Engagement in web-based interventions for individuals who sexually abused children
by Sonja Schröder
Date of Examination:2024-04-12
Date of issue:2024-05-16
Advisor:Dr. Peter Fromberger
Referee:Prof. Dr. Lars Penke
Referee:Prof. Dr. York Hagmayer
Persistent Address:
http://dx.doi.org/10.53846/goediss-10467
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Abstract
English
Although treatment for individuals who committed sexual offenses against children (ICSOC) can reduce their likelihood of reoffending, many individuals remain without treatment due to a lack of its availability. One way to increase the number of treatments on offer may be through web-based interventions (WBIs). Manuscript I of this dissertation is a viewpoint paper that includes a comprehensive literature review of existing WBIs for ICSOC and individuals who have an increased risk of committing sexual offenses against children as well as a summary of the criteria that can be derived from previous research for the successful development, evaluation, and implementation hereof. For WBIs to be effective, engagement of the users with the WBI is an important prerequisite. However, findings from research on face-to-face treatment for ICSOC and on WBIs for health and mental health problems show that treatment engagement is often low. Investigating engagement and factors influencing it can help to find ways for the optimization thereof. To that end, manuscript II and III of this dissertation focus on the acceptance of and the engagement with a WBI, respectively. It is assumed that acceptance follows the same mechanisms as for individuals who use WBIs for health and mental health problems. Further, it is assumed that engagement follows the same mechanisms as for individuals who use WBIs for health and mental health problems and engagement in face-to-face treatment for ICSOC. The predictive power of variables derived from the Unified Theory of Acceptance and Use of Technology model, the risk–need–responsivity model, the Multifactor Offender Readiness Model, and variables from previous research in the respective research fields were thus investigated using regression models. Data from 113 participants of the intermediate analysis of the @myTabu randomized placebo-controlled clinical trial were analyzed. @myTabu is a WBI designed for individuals who are convicted for sexual abuse of children or child sexual exploitation material use and are therefore under community supervision in Germany. The results show that acceptance of WBIs was high for 61% of the participants. Further, higher scores of attitudes toward WBIs and higher scores of social influence, especially the perceived opinion of people close to the participant was predictive of higher scores of acceptance. During the first 8 weeks after the login credentials were sent to the community supervisor, 81% of the participants logged into the WBI at least once. In the first 5 weeks after logging in for the first time, the participants had a median number of six logins on 5 days and a median of two completed sessions out of five sessions which they were asked to complete in that time. There was a trend that individuals who logged into the WBI within the first 8 weeks had higher scores of treatment readiness, higher scores of belief in their own technical preconditions, and higher scores of belief that people close to the participant would recommend participation. Higher scores of treatment readiness were a predictor for a higher number of login days and a higher number of completed sessions. The results can help to better understand engagement of ICSOC with WBIs and can be used to develop targeted interventions to increase acceptance and engagement. The limitations of these analyses are related to the fact that data from an intermediate analysis were used, questionnaires were altered to fit the context of the clinical trial, the results are based on a selected group of individuals who decided to take part in the clinical trial to evaluate @myTabu, and there is the potential of confounding variables. Further research should focus on the intention–behavior gap found in this dissertation by investigating further predictors of engagement and should take a closer look at different types of engagement by including affective and cognitive aspects of it.
Keywords: acceptance; engagement; web-based intervention; sexual offenses against children; child sexual exploitation material; @myTabu; Unified Theory of Acceptance and Use of Technology (UTAUT); eMental Health; forensic psychiatry
