A Multi-Regional Study Comparing Perceived Risks between Face-to-Face versus Digital Mental Health Services - Associations with Differences in Preferences and Behavioral Intentions and the Moderation of Self-Construal: A Cross-Sectional Study (Preprint)

BACKGROUND Recent studies have investigated preferences and perceptions towards face-to-face and digital psychological interventions. Understanding the potential differences in perceived risks between face-to-face and digital services as well as associations with preferences and intentions, can be worthwhile. OBJECTIVE We investigated differences in perceived likelihood of being found out and perceived severity of face loss between face-to-face psychological interventions and digital psychological interventions. We also tested the associations between differences in perceived risks and differences in intentions or preferences towards different types of interventions, and investigated the potential moderation of self-construal, regulatory focus, and cultural background. METHODS We conducted a multi-regional study with 645 college students in Hong Kong China, India, United Kingdom, and Canada. We performed t-tests, correlation analyses, and moderated multiple regressions, while combining with alternative statistical methods to examine robustness and consistency of findings across methods. RESULTS We found that people generally perceive face-to-face interventions to have higher likelihood of being found out and severity of face loss compared to digital interventions, with medium to large effects. While no significant association was found for the difference in perceived likelihood of being found out with the difference in intervention preferences and help-seeking intentions, higher perceived severity of face loss for face-to-face intervention was associated with lower preferences and intentions for face-to-face intervention relative to digital interventions. Such associations are moderated by self-construal but in the opposite direction to our hypotheses, in which people with stronger independent self-construal had stronger negative associations between difference in perceived severity of face loss and difference in preferences or intentions. CONCLUSIONS Our findings contribute by identifying differences in perceived risks between face-to-face and digital interventions as well as association with preferences and intentions. We speculate the surprising self-construal moderation findings may be due to higher reliance on personal feelings and higher prioritization for self-consistency among more independent people, and call for further studies testing such mechanisms. We encourage further much-needed investigations into various forms of perceived risks and potential associations with face-to-face or digital mental health intervention preferences, intentions, and decisions, while examining individual and cultural factors.