Willingness to Use Internet-Based Versus Bibliotherapy Interventions in a Representative US Sample: Cross-sectional Survey Study

Background: Self-help interventions have the potential to increase access to evidence-based mental health care. Self-help can be delivered via different formats, including print media or digital mental health interventions (DMHIs). However, we do not know which delivery format is more likely to result in higher engagement. Objective: The aims of this study were to identify if there is a preference for engaging in print media versus DMHIs and whether there are individual differences in relative preferences. Methods: Participants were 423 adults between the ages of 18 and 82 years (201/423, 47.5% female) recruited on Prolific as a nationally representative sample of the US population, including non-Hispanic White (293/423, 69.2%), non-Hispanic Black (52/423, 12%), Asian (31/423, 7%), Hispanic (25/423, 6%), and other individuals (22/423, 5%). We provided individuals with psychoeducation in different self-help formats and measured their willingness to use print media versus DMHIs. We also assessed participants' demographics, personality, and perception of each format's availability and helpfulness and used these to predict individual differences in the relative preferences. Results: Participants reported being more willing to engage with print media than with DMHIs (B=0.41, SE 0.08; t(422)=4.91; P<.001; d=0.24, 95% CI 0.05-0.43). This preference appeared to be influenced by education level (B=0.22, SE 0.09; t(413)=2.41; P=.02; d=0.13, 95% CI -0.06 to 0.32), perceived helpfulness (B=0.78, SE 0.06; t(411)=13.66; P<.001; d=0.46, 95% CI 0.27-0.66), and perceived availability (B=0.20, SE 0.58; t(411)=3.25; P=.001; d=0.12, 95% CI 0.07-0.30) of the self-help format. Conclusions: This study suggests an overall preference for print media over DMHIs. Future work should investigate whether receiving mental health treatment via participants' preferred delivery format can lead to higher engagement.