John A Naslund

John A Naslund
Harvard Medical School | HMS · Global Health and Social Medicine

PhD

About

159
Publications
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Introduction
Skills and Expertise

Publications

Publications (159)
Chapter
Digital therapeutics, consisting of digitally enabled interventions for mental health or substance use disorders, hold promise for expanding the access to evidence-based treatments for mental disorders globally. The success of digital therapeutics will require careful adaptations of the digital platforms and intervention content in order to meet th...
Article
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Background Despite widespread use of learning collaboratives, few randomized trials have evaluated their effectiveness as a strategy for implementing evidence based practices. This randomized trial evaluated the effectiveness of a virtual learning collaborative (VLC) in the implementation of a health promotion program for persons with serious menta...
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The present commentary discusses how social media big data could be used in mental health research to assess the impact of major global crises such as the COVID-19 pandemic. We first provide a brief overview of the COVID-19 situation and the challenges associated with the assessment of its global impact on mental health using conventional methods....
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This study investigated whether with disruptions in care due to the COVID-19 pandemic, persons who self-identified as living with a mental health condition increased their usage of an online peer support community. We also explored whether study participants who self-reported usage of online peer support communities were interested in using these c...
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Spatial approaches to epidemiological research with big social media data provide tremendous opportunities to study the relationship between the socio-ecological context where these data are generated and health indicators of interest. Such research poses a number of ethical challenges, particularly in relation to issues such as privacy, informed c...
Article
Importance: Task sharing, the training of nonspecialist workers with no formal experience in counseling, is a promising strategy for addressing the large gap in treatment for depression in low- and middle-income countries (LMICs). Objective: To examine the outcomes and moderators of task-shared psychological interventions associated with depress...
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Mobile Health (mHealth) interventions have received a mix of praise and excitement, as well as caution and even opposition over recent decades. While the rapid adoption of mHealth solutions due to the COVID-19 pandemic has weakened resistance to integrating these digital approaches into practice and generated renewed interest, the increased relianc...
Article
Aim: The purpose of this study was to examine factors associated with weight gain prevention among young adults with serious mental illness who participated in the Fit Forward randomized controlled trial evaluating lifestyle interventions adapted for this high-risk group. The aims were to: (1) examine baseline differences between participants that...
Article
Increasing rates of depression, anxiety, and suicide in the construction industry have drawn the attention of researchers to consider mental health as an integral part of health and safety. However, prior research has focused mainly on determining the sources of work stress, with a paucity of studies related to measures to improve mental health. Th...
Chapter
This chapter describes the rapid spread of digital mental health technologies across the world and further explores specific case studies in low-income and middle-income countries (LMICs). We are increasingly seeing rapid rates of technological innovation and adaptation in low-resource settings including the widespread use of smartphone mobile devi...
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We continue to increase our exchange of information through health technologies, used to access, disseminate, and analyze information. Clinical informatics is a rapidly expanding area and facilitates patient-centered care as defined by quality, affordability, and timely health care. This chapter covers developments in information systems, electroni...
Article
Background Mental health stigma is a major barrier to seeking help, and leads to poor quality of life and social withdrawal for individuals living with mental illness. These concerns are especially severe in low-income and middle-income countries (LMICs) that face a disproportionate share of the global burden of mental illnesses. With growing acces...
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Background Work-related stress in the construction industry increases the prevalence of depression and anxiety among personnel. In low-resource settings such as Nigeria, construction personnel face high demands and severe working conditions but only have a few services to address their mental health needs. With emerging research showing that digita...
Article
Digital technology has emerged as a promising approach for training and building capacity of community health workers in low-income and middle-income countries (LMICs). Little is known about the cost of developing digital training programs in LMICs, which hinders the adoption, implementation, and scaling up of the programs in routine primary care s...
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Aim: The present study aimed to investigate the cross-sectional association between self-reported use of electronic wearable devices (EWDs) and the levels of physical activity among a representative sample of adults with depression and anxiety in the United States. Methods: For this cross-sectional study, data were pooled from the Health Informatio...
Article
Background : Digital technology holds promise for reaching young adults with serious mental illness. This study seeks to characterize technology use and explore interests in digital health interventions among young adults with serious mental illness. Methods : A survey was collected from participants age 18-35 enrolled in a lifestyle intervention...
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Background Despite significant advancements in healthcare technology, digital health solutions – especially those for serious mental illnesses – continue to fall short of their potential across both clinical practice and efficacy. The utility and impact of medicine, including digital medicine, hinges on relationships, trust, and engagement, particu...
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Introduction Social media use is growing in Latin America and is increasingly being used in innovative ways. This study sought to characterise the profile of social media users, among primary care patients in Colombia, and to assess predictors of their use of social media to search for health and mental health information (searching behaviour). Me...
Article
Objective Assess the prevalence and types of digital technology use, as well as the extent to which patients use the internet and mobile devises. Evaluate the socioeconomic characteristics of patients and the possible relation to patterns of technology use in Colombia. Understand the nature of patient technology use in primary care for finding medi...
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The COVID-19 pandemic impacted ongoing clinical trials globally resulting in the suspension, cancellation or a transition to an entirely remote implementation of studies. In India, the countrywide lockdown was imposed in phases starting from March 2020 to June 2020, followed by continued restriction on in-person activities including study procedure...
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Objective: Evidence-based lifestyle interventions tailored to young adults with serious mental illness are needed to reduce their cardiometabolic risk. This study evaluated the effectiveness of a group lifestyle intervention ("PeerFIT") enhanced with mobile health (mHealth) compared with one-on-one mHealth coaching (basic education supported by ac...
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Behavioral health has the opportunity to lead the way in using lifestyle interventions to address obesity and health disparities in people with serious mental illness (SMI) in the COVID-19 era. Evidence-based interventions for weight loss in individuals with SMI exist, and the field has developed strategies for implementing these interventions in r...
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John Naslund and Eirini Karyotaki discuss Mark Jordans and colleagues' accompanying research study on therapy for people with psychological distress in Nepal.
Preprint
BACKGROUND Digital mental health treatments have the potential to expand access to services in low- and middle-income countries (LMICs), but the uptake of interventions has been limited. Furthermore, the attitudes of those in LMICs toward intervention formats are rarely studied. OBJECTIVE To understand the attitudes of Indian college students towa...
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The COVID-19 pandemic has had an unprecedented impact on health systems in most countries, and in particular, on the mental health and well-being of health workers on the frontlines of pandemic response efforts. The purpose of this article is to provide an evidence-based overview of the adverse mental health impacts on healthcare workers during tim...
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Background Depression and anxiety impact up to 1 in 5 pregnant and postpartum women worldwide. Yet, as few as 20% of these women are treated with frontline interventions such as evidence-based psychological treatments. Major barriers to uptake are the limited number of specialized mental health treatment providers in most settings, and problems wit...
Article
Objective Although digital health tools (DHT) are a promising alternative and effective strategy to deliver cancer care and support, their role in health promotion among cancer survivors remains relatively unexplored. We aimed to investigate the acceptability and impact of DHT for health promotion in cancer survivors. Methods Data was pooled from...
Article
Resumen Introducción El uso de las redes sociales está creciendo en América Latina y de manera cada vez más innovadora. Este estudio busca caracterizar el perfil de los usuarios de las redes sociales entre los pacientes de atención primaria en Colombia y evaluar los predictores de utilización de las redes sociales para buscar información de salud...
Article
Aim: To characterize subjective sleep quality and examine its associations with mental health, physical health and health behaviours in a transdiagnostic sample of young adults with serious mental illness (SMI) enrolled in a lifestyle intervention trial. Methods: Baseline data from a lifestyle intervention trial with young adults (ages 18-35 yea...
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Background Internet-based interventions show clinical effectiveness for treating anxiety disorders and depression and could make mental healthcare more affordable. Methods We searched databases including PubMed; EMBASE; Cochrane Central; PsychINFO; CINAHL; EconLit; and Web of Science from January 1, 2000 to August 21, 2020. Inclusion criteria were...
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Introduction: The immediate impact of COVID-19 on morbidity and mortality has raised the need for accurate and real time data monitoring and communication. The aim of this study is to document initial observations from multiple digital services providers during the COVID-19 crisis, especially those related to mental health and wellbeing. Materials...
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Most of the global population live in low-income and middle-income countries (LMICs), which have historically received a small fraction of global resources for mental health. The COVID-19 pandemic has spread rapidly in many of these countries. This Review examines the mental health implications of the COVID-19 pandemic in LMICs in four parts. First...
Article
Objective This study explored perspectives of researchers working with the National Institute of Mental Health (NIMH) Scale-Up Hubs, consisting of research partnerships for scaling up mental health interventions in low- and middle-income countries (LMICs), to: 1) identify common barriers to conducting impactful research on the implementation of evi...
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Background Predicting and preventing relapse presents a crucial opportunity and first step to improve outcomes and reduce the care gap for persons living with schizophrenia. Using commercially available smartphones and smartwatches, technology now affords opportunities to capture real-time and longitudinal profiles of patients’ symptoms, cognition,...
Article
Background Training non-specialist health workers (NSHWs) at scale is a major barrier to increasing the coverage of depression care in India. This trial will test the effectiveness of two forms of digital training compared to conventional face-to-face training in changing the competence of NSHWs to deliver a brief evidence-based psychological treat...
Chapter
Addressing mental health problems in urban populations represent an important challenge for the theoretical and clinical approach to treatment. This chapter presents a general framework for better understanding mental health in urban environments. We highlight the emerging evidence for the relations between risks and protective factors and urban me...
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Background: Digital technologies hold promise for building capacity of non-specialist health workers towards scaling up depression care in low-resource settings. The purpose of this study was to describe the systematic approach to designing a digital program for training non-specialist health workers to deliver an evidence-based brief psychologica...
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The rapid spread of COVID-19 and the devastating consequences to economies and healthcare systems around the world has highlighted the exigent need for accessible mental health support. Increasing use of mobile devices in Lower Middle-Income Countries (LMIC) such as India offers novel opportunity to expand treatment options and reach underserved po...
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In low-income and middle-income countries (LMICs), emerging digital mental health interventions should be accompanied by regular and comprehensive assessment of available scientific evidence. This review aims to support efforts to monitor progress in digital mental health research, ensuring new evidence can guide researchers, clinicians, policymake...
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Increased interest in disseminating and implementing psychological treatments has focused on the need for evidence-based training programs for providers, especially those without specialized training. To evaluate provider-training programs, validated outcome measures are necessary; however, the scalable measurement of training outcomes has been lar...
Preprint
UNSTRUCTURED Mental health is a growing public health priority in the United States and globally. Measurement-based care (MBC) has been shown to improve outcomes in clinical care, yet there are significant challenges to implementation. New technologies offer opportunities to address these obstacles and to measure new and existing constructs at a sc...
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Healthcare systems in many countries have been overwhelmed by the coronavirus disease (COVID-19) pandemic, with increasing demands to contain and respond to the virus. The result has been increased pressure on frontline health workers. As the pandemic unfolds, the impact on health systems in low-income and middle-income countries (LMICs) is becomin...
Preprint
BACKGROUND Anxiety is an extremely prevalent condition, but has received notably less attention than depression and other mental health conditions from a research, clinical, and public health perspective. Growing concerns about the burden of anxiety have only been exacerbated by the Coronavirus (COVID-19) pandemic due to the confluence of physical...
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Background Anxiety is an extremely prevalent condition, and yet, it has received notably less attention than depression and other mental health conditions from a research, clinical, and public health perspective. The COVID-19 pandemic has only exacerbated growing concerns about the burden of anxiety due to the confluence of physical health risks, e...
Preprint
Full-text available
Digital mental health treatments have the potential to expand access to services in low- and middle-income countries (LMICs), but the uptake of interventions has been limited. Furthermore, the attitudes of those in LMICs toward intervention formats are rarely studied. In this study, Indian college students were asked to rate a variety of treatment...
Article
Full-text available
Introduction: Task sharing holds promise for scaling up depression care in countries such as India, yet requires training large numbers of non-specialist health workers. This pilot trial evaluated the feasibility and acceptability of a digital program for training non-specialist health workers to deliver a brief psychological treatment for depressi...
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Objective Telepsychiatry involves use of telecommunications technology to deliver psychiatric care and offers promise to reduce costs and increase access to mental health services. This systematic review examined cost reporting of telepsychiatry programmes for mental healthcare. Methods We systematically searched electronic databases for studies r...
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Globally, water scarcity has become a common challenge across many regions. Digital surveillance holds promise for monitoring environmental threats to population health due to severe drought. The 2019 Chennai water crisis in India resulted in severe disruptions to social order and daily life, with local residents suffering due to water shortages. T...
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Purpose of review: Increasingly, digital technologies, especially mobile telecommunications and smartphone apps, are seen as a novel tool for managing severe mental disorders (SMDs) in low-income and middle-income countries (LMICs). However, there is a need to identify best practices in the use of digital technologies to effectively reach, support...
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Integration of behavioral health care into primary care can improve health and economic outcomes. This study adapted the Behavioral Health Integration in Medical Care (BHIMC) index to the Colombian context and assessed the baseline level of behavioral health integration in a sample of primary care organizations. The BHIMC was able to detect the cap...
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The excess risk of early mortality, medical comorbidity, early institutionalization, and high costs among older adults with serious mental illness necessitates development and dissemination of effective and sustainable integrated care models that simultaneously address mental and physical health needs. This overview highlights current, evidence-bas...
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Aims and method This systematic review examines the effectiveness and cost-effectiveness of behavioural health integration into primary healthcare in the management of depression and unhealthy alcohol use in low- and middle-income countries. Following PRISMA guidelines, this review included research that studied patients aged ≥18 years with unhealt...
Article
Social media platforms are popular venues for sharing personal experiences, seeking information, and offering peer-to-peer support among individuals living with mental illness. With significant shortfalls in the availability, quality, and reach of evidence-based mental health services across the United States and globally, social media platforms ma...
Conference Paper
Mental health conditions pose a major challenge to healthcare providers and society at large. Early intervention can have significant positive impact on a person's prognosis, particularly important in improving mental health outcomes and functioning for young people. Virtual Reality (VR) in mental health is an emerging and innovative field. Recent...
Preprint
BACKGROUND Work-related stress in the construction industry gives rise to the prevalence of depression and anxiety among personnel. In low resource settings like Nigeria, construction personnel face high demands, severe working conditions, and there are few services available to address mental health needs. With emerging research showing that digit...
Article
Full-text available
Background: Peer support is recognized globally as an essential recovery service for people with mental health conditions. With the influx of digital mental health services changing the way mental health care is delivered, peer supporters are increasingly using technology to deliver peer support. In light of these technological advances, there is...
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Full-text available
Older adults with obesity are at a high risk of decline, particularly in rural areas. Our study objective was to gain insights into how a potential Mobile Health Obesity Wellness Intervention (MOWI) in rural older adults with obesity, consisting of nutrition and exercise sessions, could be helpful to improve physical function. A qualitative methods...
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Purpose Globally, individuals living with mental disorders are more likely to have access to a mobile phone than mental health care. In this commentary, we highlight opportunities for expanding access to and use of digital technologies to advance research and intervention in mental health, with emphasis on the potential impact in lower resource set...
Conference Paper
Mental health conditions pose a major challenge to healthcare providers and society at large. According to the Mental Health Foundation of New Zealand, one in five people will develop a serious mood disorder, including depression, at some time in their life [2]. Early intervention can have significant positive impact on a person’s prognosis, partic...