implementation tool.

Haukeland University Hospital is one of 14 partners in the PIECES Project. PIECES is funded by the European Union and is due for completion in 2027.  

Our partner Lifekeys won a tender competition from the Directorate of Health

The self-help tool developed by Lifekeys was recently launched by the Directorate of Health as one of 4 health apps for young people. (Photo: Pexels.com, Samuel Silitonga jr.)

The Self-help is a new digital solution with personalized courses and coping tools that contribute to better mental health. The courses cover topics such as sleep, stress, anxiety, depression and resilience.

In the Self-help, young people can learn more about their mental health, how to maintain well-being and develop personal skills. The goal is to gain control over your own situation by taking simple tests and getting help to understand how you feel and why. This is a free tool for young people between the ages of 13 and 20. The self-help tool has been quality assessed by the Directorate of Health and is completely anonymous to use. You do not need to download any app but can use the browser on mobile, tablet or PC.

The self-helper: Well-being tool for young people

About Lifekeys:

  • Online psychologist service that offers video consultations and theme-based seminars with selected psychologists. Established in 2017.
  • Has high standards for innovative solutions that make it easier to get in touch with a psychologist when needed.
  • Experts in online psychologist services, and offer good cooperation with organizations and companies.

Read more about our partners.

Read about Forhelse’s health app UngSpotlight, which was also recently launched by the Directorate of Health.

The Directorate of Health is launching four new mental health apps for young people

Helseapp lansering

In this connection, Minister of Health Ingvild Kjerkol (Ap) visited a high school in Oslo. There she was told that using apps is good, but beeing able to get advice from the health nurse and psychologist are also important. Read the whole story in Dagens Medisin.

One of the apps being launched is UngSpotlight, developed by Helse Bergen HF and Youwell.

UngSpotlight (from 13 years) is a digital self-help program with coping techniques for young people who experience fear or discomfort when speaking in front of strangers, assemblies or the class. The training program lasts for 6 weeks, and it is recommended to work with the program at least 3 times a week.

The program was tested in 2022 and had close to 10,000 downloads during the pilot period. The program has been tested through a randomized controlled trial (RCT) and has a proven effect on presentation anxiety.

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The three other apps that the Directorate of Health are launching are:

Thought virus (from 16 years) is an app based on cognitive psychology with daily videos and tips that contribute to coping and normalization of negative thoughts.

Grubl (from 16 years) is an app based on metacognitive psychology with daily videos and experiments that might help training the user’s attention and reduce brooding. The app is new.

The Self-helper (from 16 years) is a digital course bank with personalized courses and coping tools that contribute to better mental health. The courses cover topics such as sleep, stress, anxiety, depression, habits, emotional intelligence, goal setting, performance anxiety, alcohol and substance abuse, grief, inner motivation and loneliness. The tool is new.

The apps that are launched have been approved by the Directorate of Health, through the project “Safer health apps”, and are accessible via the government’s online portal Ung.no

Publication of the results of the UngSpotlight study

Smiti Cahole

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

Oversiktsbilde over debattdeltakere

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:

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

eID-digdir Leikanger

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.