# Barriers to participating in an online family- and group-based prevention programme for parents with depression: an online survey

## TL;DR

This study explores why parents with depression may avoid a prevention program for their children's mental health, finding that shame and emotional avoidance are key barriers.

## Contribution

The study identifies individual emotional barriers rather than structural issues as the main obstacles to participation in an online prevention program for parents with depression.

## Key findings

- Shame regarding depression, overburden, and avoidance were identified as significant barriers to participation.
- The online format was not found to be a significant barrier for parents.
- Most correlations between symptom severity and barrier ratings were statistically significant.

## Abstract

Children of parents with depression have an increased risk of mental illness themselves and there is an urgent need to implement effective prevention programmes for this population. "Growing Up Healthy and Happy" (“GuG-Auf-Online") is an online family- and group-based cognitive-behavioural preventive programme with a strong evidence base. The aim of the current study was to understand what factors might hamper parents with depression from participating in the programme.

An online cross-sectional survey was conducted in Germany with 274 parents who fulfilled the inclusion criteria for the programme (parental history of depression and a child aged eight to 17 years with no mental illness). The survey included several a priori-defined barriers (e.g. online format, feelings of shame) which parents rated in terms of (a) whether the barrier was relevant to them and if so, (b) how much it held them back from participating. Open-ended questions identified additional barriers. In addition to qualitative content analysis according to Mayring (2008), Pearson correlations were calculated to determine whether the current severity of parents’ symptoms were associated with their responses.

The following aspects emerged as relevant barriers: (a) shame regarding one's depression, (b) overburden and (c) avoidance (not wanting to be reminded of depression). There was no evidence that the online setting was a significant barrier. Most of the correlations between the current severity of parent’s symptoms and their responses were statistically significant (p < .0037).

The main barriers to participation in prevention related to individual characteristics/ emotional experiences rather than structural issues. Addressing these barriers in the advertisement of future programmes could improve uptake.

The online version contains supplementary material available at 10.1186/s40359-024-02266-8.