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Articles 1 - 30 of 38
Full-Text Articles in Psychiatric and Mental Health
Every Moment Counts (Emc): Understanding School Stakeholder Perceptions Of Positive Mental Health Promotion In The Elementary School Setting. A Preliminary Report., Madeline Malooly, Angela Blackwell, Lauren Thomas
Every Moment Counts (Emc): Understanding School Stakeholder Perceptions Of Positive Mental Health Promotion In The Elementary School Setting. A Preliminary Report., Madeline Malooly, Angela Blackwell, Lauren Thomas
Spring 2024 Virtual OTD Capstone Symposium
For children and adolescents, the prevalence of psychological disorders associated with mental illness continues to rise in North America and is now considered to be the leading cause of disability for this population (Bitsko et al., 2022). It was estimated that between 25 and 50% of adult mental illnesses could be prevented through early intervention and preventative measures in childhood (Kim-Cohen et al., 2003). In an effort to address mental health promotion in schools, Dr. Susan Bazyk founded and created EMC, which is a “multi-pronged mental health promotion initiative to help all children to be mentally healthy in order to …
Impact Of Mental Health Boarding In The Emergency Department And Recommendations On How We Can Improve, Kyra Buettner
Impact Of Mental Health Boarding In The Emergency Department And Recommendations On How We Can Improve, Kyra Buettner
Master of Science in Physician Assistant Studies Capstone Presentations (Center City)
Introduction
Every year in the United States there is an estimated 2 million adolescents who experience suicidal ideation or attempt suicide.1 The shortage of behavioral and mental health professionals has led to an increase in emergency department (ED) visits. “Boarding” is defined as “the practice of holding patients in the ED or another temporary location after the decision to admit or transfer has been made.2” The purpose of this study is to evaluate the following question - in adolescent patients with suicide attempt or mental health crisis, does boarding in the ED result in poorer mental health …
The Impact Of The Covid-19 Pandemic On The Physical And Mental Health Of School-Aged Children, Syed Azlan Abbas, Sufia Athar, Nadeem Zafar Jilani
The Impact Of The Covid-19 Pandemic On The Physical And Mental Health Of School-Aged Children, Syed Azlan Abbas, Sufia Athar, Nadeem Zafar Jilani
HCA Healthcare Journal of Medicine
The SARS-CoV-2 (COVID-19) pandemic caused a deleterious impact on global health. School-aged children were significantly impacted by the pandemic. These impacts may be attributed to the fact that this age group is at a vulnerable developmental stage and is susceptible to profound effects. We conducted a thorough literature review using PubMed, Medline, and Science Direct electronic database searches between 2020-2022. We retrieved 757 studies, 25 of which were included in our review. We considered the impact of the COVID-19 pandemic on the physical and mental health of school-aged children (5-18 years), and the results were analyzed and included in our …
Addressing The Access And Barriers To Mental Health Resources In High School Students, Tainiz Polanco, Ocean Alam, Diana Lopez, Vanessa Pizutelli
Addressing The Access And Barriers To Mental Health Resources In High School Students, Tainiz Polanco, Ocean Alam, Diana Lopez, Vanessa Pizutelli
Rowan-Virtua Research Day
Minority populations throughout the world are hit with obstacles that interfere with their mental health, especially high school students. The recent COVID-19 pandemic has had drastic effects on the performance of these individuals and their social engagement. As observed, there is a divide amongst different races of students that highlights the lack of mental health resources provided to them and how they are utilized. After conducting further research on such issues, we were able to determine the major barriers existing today that tend to push students away from utilizing existing resources. Some of these barriers could vary from external stress …
Relationship Between Screentime And Depressive Symptoms And Associated Mediators For African American Adolescents In The United States, Brittney Jones
Relationship Between Screentime And Depressive Symptoms And Associated Mediators For African American Adolescents In The United States, Brittney Jones
Walden Dissertations and Doctoral Studies
The prevalence of adolescent depression in the United States is increasing as adolescents’ use of electronic screen devices increases. Some studies have found associations between screentime and adolescent depression, and other researchers have posited that screentime is not intrinsically harmful. High screentime in African American adolescents may place them at risk for worse depressive symptom outcomes, but the relationship between screentime and depressive symptoms for this population is unknown. The three research questions of this study addressed whether there is a relationship between screentime and depressive symptoms in African American adolescents, and whether sleep duration and the frequency of physical …
Relationship Between Screentime And Depressive Symptoms And Associated Mediators For African American Adolescents In The United States, Brittney Jones
Relationship Between Screentime And Depressive Symptoms And Associated Mediators For African American Adolescents In The United States, Brittney Jones
Walden Dissertations and Doctoral Studies
The prevalence of adolescent depression in the United States is increasing as adolescents’ use of electronic screen devices increases. Some studies have found associations between screentime and adolescent depression, and other researchers have posited that screentime is not intrinsically harmful. High screentime in African American adolescents may place them at risk for worse depressive symptom outcomes, but the relationship between screentime and depressive symptoms for this population is unknown. The three research questions of this study addressed whether there is a relationship between screentime and depressive symptoms in African American adolescents, and whether sleep duration and the frequency of physical …
Cultural And Contextual Adaptation Of Mental Health Measures In Kenya: An Adolescent-Centered Transcultural Adaptation Of Measures Study, Vincent Nyongesa, Shillah Mwaniga, Joseph Kathono, Obadia Yator, Beatrice Madeghe, Sarah Kanana, Beatrice Amugune, Naomi Anyango, Darius Nyamai, Manasi Kumar
Cultural And Contextual Adaptation Of Mental Health Measures In Kenya: An Adolescent-Centered Transcultural Adaptation Of Measures Study, Vincent Nyongesa, Shillah Mwaniga, Joseph Kathono, Obadia Yator, Beatrice Madeghe, Sarah Kanana, Beatrice Amugune, Naomi Anyango, Darius Nyamai, Manasi Kumar
Brain and Mind Institute
Introduction: There is paucity of culturally adapted tools for assessing depression and anxiety in children and adolescents in low-and middle-income countries. This hinders early detection, provision of appropriate and culturally acceptable interventions. In a partnership with the University of Nairobi, Nairobi County, Kenyatta National Hospital, and UNICEF, a rapid cultural adaptation of three adolescent mental health scales was done, i.e., Revised Children’s Anxiety and Depression Scale, Patient Health Questionnaire-9 and additional scales in the UNICEF mental health module for adolescents.
Materials and methods: Using a qualitative approach, we explored adolescent participants’ views on cultural acceptability, comprehensibility, relevance, and completeness of …
Assessing The Impact Of The Covid-19 Pandemic On Adolescent Mental Health, Vanessa Pizutelli, Yanil Morales, Christina Copeland, Archana Salek
Assessing The Impact Of The Covid-19 Pandemic On Adolescent Mental Health, Vanessa Pizutelli, Yanil Morales, Christina Copeland, Archana Salek
Rowan-Virtua Research Day
Adolescence is a crucial period in which adverse childhood experiences, social relationships, and habits can influence mental wellbeing. According to the CDC, the onset of mental illness is 14.5 years old, which is why it is imperative that individuals with mental health conditions receive early intervention. Since the start of the Covid-19 pandemic, research has shown a dramatic decline in adolescent mental health. Specifically in New Jersey, it has been reported that individuals ages 18-23 have the highest levels of stress and depressive symptoms since the start of the pandemic. In light of these findings, it is vital that more …
The Impact On Adolescent Mental Health In South Jersey Due To The Cancelation And Return Of Sports, Tara Pellegrino, Tara Young
The Impact On Adolescent Mental Health In South Jersey Due To The Cancelation And Return Of Sports, Tara Pellegrino, Tara Young
Rowan-Virtua Research Day
Due to the Covid-19 pandemic, many organized sports programs have been canceled or limited in participation. While research prior to the pandemic has strongly suggested that participation in organized sports has benefits for mental and physical health, especially in adolescence, there have been minimal studies on how the removal of organized sports affects mental health outcomes. Additionally, studies have found that the stress of the pandemic and its associated life changes has greatly decreased mental health outcomes in our target population. These findings may indicate the importance of return to organized sports in a time where mental health outcomes are …
Adolescent Suicide Prevention Via Parental Education, Junelle Shepard, Mary Val Palumbo
Adolescent Suicide Prevention Via Parental Education, Junelle Shepard, Mary Val Palumbo
College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications
Purpose. Up to 24% of children from the ages of 12 to 17 have reported suicidal ideation, with 7-11% reporting at least one suicide attempt in the past 12 months (Hetrick, 2017). In a study by Jones et al (2019) over 50% of parents were unaware their child was exhibiting suicidal ideation. This project aims to increase community awareness of suicidal ideation and teach community members how to talk with adolescents about this sensitive topic.
Methods. Five online training sessions were offered in Fall 2021, with each session lasting 90 minutes. Using Smith et al.’s Suicide Knowledge and Skills Questionnaire, …
The Acute And Persisting Impact Of Covid-19 On Trajectories Of Adolescent Depression: Sex Differences And Social Connectedness, Sabrina R. Liu, Elyssia Poggi Davis, Anton M. Palma, Curt A. Sandman, Laura M. Glynn
The Acute And Persisting Impact Of Covid-19 On Trajectories Of Adolescent Depression: Sex Differences And Social Connectedness, Sabrina R. Liu, Elyssia Poggi Davis, Anton M. Palma, Curt A. Sandman, Laura M. Glynn
Psychology Faculty Articles and Research
Background
The COVID-19 era is a time of unprecedented stress, and there is widespread concern regarding its short- and long-term mental health impact. Adolescence is a sensitive period for the emergence of latent psychopathology vulnerabilities, often activated by environmental stressors. The present study examined COVID-19′s impact on adolescent depression and possible influences of different domains of social connectedness (loneliness, social media use, social video game time, degree of social activity participation).
Methods
A community sample of 175 adolescents (51% boys, mean age = 16.01 years) completed questionnaires once before and twice during the COVID-19 pandemic. Piecewise growth modeling examined the …
Development And Presentation Of A Lesson On Mental Health For High School Students During The 2021 Covid-19 Pandemic, Daniel Yang, Sana Farhat, Jhocelin Morquecho, Rutva Patel, Rui Shi, Md Fateha, Mary Duggan
Development And Presentation Of A Lesson On Mental Health For High School Students During The 2021 Covid-19 Pandemic, Daniel Yang, Sana Farhat, Jhocelin Morquecho, Rutva Patel, Rui Shi, Md Fateha, Mary Duggan
Rowan-Virtua Research Day
With the support of the HRSA, the Health Careers Opportunity Program (HCOP) was established to increase the number of students from underrepresented backgrounds to pursue careers in healthcare. HCOP combines the efforts of high school, undergraduate, and medical students in creating an original project to serve a need within the community. In this HCOP project, we aim to address the issue of mental health with high school students at two New Jersey high schools: Pennsauken and Williamtown.
Dialectical Behavior Therapy For Dual Diagnosis: Treating Adolescent Substance Use Disorder And Co-Occurring Mood Disorders, Melody R. Gately
Dialectical Behavior Therapy For Dual Diagnosis: Treating Adolescent Substance Use Disorder And Co-Occurring Mood Disorders, Melody R. Gately
Senior Honors Projects
No abstract provided.
Understanding The Profiles Of Adolescents Engaged In Intentional Self-Poisoning With Suicidal Intent And The Role Of Primary Care In Early Intervention In Vermont, Rachael Comeau
Graduate College Dissertations and Theses
Suicide prevention is a top public health priority in Vermont. It is a complex issue, requiring a multi-faceted response from many different public and private stakeholders. Because intentional self-poisoning with suicidal intent is rarely lethal, it presents a particularly good opportunity for secondary interventions in the primary care setting. Extensive research has been done on intentional self-poisoning with suicidal intent and its relationship to subsequent risk of death by suicide, but gaps exist in research utilizing poison center data in the primary care setting. This dissertation employs an explanatory sequential mixed method research design to (a) develop a profile of …
Mindfulness Therapy Is An Effective Adjunctive Treatment For Adolescents Living With Hiv, Samantha Rea
Mindfulness Therapy Is An Effective Adjunctive Treatment For Adolescents Living With Hiv, Samantha Rea
Clinical Research in Practice: The Journal of Team Hippocrates
A clinical decision report appraising Webb L, Perry-Parrish C, Ellen J, Sibinga E. Mindfulness instruction for HIV-infected youth: a randomized controlled trial. AIDS Care. 2018;30(6):688–695. https://doi.org/10.1080/09540121.2017.1394434
An Interdisciplinary Study To Understand Treatment Seeking Behavior Among Female Survivors Of Anorexia Nervosa, Meaghan Victoria Tipton
An Interdisciplinary Study To Understand Treatment Seeking Behavior Among Female Survivors Of Anorexia Nervosa, Meaghan Victoria Tipton
Graduate Theses and Dissertations
This study was done to examine what psychosocial factors influence treatment seeking behavior among female survivors of eating disorders. This study uses a mixed methods survey consisting of open-ended item questions regarding treatment experience and social environment, and close-ended items to measure constructs from the Health Belief Model. Fourteen participants were recruited for this study to retrospectively detail their experiences of treatment during their eating disorder. All fourteen participants identified as Caucasian, thirteen identified as female, one identified with other gender, each with a history of medically diagnosed anorexia nervosa. The mean of age of current participants was 29.46, and …
Mental Health Service Utilization Among Urban Adolescents: The Roles Of Perceived Mental Health Problems, Attitudes Towards Professional Help, And Stigma, Yi Tak Tsang
Wayne State University Dissertations
Mental health among adolescents is widely acknowledged as a significant concern in the United States. Based on a national survey, Merikangas et al. (2010) found that among 13-17 year olds, 42% to 48% reported experiencing mental health concerns. It is estimated that only half of adolescents with mental health problems utilize mental health services (Costello et al., 2014). An initial study found that caregivers of disadvantaged youth appeared to function as the “gatekeepers” to mental health services (Tsang et al., 2020). Also, the results suggested that positive attitude towards professional psychological help, but not stigma, predicted service enrollment. The current …
Acknowledging And Addressing Adolescent Depression, Johnsie Burke Hughes
Acknowledging And Addressing Adolescent Depression, Johnsie Burke Hughes
Walden Dissertations and Doctoral Studies
A family practice was found to inconsistently screen adolescents for depression even with the necessary Patient Health Questionnaire (PHQ) screening tools being readily available in their electronic medical record. The development of a practice guideline that offers a systematic approach to screening using the PHQ2 and the PHQ9 will potentially result in an increased guidance and provider willingness to screen for adolescent depression in the family practice setting. The purpose of this DNP project was to determine if an algorithmic practice guideline would increase provider willingness to assess for adolescent depression and identify any barriers to the use of the …
The Impact Of Mother And Adolescent Offspring Distress Reduction Training On Maternal Anxiety And Alcohol Related Behaviors Following Conflict, Sarah Ann Bilsky
The Impact Of Mother And Adolescent Offspring Distress Reduction Training On Maternal Anxiety And Alcohol Related Behaviors Following Conflict, Sarah Ann Bilsky
Graduate Theses and Dissertations
Nearly half of people suffering from psychopathology meet criteria for more than one disorder. Scholars have focused on understanding factors that may simultaneously maintain multiple psychiatric problems. Elevated distress during interpersonal conflict is likely to maintain both alcohol use and anxiety psychopathology. Reducing distress elicited by normative mother-adolescent conflict holds particular promise. Conflict is common in families with problematic drinking and anxiety disorders and the affective impact of parent-offspring conflict is malleable. Distress reduction skills, such as cognitive reappraisal, are effective in reducing distress during conflict. The current study examined the unique and combined effects of training mothers and adolescents …
Identifying Youth At Clinical High Risk: What’S The Emotional Impact?, K A. Woodberry, K S. Powers, C Bryant, D Downing, M Verdi, L Kennedy, D I. Shapiro, R Girgis, G Brucato, D Huang, F M. Crump, C M. Corcoran, L I. Seidman, B Link, W R. Mcfarlane, L Yang
Identifying Youth At Clinical High Risk: What’S The Emotional Impact?, K A. Woodberry, K S. Powers, C Bryant, D Downing, M Verdi, L Kennedy, D I. Shapiro, R Girgis, G Brucato, D Huang, F M. Crump, C M. Corcoran, L I. Seidman, B Link, W R. Mcfarlane, L Yang
Maine Medical Center
Background:
Early intervention in major mental illness promises to improve the lives of those identified.
• But could identifying youth as at clinical high risk (CHR) for psychosis also do harm given that the majority never develop a psychotic disorder?
• Could telling someone they are at risk for psychosis activate internalized stigma that has been associated with increased emotional distress, social withdrawal, non-engagement in treatment, and suicide risk in CHR youth?
• Within the context of a larger study of stigma in CHR, we compared emotional responses to the CHR concept assessed before and after clinical feedback by study …
Opioid Abuse In Rural Communities Among Adolescents With Bipolar Disorder, Sherlina Daishernai Holland
Opioid Abuse In Rural Communities Among Adolescents With Bipolar Disorder, Sherlina Daishernai Holland
Walden Dissertations and Doctoral Studies
Abstract
Low population density in rural areas makes it difficult to deliver services to people with mental health problems and nonmedical prescription opioid abuse remains a problem in the United States. The purpose of this cross-sectional study was to determine whether a parent's socioeconomic status affected care opportunities for children 12 to 17 years of age and whether bipolar disorder increased the likelihood of substance abuse in those children. The theory of reasoned action/planned behavior provided the framework for the study. Secondary data from the Interuniversity Consortium for Political and Social Research 36361 data system, specifically the National Survey on …
A Meta-Synthesis Of Adolescent Psychological Help-Seeking, Karen Barnes
A Meta-Synthesis Of Adolescent Psychological Help-Seeking, Karen Barnes
Walden Dissertations and Doctoral Studies
Although adolescents experience psychological difficulty at a rate higher than any other age group, most do not get the support they need. The purpose of this study was to explore perceptions about barriers, facilitating factors, and help-seeking preferences for psychological support among adolescents. This study involved Best, Gil-Rodriguez, Manktelow, and Taylor’s conceptual framework pathways to online help-seeking to help explain adolescents’ perceptions of factors that influence them seeking support as well as identify pathways for support. A qualitative meta-synthesis design was used to synthesize findings of individual qualitative studies into themes around the central phenomenon of adolescent help-seeking. Data were …
Resting-State Functional Connectivity In Youth With Gender Dysphoria, Felix L. Garcia
Resting-State Functional Connectivity In Youth With Gender Dysphoria, Felix L. Garcia
Dissertations, Theses, and Capstone Projects
Current developmental models of gender identity and gender dysphoria (GD) lack sex-specific profiles of brain function that differentiate between typically-developing and cross-gender identified youth, as postulated by models like the unified theory of the origins of sex differences (Arnold, 2009) and the neurobiological theory of the origins of transsexuality (Swaab & Garcia-Falgueras, 2009). Previously, investigators have used brain imaging modalities such as Resting-State functional Magnetic Resonance Imaging (R-fMRI) to demonstrate differences in resting-state functional connectivity (RSFC) between typically-developing male and female youth, and between typically-developing and GID-diagnosed youth. In the present pilot study, I used R-fMRI to investigate differences in …
The Contributing Factors To Adolescent Depression, Josie H. Lee
The Contributing Factors To Adolescent Depression, Josie H. Lee
Independent Study Project (ISP) Collection
Objective: This paper reviews individual, familial, peer, and societal factors influencing adolescent depression in developed countries. Background: Depression usually onsets at adolescence and contributes to high DALYs. Since depression is treatable, efforts should be made to reduce its prevalence and effect. Methods: The research consisted of looking at literature relevant to the topic and age group and conducting interviews with experts who know about and have worked with adolescent depression. Discussion: Adolescents begins at the onset of puberty, allowing different biological factors such as genetics, stress of puberty, and cognitive changes to increase vulnerability to depression. Adolescents who had substance …
Implementation Of The National Asthma Guidelines In A Residential Pediatric Clinic, Patricia A. Foster-Staples
Implementation Of The National Asthma Guidelines In A Residential Pediatric Clinic, Patricia A. Foster-Staples
Dissertations
Abstract
Purpose: Foster care children admitted to residential facilities are a unique and vulnerable group, many presenting with undiagnosed or poorly managed asthma. The alarming rate of residents admitted to a particular residential primary care clinic with a diagnosis of asthma led to the project question: “Based on record reviews, does staff education about the importance of utilizing the national guidelines for asthma education influence the implementation of such guidelines in a residential pediatric clinic?” The purpose of this quality improvement project was to implement a systematic process to influence practice change. The project was conducted over a period …
Serious Mental Illness Among Young Adult Women Who Use Drugs In The Club Scene: Co-Occurring Biopsychosocial Factors, Maayan Lawental, Hilary L. Surratt, Mance E. Buttram, Steven P. Kurtz
Serious Mental Illness Among Young Adult Women Who Use Drugs In The Club Scene: Co-Occurring Biopsychosocial Factors, Maayan Lawental, Hilary L. Surratt, Mance E. Buttram, Steven P. Kurtz
Center for Health Services Research Faculty Publications
Young women who regularly attend nightclubs are at risk for numerous health and social consequences, including mental distress, sexual and physical victimization and substance dependence. This paper uses a biopsychosocial framework to examine co-occurring mental health problems, victimization, substance dependence, sexual risk and physical pain among a sample of young women who use drugs (N = 222) in Miami’s club scene. The majority of women were under 24 years old, Hispanic, and identified as heterosexual. Almost all the women reported past 90-day use of alcohol, ecstasy/MDMA, marijuana, cocaine and prescription opioids and benzodiazepines; 32% of women reported being in a …
Depression In Low-Income Adolescents: Guidelines For School-Based Depression Intervention Programs, Gopika Hari
Depression In Low-Income Adolescents: Guidelines For School-Based Depression Intervention Programs, Gopika Hari
Auctus: The Journal of Undergraduate Research and Creative Scholarship
Adolescent depression is growing in interest to clinicians. In addition to the estimated 2 million cases of adolescent major depressive episodes each year, depressive symptoms in youth have become indicators of mental health complications later in life. Studies indicate that being low-income is a risk factor for depression and that socioeconomically disadvantaged teenagers are more than twice as likely to develop mental illnesses. Only an estimated 1 in 4 children with mental illnesses receive adequate help and 80% of these resources come through schools. Thus, this study focuses on establishing the importance of depression intervention programs in low-income high schools …
Adolescent Grief: The Nurse's Role In Promoting Healthy Coping Mechanisms And Preventing Future Hospitalizations, Erica C. Reighard
Adolescent Grief: The Nurse's Role In Promoting Healthy Coping Mechanisms And Preventing Future Hospitalizations, Erica C. Reighard
Senior Honors Projects, 2010-2019
Age and developmental stage directly influence the grieving individual's ability to understand and process death. Adolescents are especially vulnerable to developing negative coping skills such as substance abuse, self-destructive behaviors, and eating disorders. After a loss occurs, nurses can use their role as a caregiver who is neither a parent nor a peer to provide adolescents with an opportunity to express their grief. Nurses can educate grieving adolescents on the differences between positive and negative coping skills and can therefore reduce the number of future hospitalizations related to ineffective coping mechanisms.
High School Teachers' Perceptions Of Mental Health And Adolescent Depression, Christine Ann Breuer
High School Teachers' Perceptions Of Mental Health And Adolescent Depression, Christine Ann Breuer
Walden Dissertations and Doctoral Studies
Adolescents have a high rate of untreated mental health issues, specifically related to depression. Current literature does not indicate the impact of teachers' attitudes toward mental health on their decisions to refer students for services. This study provides understanding specifically, how teachers' beliefs about mental health, as well as their age, gender, ethnicity, years of education, and years of teaching, were analyzed to determine the impact each these characteristics had on the decision to refer a student for services. 92 high school teachers participated in this quantitative study by completing a survey measuring their attitudes of mental health, and then …
Development Of A Technology-Based Behavioral Vaccine To Prevent Adolescent Depression: A Health System Integration Model, Benjamin W. Van Voorhees, Tracy Gladstone, Stephanie Cordel, Monika Marko-Holguin, William Beardslee, Sachiko Kuwabara, Mark Allan Kaplan, Joshua Fogel, Anne Diehl, Chris Hansen, Carl Bell
Development Of A Technology-Based Behavioral Vaccine To Prevent Adolescent Depression: A Health System Integration Model, Benjamin W. Van Voorhees, Tracy Gladstone, Stephanie Cordel, Monika Marko-Holguin, William Beardslee, Sachiko Kuwabara, Mark Allan Kaplan, Joshua Fogel, Anne Diehl, Chris Hansen, Carl Bell
Publications and Research
Efforts to prevent depression have become a key health system priority. Currently, there is a high prevalence of depression among adolescents, and treatment has become costly due to the recurrence patterns of the illness, impairment among patients, and the complex factors needed for a treatment to be effective. Primary care may be the optimal location to identify those at risk by offering an Internet-based preventive intervention to reduce costs and improve outcomes. Few practical interventions have been developed. The models for Internet intervention development that have been put forward focus primarily on the Internet component rather than how the program …