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The Korean Society for Journalism & Communication (KSJCS)
[ Brdadcast Contents / Culture ]
Korean Journal of Journalism & Communication Studies - Vol. 62, No. 6, pp.167-194
ISSN: 2586-7369 (Online)
Print publication date 31 Dec 2018
Received 09 Oct 2018 Revised 30 Nov 2018 Accepted 03 Dec 2018
DOI: https://doi.org/10.20879/kjjcs.2018.62.6.006

정신건강 증진을 위한 모바일 정신건강 앱 이용에 관한 연구 : 정보-동기-행동능력모델의적용

안순태** ; 이하나***
**이화여자대학교커뮤니케이션·미디어학부교수 soontae@ewha.ac.kr
***이화여자대학교커뮤니케이션·미디어박사과정 hoy1222@naver.com
Use of Mobile Mental Health Application for Mental Health Promotion : Based on the Information-Motivation-Behavioral Skills Model
Soontae An** ; Hannah Lee***
**Professor, School of Communication and Media, Ewha Womans University soontae@ewha.ac.kr
***Doctoral Student, School of Communication and, Media Ewha Womans University hoy1222@naver.com

초록

건강관리에대한모바일앱의효과가확인되었지만, 정신건강앱이용의활성화요인을탐색한 연구는미흡하다. 한국사회의 높은 자살률과정신질환 증가율을 고려했을때, 모바일 앱은 정신건강 관리와 증진을 위한 효과적인 도구로 사용될 수 있다. 이에 본 연구는 정보-동기-행동능력 모델을 토대로 정신건강 앱 이용에 미치는 개인적, 사회 심리적 요인들이 무엇인지 조사하였다. 온라인으로 진행된조사에는총228명의성인남녀가참여하였다. 구조방정식모델을 이용한분석결과, 정신건강앱이용의도에대한정보요인(예, 정신건강지식)의직접효과 및 간접효과는유의미하지않았다. 반면, 정신건강앱이용에대한동기요인(예, 사회적지지, 주관적규범, 정신건강앱이용태도)의직접효과및간접효과가모두나타났다. 행동능력(예, 자기 효능감)은 동기와 앱 이용 의도 사이를 매개하였다. 또한, 본 연구는 정보-동기-행동 능력모델에문화적변인인정신과 상담/치료에대한태도를추가하였으며, 해당변인은 앱이용 의도에 부적인 영향력을 보여주었다. 본 연구의 결과는 정신건강 관리를 위한 모바일 앱 이용 및 정신건강중재방안으로서개인적, 사회적 동기의 촉진과 정신건강서비스에 대한 태도가 중요함을 지적한다.

Abstract

Although the positive effects of mobile applications on health care have been well-documented, little is known about the factors affecting one’s intention for using a mental health application. Given the increasing prevalence of mental health illnesses and high suicide rates, mobile applications are a promising tool for prevention and treatment of mental illnesses in Korean society. The current study examined the cognitive and social psychological determinants of the mental health app use based on the information-motivation-behavioral skills model. A total of 228 men and women participated in the online survey. Structural equation modeling demonstrated that the information factor (ex. level of mental health knowledge) did not show direct or indirect effects on intention to use the mental health app. The motivation factor (ex. social support, subjective norm, and attitudes toward mental health app use), however, demonstrated both indirect and direct influences. Further, behavioral skill (ex. self-efficacy) played a mediating role between motivation and intention to use the app. Also, this study expanded the model by adding a cultural variable (ex. attitudes toward seeking professional help; ATSPH). Results revealed a significant negative relation between ATSPH and intention to use the app. The results of this study highlight the important role of mobile app for prevention and treatment of mental illnesses by promoting individual and social motivation for mental health intervention.

Keywords:

Mental Health Application, Social Stigma, Information-Motivation-Behavioral Skills Model, Attitudes toward Seeking Professional Help, Mental Health Promotion

키워드:

정신건강앱, 사회적낙인, 정보-동기-행동능력모델, 정신과상담/치료에대한태도, 정신건강증진

Acknowledgments

이논문은2018년대한민국교육부와한국연구재단의지원을받아수행된연구임(NRF-2018S1A5A2A01028437)

References

  • 김기찬 (2017.11.17). 고독한 한국인 … SNS 활동 많은데 정작 의지할 사람 없다. <중앙일보>. https://news.joins.com/article/22123825
  • 김대업(2008). <Amos A to Z: 논문작성절차에따른구조방정식모형분석>. 서울: 학현사.
  • 김영욱·이하나·김혜인·문현지 (2017). 미세먼지 어플리케이션 이용 효과 및 수용 요인에 대한 연구. <홍보학연구>, 21권4호, 114-142.
  • 박종진·최규석·김정래·박인규·강정진·손병기 (2014). 정신건강 관리용 모바일 헬스케어 앱 개발-분노관리를중심으로. <한국인터넷방송통신학회논문지>, 14권6호, 13-18.
  • 배소미·유채린·최아영·유준(2017). <스마힐링: 우울증환자를위한웃음치료모바일어플리케이션>. 한국정보과학회학술발표논문집, 1738-1740.
  • 보건복지부(2017). 2016년도정신질환실태조사. http://www.mohw.go.kr/react/modules/download.jsp?BOARD_ID=140&CONT_SEQ=339117&FILE_SEQ=205288
  • 서울시정신건강복지센터(2017). <2017년정신건강에관한서울시민인식도조사보고서>. 서울: 서울시 정신건강복지센터. http://seoulmentalhealth.kr/dataroom/report.jsp?cmd=view&test_num=90
  • 송선미(2017). 스트레스관리: 건강에미치는영향과정책적함의. <국민건강증진포럼> 통권4호, 4-17.
  • 안순태·이하나(2017). 자살에대한인식과태도: 부정적감정수용과자살리터러시의역할에대한탐색. <한국사회복지조사연구>, 52권, 95-117.
  • 왕보람·박지윤·최인영(2011). 스마트폰헬스케어애플리케이션수용을위한주요영향요인. <한국콘텐츠학회논문지>, 11권10호, 396-404.
  • 이윤혜·황민철·이수진·김환희 (2013). <제한적 커뮤니케이션 서비스기반 모바일 전문상담 어플리케이션에관한연구>. 한국감성과학회추계학술대회. 83-84.
  • 이이삭·이상현·정재선·노기영(2017). 모바일헬스케어앱의지속사용의도에미치는심리적요인의영향연구. <디지털융복합연구>, 15권7호, 445-456.
  • 장재순·조성훈(2016). 정신건강분야에서의모바일헬스(mobile health). <스트레스硏究>, 24권4호, 231-236.
  • 정광재·이보겸 (2016). <모바일 웹과 앱의 이용패턴 비교와 모바일 인터넷 서비스의 생태계> (기본연구 16-03). 충북: 정보통신정책연구원
  • 조유제·최정일 (2011). 스마트폰 애플리케이션 사용자의 지각된 특성이 지속사용의도에 미치는 영향에 관한연구. <한국IT서비스학회지>, 10권, 41-60.
  • 조재희(2014). 건강관련앱의지속적이용에대한인지적, 사회적요인사회적영향을포함한확장된기술수용모델(TAMII) 을중심으로. <홍보학연구>, 18권1호, 212-241.
  • 차동필 (2004). IMB 모델을 적용한 에이즈 (AIDS) 예방행동의 이해. <한국광고홍보학보>, 6권 3호, 196-228.
  • 통계청(2010). 2010 인구주택총조사전수집계결과. http://kostat.go.kr/portal/korea/kor_nw/2/1/index.board?bmode=read&aSeq=249070
  • 홍현숙·김수진·송진희·하유정·노성원(2008). <우리나라일반성인의정신건강지식(Mental Health Literacy) 실태조사>. 서울: 국립서울병원국립정신보건교육연구센터.
  • An, S. & Lee, H. (2018). Wireless Mobile Communication and Healthcare. In Paolo P., Amir M. R, & Nima T. Adoption of Mobile Apps for Mental Health: Socio-psychological and Technological Factors (pp. 29-37). Springer. [https://doi.org/10.1007/978-3-319-98551-0_4]
  • Anderson, K., Burford, O., & Emmerton, L. (2016). Mobile health apps to facilitate self-care: a qualitative study of user experiences. PLoS One, 11(5), 1-21. Retrieved from https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0156164&type=printable [https://doi.org/10.1371/journal.pone.0156164]
  • APAC (2016). Mobile Apps in APAC 2016 Report. Retrieved from http://apac.thinkwithgoogle.com/articles/mobile-apps-in-apac-2016-report.html
  • Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191-215. [https://doi.org/10.1037//0033-295X.84.2.191]
  • Bandura, A. (1989). Human agency in social cognitive theory. American Psychologist, 44(9), 1175-1184. [https://doi.org/10.1037//0003-066X.44.9.1175]
  • Bentley, K. H., Franklin, J. C., Ribeiro, J. D., Kleiman, E. M., Fox, K. R., & Nock, M. K. (2016). Anxiety and its disorders as risk factors for suicidal thoughts and behaviors: Ameta-analytic review. Clinical Psychology Review, 43, 30-46. [https://doi.org/10.1016/j.cpr.2015.11.008]
  • Berrouiguet, S., Baca-García, E., Brandt, S., Walter, M., & Courtet, P. (2016). Fundamentals for future mobile-health (mHealth): a systematic review of mobile phone and web-based text messaging in mental health [On-Line]. Journal of Medical Internet Research, 18(6), 135. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4920962/ [https://doi.org/10.2196/jmir.5066]
  • Brian, R. M., & Ben-Zeev, D. (2014). Mobile health (mHealth) for mental health in Asia: objectives, strategies, and limitations. Asian Journal of Psychiatry, 10, 96-100. [https://doi.org/10.1016/j.ajp.2014.04.006]
  • Cho, S. J., Lee, J. Y., Hong, J. P., Lee, H. B., Cho, M. J., & Hahm, B. J. (2009). Mental health service use in a nationwide sample of Korean adults. Social Psychiatry and Psychiatric Epidemiology, 44(11), 943-951. [https://doi.org/10.1007/s00127-009-0015-7]
  • Choi, E., Chentsova-Dutton, Y., & Parrott, W. G. (2016). The effectiveness of somatization in communicating distress in Korean and American cultural contexts. Frontiers in Psychology, 7, 383. Retrieved from https://doi.org/10.3389/fpsyg.2016.00383 [https://doi.org/10.3389/fpsyg.2016.00383]
  • Christensen, H., Griffiths, K., & Evans, K. (2002). e-Mental health in Australia: Implications of the Internet and related technologies for policy. Canberra: Commonwealth Department of Health and Ageing. [https://doi.org/10.1037/e677122010-001]
  • Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., ... & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45(1), 11-27. [https://doi.org/10.1017/S0033291714000129]
  • Cohen, G. E., & Kerr, B. A. (1999). Computer-mediated counseling: An empirical study of a newmental health treatment. Computers in Human Services, 15(4), 13-26. [https://doi.org/10.1300/J407v15n04_02]
  • Corrigan, P. W. (2002). Testing social cognitive models of mental illness stigma: The prairie state stigma studies. Psychiatric Rehabilitation Skills, 6(2), 232-254. [https://doi.org/10.1080/10973430208408434]
  • Craig Lefebvre, R., & Flora, J. A. (1988). Social marketing and public health intervention. Health Education Quarterly, 15(3), 299-315. [https://doi.org/10.1177/109019818801500305]
  • Donker, T., Petrie, K., Proudfoot, J., Clarke, J., Birch, M. R., & Christensen, H. (2013). Smartphones for smarter delivery of mental health programs: a systematic review [On-Line]. Journal of Medical Internet Research, 15(11). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3841358/ [https://doi.org/10.2196/jmir.2791]
  • Fischer, E. H., & Farina, A. (1995). Attitudes toward seeking professional psychologial help: A shortened form and considerations for research. Journal of College Student Development, 36(4), 368-373. [https://doi.org/10.1037/t05375-000]
  • Fishbein, M., & Ajzen, I. (1975). Belief, attitude, intention and behavior: An introduction to theory and research. MA: Addison-Wesley.
  • Fisher, J. D., & Fisher, W. A. (1992). Changing AIDS-risk behavior. Psychological Bulletin, 111(3), 455-474. [https://doi.org/10.1037//0033-2909.111.3.455]
  • Fisher, J. D., & Fisher, W. A. (1996). The Information-Motivation-Behavioral skills model of AIDS risk behavior change: Empirical support and application. In S. Oskamp & S. C. Thompson (Eds.), The Claremont Symposium on Applied Social Psychology. Understanding and preventing HIV risk behavior: Safer sex and drug use (pp. 100-127). Thousand Oaks, CA, US: Sage Publications, Inc.
  • Fisher, J. D., & Fisher, W. A. (2000). Theoretical approaches to individual-level change in HIV risk behavior. In J. Peterson & R. J. DiClemente (Eds.), HIV prevention handbook (pp. 3-55). New York: Kluwer Academic PlenumPress [https://doi.org/10.1007/978-1-4615-4137-0_1]
  • Fisher, J. D., Fisher, W. A., Amico, K. R., & Harman, J. J. (2006). An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychology, 25(4), 462-473. [https://doi.org/10.1037/0278-6133.25.4.462]
  • Fisher, W. A., Fisher, J. D., & Harman, J. (2003). The information-motivation-behavioral skills model: A general social psychological approach to understanding and promoting health behavior. Social Psychological Foundations of Health and Illness, 82-106. [https://doi.org/10.1002/9780470753552.ch4]
  • Fisher, J. D., Fisher, W. A., Williams, S. S., & Malloy, T. E. (1994). Empirical tests of an information-motivation-behavioral skills model of AIDS-preventive behavior with gay men and heterosexual university students. Health Psychology, 13(3), 238-250. [https://doi.org/10.1037//0278-6133.13.3.238]
  • Frisman, G. H., & Berterö, C. (2008). Having knowledge of metabolic syndrome: Does the meaning and consequences of the risk factors influence the life situation of Swedish adults?. Nursing & Health Sciences, 10(4), 300-305. [https://doi.org/10.1111/j.1442-2018.2008.00418.x]
  • Gao, J., Wang, J., Zhu, Y., & Yu, J. (2013). Validation of an information–motivation– behavioral skills model of self-care among Chinese adults with type 2 diabetes. BMC Public Health, 13(1), 100-106. [https://doi.org/10.1186/1471-2458-13-100]
  • Henry, C., Van den Bulke, D., Bellivier, F., Etain, B., Rouillon, F., & Leboyer, M. (2003). Anxiety disorders in 318 bipolar patients: prevalence and impact on illness severity and response to mood stabilizer. Journal of clinical psychiatry, 64(3), 331-335. [https://doi.org/10.4088/JCP.v64n0316]
  • Hoque, M. R. (2016). An empirical study of mHealth adoption in a developing country: the moderating effect of gender concern. BMC Medical Informatics and Decision Making, 16(1), 51-61. [https://doi.org/10.1186/s12911-016-0289-0]
  • Jeon, H. J., Walker, R. S., Inamori, A., Hong, J. P., Cho, M. J., Baer, L., ... & Mischoulon, D. (2014). Differences in depressive symptoms between Korean and American outpatients with major depressive disorder. International Clinical Psychopharmacology, 29(3), 150-156. [https://doi.org/10.1097/YIC.0000000000000019]
  • Jorm, A. F., Morgan, A. J., & Malhi, G. S. (2013). The future of e-mental health, Australian & New Zealand Journal of Psychiatry, 47(2), 104-106. [https://doi.org/10.1177/0004867412474076]
  • Ki, M., Paik, J. W., Choi, K. S., Ryu, S. H., Han, C., Lee, K., ... & Lee, M. S. (2014). Delays in depression treatment among Korean population. Asia‐Pacific Psychiatry, 6(4), 414-424. [https://doi.org/10.1111/appy.12140]
  • Kiene, S. M., Fisher, W. A., Shuper, P. A., Cornman, D. H., Christie, S., MacDonald, S., ... & Fisher, J. D. (2013). Understanding HIV transmission risk behavior among HIV-infected South Africans receiving antiretroviral therapy: An Information— Motivation—Behavioral Skills Model analysis. Health Psychology, 32(8), 860-868. [https://doi.org/10.1037/a0030554]
  • Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ‐9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606-613. [https://doi.org/10.1046/j.1525-1497.2001.016009606.x]
  • Lal, S., & Adair, C. E. (2014). E-mental health: a rapid review of the literature. Psychiatric Services, 65(1), 24-32. [https://doi.org/10.1176/appi.ps.201300009]
  • Luxton, D. D., McCann, R. A., Bush, N. E., Mishkind, M. C., & Reger, G. M. (2011). mHealth for mental health: Integrating smartphone technology in behavioral healthcare. Professional Psychology: Research and Practice, 42(6), 505-512. [https://doi.org/10.1037/a0024485]
  • Misovich, S. J., Martinez, T., Fisher, J. D., Bryan, A., & Catapano, N. (2003). Predicting Breast Self‐Examination: A Test of the Information‐Motivation‐Behavioral Skills Model 1. Journal of Applied Social Psychology, 33(4), 775-790. [https://doi.org/10.1111/j.1559-1816.2003.tb01924.x]
  • Mita, S. C., Li, E., & Goodell, L. S. (2013). A qualitative investigation of teachers' information, motivation, and behavioral skills for increasing fruit and vegetable consumption in preschoolers. Journal of Nutrition Education and Behavior, 45(6), 793-799. [https://doi.org/10.1016/j.jneb.2013.05.001]
  • Musiat, P., Goldstone, P., & Tarrier, N. (2014). Understanding the acceptability of e-mental health-attitudes and expectations towards computerised self-help treatments for mental health problems. BMC Psychiatry, 14(1), 109, 1-8. [https://doi.org/10.1186/1471-244X-14-109]
  • Musiat, P., & Tarrier, N. (2014). Collateral outcomes in e-mental health: a systematic review of the evidence for added benefits of computerized cognitive behavior therapy interventions for mental health. Psychological Medicine, 44(15), 3137-3150. [https://doi.org/10.1017/S0033291714000245]
  • Park, Y., & Chen, J. V. (2007). Acceptance and adoption of the innovative use of smartphone. Industrial Management & Data Systems, 107(9), 1349-1365. [https://doi.org/10.1108/02635570710834009]
  • Park, C., & Park, Y. H. (2013). Validity and reliability of Korean version of health empowerment scale (K-HES) for older adults. Asian Nursing Research, 7(3), 142-148. [https://doi.org/10.1016/j.anr.2013.07.004]
  • Peek, S. T., Wouters, E. J., van Hoof, J., Luijkx, K. G., Boeije, H. R., & Vrijhoef, H. J. (2014). Factors influencing acceptance of technology for aging in place: a systematic review. International Journal of Medical Informatics, 83(4), 235-248. [https://doi.org/10.1016/j.ijmedinf.2014.01.004]
  • Price, M., Yuen, E. K., Goetter, E. M., Herbert, J. D., Forman, E. M., Acierno, R., & Ruggiero, K. J. (2014). mHealth: a mechanism to deliver more accessible, more effective mental health care. Clinical Psychology & Psychotherapy, 21(5), 427-436. [https://doi.org/10.1002/cpp.1855]
  • Quinn, D. M., & Chaudoir, S. R. (2009). Living with a concealable stigmatized identity: the impact of anticipated stigma, centrality, salience, and cultural stigma on psychological distress and health. Journal of Personality and Social Psychology, 97(4), 634-651. [https://doi.org/10.1037/a0015815]
  • Shea, M., & Yeh, C. (2008). Asian American students' cultural values, stigma, and relational self-construal: Correlates of attitudes toward professional help seeking. Journal of Mental Health Counseling, 30(2), 157-172. [https://doi.org/10.17744/mehc.30.2.g662g5l2r1352198]
  • Sezgin, E., & Yıldırım, S. Ö. (2014). A literature review on attitudes of health professionals towards health information systems: from e-Health to m-Health. Procedia Technology, 16, 1317-1326. [https://doi.org/10.1016/j.protcy.2014.10.148]
  • Venkatesh, V., & Davis, F. D. (2000). A theoretical extension of the technology acceptance model: Four longitudinal field studies. Management Science, 46(2), 186-204. [https://doi.org/10.1287/mnsc.46.2.186.11926]
  • Vogel, D. L., Wade, N. G., & Hackler, A. H. (2007). Perceived public stigma and the willingness to seek counseling: The mediating roles of self-stigma and attitudes toward counseling. Journal of Counseling Psychology, 54(1), 40-50. [https://doi.org/10.1037/0022-0167.54.1.40]
  • Young, K. S. (2005). An empirical examination of client attitudes towards online counseling. Cyber Psychology & Behavior, 8(2), 172-177. [https://doi.org/10.1089/cpb.2005.8.172]
  • Yuan, S., Ma, W., Kanthawala, S., & Peng, W. (2015). Keep using my health apps: Discover users' perception of health and fitness apps with the UTAUT2 model. Telemedicine and e-Health, 21(9), 735-741. [https://doi.org/10.1089/tmj.2014.0148]
  • World Health Organization [WHO]. (1948). International Classification of Diseases (10th ed.). Geneva, Swizerland: Author.
  • World Health Organization [WHO]. (2014). Mental health: a state of well-being. Retrieved from http://www.who.int/features/factfiles/mental_health/en/