Exploring the Effect of Online Health Services on Remote Mental Health

This research proposal investigates the effect of online health services and mobile applications on the mental health of people in remote areas, particularly focusing on the population of Kiwirrkurra, Western Australia. It addresses the treatment gap observed in rural areas due to the unavailability of health professionals and stigma. The proposal outlines a cross-sectional study using a random sample technique to gather primary data through questionnaires. Statistical analysis will be conducted using descriptive methods. The study aims to determine the impact of online health services, exploring both positive and negative effects, and suggests improvements for mobile health services to better address mental health issues in remote populations. The research acknowledges limitations related to time, budget, and sample size, while adhering to ethical considerations through informed consent.

Research Proposal 1
Running Head: Research Proposal
Research proposal

Research Proposal 2
Table of Contents
Table of Contents........................................................................................................................................2
Research Title..............................................................................................................................................3
Introduction.................................................................................................................................................3
Background.................................................................................................................................................3
Research Hypotheses...................................................................................................................................4
Significance of the study.............................................................................................................................4
Study design................................................................................................................................................5
Sampling technique.....................................................................................................................................5
Data collection.............................................................................................................................................5
Statistical analyses.......................................................................................................................................6
Ethics application........................................................................................................................................6
Limitations of the study...............................................................................................................................7
Research Question.......................................................................................................................................7
Literature Review........................................................................................................................................7
Conclusion.................................................................................................................................................10
References.................................................................................................................................................11

Research Proposal 3
Research Title
The title or topic of this research proposal is “The Effect of Online Health Services or Mobile
applications on the Mental Health in the remote population."
Introduction
The study of online health services and mobile applications in remote areas has become
important today among the research community. Online health service or m-Health is a term for
the use of mobile phones and other wireless communication devices in health care in order to
educate patients about preventive health care. The use of m-health is highly popular in the rural
areas where healthcare amenities are far off or not available or inaccessible. Therefore, the
research scope in this topic is expanding day by day, along with the diversification of the impact
areas such as mental health (Mohr, Burns, Schueller, Clarke and Klinkman, 2013). In this
context, this research proposal is designed to provide an insight into the effect of an online health
service or mobile application on the mental health of people in the remote areas.
Background
From the past few years, it has been observed that around 25 percent of the Australian population
from the rural areas experience mental health issues however, only 10 to 15% of them receive
proper care. The key reasons for this treatment gap are unavailability of health professionals,
health services, and stigma that are worse especially in the remote areas of Australia. Thus, the
use of mobile technology is helpful in delivering mental health care coupled with training of
primary care health professionals for depression, stress, and suicidal cases in people (Price,

Research Proposal 4
Yuen, Goetter, Herbert, Forman, Acierno and Ruggiero, 2014). Despite the fact that the evidence
supports the use of online health apps as a means for providing mental health treatment, there
remains question around whether such online applications have brought high efficacy in remote
areas.
Research Hypotheses
The hypotheses for this research proposal are:
H1: There is a Positive Effect of Online Health Services or Mobile applications on the Mental
Health in the remote population
H2: There is a Negative Effect of Online Health Services or Mobile applications on the Mental
Health in the remote population.
Significance of the study
Globally, the use of internet has risen considerably over the past decade, with a jump up to 52%
of the population in the Australia. Although online health services and m-health information
differ in quality and readability however it has helped people by improving disease coping
strategies, self-efficacy, and empowerment for the remote population of Australia. In this
context, this study establishes the doctor-patient relationship, and enhances the ability of remote
area consumers to make decisions on health-related behaviors. This research also creates a
foundation for the future researches on the impact of online health services on consumers at
global level.

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Study design
Since this research proposal is prepared using quantitative approach, cross-sectional study will
be used in this research. The remote place chosen for the study is Kiwirrkurra, located in
Western Australia, and the time duration taken is one month.
The cross-sectional study is helpful studying one or more variables within a given population at one point
in time but the cohort study is not helpful for this type of researches as it is useful to investigate to a
group of people within a population.
Sampling technique
The sample technique used by the researcher in this study is random sample technique. The
target population selected using this technique is 24 participants from Kiwirrkurra area. Random
sampling technique has been selected as it gives equal chance to every unit of the population to
participate, and thus helps the researcher in yielding unbiased results.
Stratified random technique has not been used because it takes participants from the
selected/identifiable groups and populations. It ultimately results in hampering the research
results.
Data collection
Data collection part is an essential part of a research study in which the researcher selects an
appropriate method to collect the relevant information about the research issue. In this research
study the researcher will use primary data collection method appropriate information about the
research issue.

Research Proposal 6
Primary data collection method is an appropriate method of collecting information from the
research participants and understands their behavior and attitude about the research issue. On the
other hand, the secondary data collection method cannot be used to collect information regarding
the behavioral aspect of the research participants. However, the secondary information is used to
support the reliability and viability of the research outcomes in proper manner.
Statistical analyses
In this research study, descriptive statistical analysis method will be used to analyze the collected
data in effective manner.
The descriptive statistical analysis is an effective method for the quantitative research studies and
analyzes the collected data through survey strategy through a systematic questionnaire. In
addition, it is an effective method for small sample size research studies. Therefore, descriptive
analysis will be used in this research study. On the other hand, inferential statistical method is a
good method to big sample size research studies so that it cannot be used in this research study.
Ethics application
In this research study, a consent form is signed from the research participants to get their
acceptance in the research study.
Consent form is a standard method of eliminating ethical consideration from the research
participants as it includes entire process and propose of the research study. As well as, this form
provides a free environment where the research participants can leave the research study at any
time.

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Limitations of the study
The limitations of this research study are time, budget and limited sample size. These limitations
restricts the scope of the research study.
Research Question
In order to confirm the findings of the preliminary research, following research questions have
been designed:
RQ1: What is the impact of using online health service or mobile application on mental health?
RQ2: What are the benefits of using online health service or mobile application in the remote
population?
RO3: How can be the use of mobile health services can be improved in the remote areas to treat
mental health issues?
Literature Review
RQ1: What is the impact of using online health service or mobile application on mental
health?
In the view of Berrouiguet, Baca-Garcia, Brandt, Walter & Courtet (2016), in the recent years,
online health services or mobile applications have targeted a wide range of mental disorders.
These apps have different functionalities and designs. The mental health apps are helpful in
cognition improvement, self management, social support, passive data collection, skill training,
and symptom tracking. At all stages of medical care delivery, the mental health apps facilitate
prevention, effective crisis intervention, supplement to personal therapy, primary treatment,

Research Proposal 8
diagnosis, and condition management after treatment. Kallander, Tibenderana, Akpogheneta,
Strachan, Hill, Asbroek & Meek (2013) has found that online health services have brought a
positive impact in combating mental health issues, in comparison with other platforms due to
high hedonic motivation, low effort expectancy, and ease of habit for patients. Plaza, MartiN,
Martin & Medrano (2011) has examined that some mental health apps exploit transdiagnostic
tools of treatment to encourage patient involvement by minimizing the need of interaction with
numerous apps. However, being a technological limitation, the online health services are filled
with a number of challenges and threats. The malfunctioning of m-health can possess a threat
that can adversely affect the patient care. Moreover, there are still no regulations to protect
patients' rights . Privacy and ethical factors have become even more critical in psychiatric
patients at high risk who may not be able to protect their own rights.
RQ2: What are the benefits of using online health service or mobile application in the
remote population?
According to Kumar, Nilsen, Abernethy, Atienza, Patrick, Pavel & Hedeker (2013), people in
the remote areas face a number of challenges in receiving health care due to the availability of
limited resources to service communities. Also, the remote population is already facing greater
risk factors in mental health areas together with financial uncertainty and social isolation.
Varshney (2014) has stated that due to lack of healthcare provision, geographical and financial
barriers, attitudinal factors, and concerns for anonymity, the remote population is unable to get
access to the health services. The use of online health applications has the ability to connect the
consumers to health professionals by installing bio-monitoring device and comprehensive
medical library in their pocket. m-health techniques such as 3G Doctor has been successful in
improving and promoting the healthier and long life of remote population. Online health

Research Proposal 9
applications have enabled increased access to the health relevant information in remote areas,
and improved ability of diagnosing and monitoring of diseases. Moreover, the people in remote
areas can easily take appointments and the doctors text them to remind of their appointments,
thus increasing the patient engagement. The use of m-health, remote population has been able to
improve their wellness by sticking to a physician recommended diet, healthy exercise routines,
and by taking prescriptions and regular medical check-ups.
RO3: How can be the use of mobile health services can be improved in the remote areas to treat
mental health issues?
In the words of Brown, Yen, Rojas & Schnall (2013), while designing m-health apps for
providing mental health care, the unique features of the service should be considered. Such
features include privacy, safety, temperament, and evidence base, for improving the operation of
the online health services. However, the priority of development aspects that signify the areas of
continuing study can differ throughout different mobile applications or mental health status. In
support of this Chan, Torous, Hinton & Yellowlees (2015) has suggested that online health
services need to analyze the need of introducing a direct line connection between doctors and
patients in the times of emergency throughout the remote areas. Since the emergent requirement
can occur unpredictably in mental health patients, the facility of communicating instantly with
each other who can provide help in real time could be significant in the remote areas. It can take
in substance abuse consultant, a patient's therapy, contracting service hotlines, local medical
emergency care, and support from peers. In addition to this, the m-health developers should also
ensue that patients are properly communicated and attentive of the risks, capabilities, as well as
limitations of a specific m- health app. The exact expectations also need to be checked for what
advantage can be obtained from a specific application or technology to enable consumers located

Research Proposal 10
at remote areas, to search for right doctors at right time in urgent circumstances. Nhavoto and
Gronlund (2014) have also suggested that mental health care patients should be fully informed
about the limitations of interventions controlled by the providers. Given the stigma towards
mental health in remote population, the protection of consumers' information and records should
be taken into consideration.
Conclusion
From the above discussion it can be concluded that mobile health application is an effective
development in the healthcare services in remote areas. The individuals in remote areas have got
better way of communicating with the care professionals for quick care services.

Research Proposal 11
References
Berrouiguet, S., Baca-Garcia, 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. Journal of medical Internet research, 18(6).
Brown, W., Yen, P. Y., Rojas, M., & Schnall, R. (2013). Assessment of the Health IT Usability
Evaluation Model (Health-ITUEM) for evaluating mobile health (mHealth)
technology. Journal of biomedical informatics, 46(6), 1080-1087.
Chan, S., Torous, J., Hinton, L., & Yellowlees, P. (2015). Towards a framework for evaluating
mobile mental health apps. Telemedicine and e-Health, 21(12), 1038-1041.
Kallander, K., Tibenderana, J. K., Akpogheneta, O. J., Strachan, D. L., Hill, Z., Asbroek, A. H.,
& Meek, S. R. (2013). Mobile health (mHealth) approaches and lessons for increased
performance and retention of community health workers in low-and middle-income
countries: a review. Journal of medical Internet research, 15(1).
Kumar, S., Nilsen, W. J., Abernethy, A., Atienza, A., Patrick, K., Pavel, M., & Hedeker, D.
(2013). Mobile health technology evaluation: the mHealth evidence workshop. American
journal of preventive medicine, 45(2), 228-236.
Mohr, D. C., Burns, M. N., Schueller, S. M., Clarke, G., & Klinkman, M. (2013). Behavioral
intervention technologies: evidence review and recommendations for future research in
mental health. General hospital psychiatry, 35(4), 332-338.

Research Proposal 12
Nhavoto, J. A., & Gronlund, A. (2014). Mobile technologies and geographic information
systems to improve health care systems: a literature review. JMIR mHealth and
uHealth, 2(2).
Plaza, I., MartiN, L., Martin, S., & Medrano, C. (2011). Mobile applications in an aging society:
Status and trends. Journal of Systems and Software, 84(11), 1977-1988.
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.
Varshney, U. (2014). Mobile health: Four emerging themes of research. Decision Support
Systems, 66, 20-35.