***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Effective , accessible , and affordable depression treatment is of high importance considering the large personal and economic burden of depression . Internet-based treatment is considered a promising clinical and cost-effective alternative to current routine depression treatment strategies such as face-to-face psychotherapy . However , it is not clear whether research findings translate to routine clinical practice such as primary or specialized mental health care . The E-COMPARED project aims to gain knowledge on the clinical and cost-effectiveness of blended depression treatment compared to treatment-as-usual in routine care . Methods / design E-COMPARED will employ a pragmatic , multinational , r and omized controlled , non-inferiority trial in eight European countries . Adults diagnosed with major depressive disorder ( MDD ) will be recruited in primary care ( Germany , Pol and , Spain , Sweden , and the United Kingdom ) or specialized mental health care ( France , The Netherl and s , and Switzerl and ) .  Regular care for depression is compared to “ blended ” service delivery combining mobile and Internet technologies with face-to-face treatment in one treatment protocol . Participants will be followed up at 3 , 6 , and 12 months after baseline to determine clinical improvements in symptoms of depression ( primary outcome : Patient Health Question naire-9 ) , remission of depression , and cost-effectiveness . Main analyses will be conducted on the pooled data from the eight countries ( n = 1200 in total , 150 participants in each country ) . Discussion The E-COMPARED project will provide mental health care stakeholders with evidence -based information and recommendations on the clinical and cost-effectiveness of blended depression treatment . Trial registration France : Clinical Trials.gov NCT02542891 . Registered on 4 September 2015 ; Germany : German Clinical Trials Register DRKS00006866 . Registered on 2 December 2014 ; The Netherl and s : Netherl and s Trials Register NTR4962 . Registered on 5 January 2015 ; Pol and : Clinical Trials . Gov NCT02389660 . Registered on 18 February 2015 ; Spain : Clinical Trials.gov NCT02361684 . Registered on 8 January 2015 ; Sweden : Clinical Trials.gov NCT02449447 . Registered on 30 March 2015 ; Switzerl and : Clinical Trials.gov NCT02410616 . Registered on 2 April 2015 ; United Kingdom : IS RCT N registry , IS RCT N12388725 . Registered on 20 March 2015 Background Internet-based Cognitive Behavioural Therapy ( iCBT ) for the treatment of depressive disorders  is innovative and promising . Various studies have demonstrated large effect sizes up to 2.27 , but implementation in routine practice lags behind . Mental health therapists play a significant role in the uptake of internet-based interventions . Therefore , it is interesting to study factors that influence the therapists in whether they apply internet-based therapy or not . This study , as part of the European implementation project MasterMind , aims to identity the factors that promote or hinder therapists in the use of  iCBT  in depression care . Methods / Design The uptake of iCBT by  therapists in routine mental health care practice for the treatment of depression will be evaluated by a mixed method approach , to provide an underst and ing of the implementation factors ( quantitative ) , and to ascertain the facilitating and hindering factors in the involvement of therapists in the implementation of iCBT ( qualitative ) . The involvement of therapists in the implementation of  iCBT  is analysed following the RE- AIM framework on the five dimensions Reach , Efficacy/Effectiveness , Adoption , Implementation , and Maintenance . This enables us to evaluate the reach of therapists , the impact of iCBT on depression care , the extent to which therapists adopt iCBT  , the extent to which iCBT  is delivered as intended , and how  iCBT can be maintained over time . Discussion The results will provide valuable insight into the role of therapists in the implementation of iCBT for depression in secondary mental health care setting s. They will result in concrete recommendations for how therapists can be facilitated in implementing and up-scaling iCBT for depression OBJECTIVE To explore expectations and experiences of online cognitive behavioural therapy ( CBT ) among primary -care patients with depression , focusing on how this mode of delivery impacts upon the therapeutic experience . DESIGN Qualitative study , using repeat semi-structured interviews with patients before and after therapy . The study was conducted in parallel with a r and omized controlled trial examining the effectiveness and cost-effectiveness of online CBT for patients with depression . PARTICIPANTS Twenty-four patients with depression recruited from five general practice s in southwest Engl and , who were offered up to 10 sessions of CBT , delivered via the internet by a psychologist . RESULTS Most participants accessed the therapy from their home computer and found this to be a major advantage , in terms of convenience and fitting therapy into their daily routine , with any technical problems quickly resolved . Two key themes regarding expectations and experiences of online CBT were : developing a virtual relationship with a therapist , and the process of communicating thoughts and emotions via an online medium . Online CBT seems to be acceptable to , and experienced as helpful by , certain subgroups of patients with depression , particularly those who are familiar with computers , feel comfortable with writing their feelings down , enjoy the opportunities to review and reflect that written ( or typed ) communication offers are attracted to the ' anonymity ' of an online therapeutic relationship and are open to the proactive requirements of CBT itself . However , on-line CBT may feed into the vulnerability of depressed people to negative thoughts , given the absence of visual cues and the immediate response of face-to-face interaction . CONCLUSIONS Online CBT has the potential to enhance care for patients with depression who are open to engaging in ' talking ' ( or typing ) therapies as part of their treatment . If online CBT is to be provided via the NHS , it is important to establish patient preferences regarding this mode of delivery and ensure that referral practice s are appropriately targeted . The results of our main trial will provide evidence regarding the effectiveness and cost-effectiveness of receiving therapy via this modality BACKGROUND Internet-based interventions ( IBI ) are effective in treating depression . However , uptake rates in routine care are still limited . Hence , this study aim ed to ( 1 ) assess the acceptance of IBIs in primary care patients with depressive symptoms and to ( 2 ) examine the effects of a brief acceptance facilitating intervention in the form of an informational video on patients ' acceptance of IBIs . METHODS Primary care patients ( N=128 ) with Minor or Major Depression were r and omly assigned to an intervention ( IG ) or control group ( CG ) . Patients in the IG were shown a brief informational video about IBIs before receiving a question naire that assessed their  acceptance  of IBIs and other secondary outcomes . Patients of the CG filled out the question naire immediately . RESULTS Baseline acceptance of IBIs in the CG was high for 6.3 % , moderate for 53.1 % and low for 40.6 % of patients . Acceptance of IBIs was significantly higher in the IG when compared to the CG ( d=.71 , 95%-CI:.09 - 2.91 ) . Except for social influence and the general attitude towards psychological treatment , all secondary outcomes were also significantly improved ( e.g. effort- ( d=.40 ) and performance-expectancy : d=.65 ; knowledge about Internet interventions d=.35 ) . LIMITATIONS Depression of the participants was only assessed using a self-report measure ( PHQ-9 ) . CONCLUSION Primary care patients '  acceptance of IBIs for depressive symptoms was low but could be increased significantly using a brief acceptance facilitating intervention on the basis of an informational video . Future studies should further examine the potential of acceptance facilitating interventions for patients and health care providers to exploit the public health impact of IBIs OBJECTIVE Practice -based collaborative care is a complex evidence -based practice that is difficult to implement in smaller primary care practice s that lack on-site mental health staff . Telemedicine-based collaborative care virtually co-locates and integrates mental health providers into primary care setting s. The objective of this multisite r and omized pragmatic comparative effectiveness trial was to compare the outcomes of patients assigned to practice -based and telemedicine-based collaborative care . METHOD From 2007 to 2009 , patients at federally qualified health centers serving medically underserved population s were screened for depression , and 364 patients who screened positive were enrolled and followed for 18 months . Those assigned to practice -based collaborative care received evidence -based care from an on-site primary care provider and a nurse care manager . Those assigned to telemedicine-based collaborative care received evidence -based care from an on-site primary care provider and an off-site team : a nurse care manager and a pharmacist by telephone , and a psychologist and a psychiatrist via videoconferencing . The primary clinical outcome measures were treatment response , remission , and change in depression severity . RESULTS Significant group main effects were observed for both response ( odds ratio=7.74 , 95 % CI=3.94 - 15.20 ) and remission ( odds ratio=12.69 , 95 % CI=4.81 - 33.46 ) , and a significant overall group-by-time interaction effect was observed for depression severity on the Hopkins Symptom Checklist , with greater reductions in severity over time for patients in the telemedicine-based group . Improvements in outcomes appeared to be attributable to higher fidelity to the collaborative care evidence base in the telemedicine-based group . CONCLUSIONS Contracting with an off-site telemedicine-based collaborative care team can yield better outcomes than implementing practice -based collaborative care with locally available staff Background In the UK around 22 % of men and 24 % of women are obese , and there are varying but worrying levels in other European countries . Obesity is a chronic condition that carries an important health risk . National guidelines , for use in Engl and , on the management of people who are overweight or obese have been published by the National Institute for Health and Clinical Excellence ( NICE , 2006 ) . NICE recommendations for primary care teams are : determine the degree of overweight and obesity ; assess lifestyle , comorbidities and willingness to change ; offer multicomponent management of overweight and obesity ; referral to external services when appropriate . This study investigates a tailored intervention to improve the implementation of these recommendations by primary care teams . Methods / Design The study is a cluster r and omised controlled trial . Primary care teams will be recruited from the East Midl and s of Engl and , and r and omised into two study arms : 1 ) the  study group  , in which primary care teams are offered a set of tailored interventions to help implement the NICE guidelines for overweight and obesity ; or 2 ) the control group in which primary care teams continue to practice usual care . The primary outcome is the proportion of overweight or obese patients for whom the primary care team adheres to the NICE guidelines . Secondary outcomes include the proportion of patients with a record of lifestyle assessment , referral to external weight loss services , the proportion of obese patients who lose weight during the intervention period , and the mean weight change over the same period . Discussion Although often recommended , the methods of tailoring implementation interventions to account for the determinants of practice are not well developed . This study is part of a programme of studies seeking to develop the methods of tailored implementation . Trial registration Current Controlled Trials IS RCT N07457585 . Registered 09/08/2013 . R and omisation commenced 30/08/2013 Purpose Rural population s face numerous barriers to mental health care . Although internet-delivered mental health treatments may offer an accessible and cost-effective answer to these barriers , there has been little evaluation of the feasibility of this approach among rural communities . Methods Data were obtained from a r and om rural community sample through the third wave of the Australian Rural Mental Health Study .  Attitudes towards  internet-delivered mental health treatments  and availability of  internet access  were explored . Data were analysed to identify sub-groups in whom internet-delivered treatments may be usefully targeted . Results Twelve hundred and forty-six participants completed the survey ( mean age 59 years , 61 % females , 22 % from remote areas ) . Overall , 75 % had internet access and 20 % would consider using  internet-based interventions  , with 18 % meeting both of these feasibility criteria . Logistic regression revealed feasibility for internet-delivered mental health treatment  was associated with younger age , male gender , being a carer , and a 12-month mental health problem . Participants who had used internet-delivered services in the past were significantly more likely to endorse these treatments as acceptable . Conclusions There is considerable potential for internet-delivered treatments to increase service accessibility to some sub-groups , particularly among people with mental health problems who are not currently seeking help .  Resistance to internet treatments appears to be largely attitudinal , suggesting that enhancing community education and familiarity with such programs may be effective in improving perceptions and ultimately access E-mental health services are Internet-based treatment options for mental illness . There has been a proliferation of these services in recent years , with online programs now available for the treatment of mood , anxiety , eating , adjustment , and substance use disorders . ( 1 ) E-mental health services allow for greater dissemination of psychological treatments , are cost effective , and may overcome a number of client barriers to care . ( 1 ) However , the limited research available indicates that attitudes about e-mental health services are less than optimal . Past research has found that providing information about services can improve attitudes . This study investigated the relationship between knowledge of e-mental health services and attitudes toward e-mental health services .  The attitudes examined were the perceived helpfulness of e 
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Conclusions Of the 37 determinants , three were reported most frequently : ( 1 ) the acceptance of eMH concerning expectations and preferences of patients and professionals about receiving and providing eMH in routine care , ( 2 ) the appropriateness of eMH in addressing patients ’ mental health disorders , and ( 3 ) the availability , reliability , and interoperability with other existing technologies such as the electronic health records are important factors for mental health care professionals to remain engaged in providing eMH to their patients in routine care .