Prompting Depression Treatment Seeking among Smokers: A Comparison of Participants from Six Countries in an Internet Stop Smoking RCT

Websites containing information and advice about health are increasingly common and popular. It is important to understand whether the material these sites contain can positively influence individual behavior, and whether populations differ in their response to that material. Participants in an international web-based stop smoking randomized controlled trial (RCT) were screened for major depression; participants whose history and/or depression symptoms were deemed of concern were offered one of two prompts (Strong and Mild) to seek treatment, depending on depression history. Participants from 3 predominantly English-speaking and 3 predominantly Spanish-speaking countries were analyzed. Individuals given a Strong prompt were more likely to seek treatment for depression than those given a weak prompt (16.6% vs. 10.2% of previously untreated individuals reported seeking treatment), controlling for symptom level and other variables. Country-specific differences were observed, with participants from South Africa and Spain departing from the common pattern of Strong prompt leading to higher likelihood of treatment seeking. Older age and female gender, but not symptom level predicted higher likelihood of seeking treatment following a prompt. The results suggest that information provided by the health websites can promote help seeking in affected individuals.