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评估基于网络的大学生心理韧性干预措施的效果和可接受性:先导性随机对照试验

Assessing the Efficacy and Acceptability of a Web-Based Intervention for Resilience Among College Students: Pilot Randomized Controlled Trial.

作者信息

Enrique Roig Angel, Mooney Olwyn, Salamanca-Sanabria Alicia, Lee Chi Tak, Farrell Simon, Richards Derek

机构信息

E-mental Health Research Group, School of Psychology, Trinity College Dublin, The University of Dublin, Dublin, Ireland.

Clinical Research & Innovation, SilverCloud Health, Dublin, Ireland.

出版信息

JMIR Form Res. 2020 Nov 11;4(11):e20167. doi: 10.2196/20167.

Abstract

BACKGROUND

College students are at elevated risk for developing mental health problems and face specific barriers around accessing evidence-based treatment. Web-based interventions that focus on mental health promotion and strengthening resilience represent one possible solution. Providing support to users has shown to reduce dropout in these interventions. Further research is needed to assess the efficacy and acceptability of these interventions and explore the viability of automating support.

OBJECTIVE

This study investigated the feasibility of a new web-based resilience program based on positive psychology, provided with human or automated support, in a sample of college students.

METHODS

A 3-armed closed pilot randomized controlled trial design was used. Participants were randomized to the intervention with human support (n=29), intervention with automated support (n=26), or waiting list (n=28) group. Primary outcomes were resilience and well-being, respectively measured by the Connor-Davidson Resilience Scale and Pemberton Happiness Index. Secondary outcomes included measures of depression and anxiety, self-esteem, and stress. Outcomes were self-assessed through online questionnaires. Intention-to-treat and per-protocol analyses were conducted.

RESULTS

All participants demonstrated significant improvements in resilience and related outcomes, including an unexpected improvement in the waiting list group. Within- and between-group effect sizes ranged from small to moderate and within-group effects were typically larger for the human than automated support group. A total of 36 participants began the program and completed 46.46% of it on average. Participants were generally satisfied with the program and found it easy to use.

CONCLUSIONS

Findings support the feasibility of the intervention. Preliminary evidence for the equal benefit of human and automated support needs to be supported by further research with a larger sample. Results of this study will inform the development of a full-scale trial, from which stronger conclusions may be drawn.

TRIAL REGISTRATION

International Standard Randomized Controlled Trial Number (ISRCTN) 11866034; http://www.isrctn.com/ISRCTN11866034.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1016/j.invent.2019.100254.

摘要

背景

大学生出现心理健康问题的风险较高,且在获取循证治疗方面面临特定障碍。专注于心理健康促进和增强心理韧性的网络干预措施是一种可能的解决方案。向用户提供支持已被证明可减少这些干预措施中的退出率。需要进一步研究来评估这些干预措施的有效性和可接受性,并探索自动化支持的可行性。

目的

本研究在大学生样本中调查了一种基于积极心理学、提供人工或自动化支持的新型网络心理韧性项目的可行性。

方法

采用三臂封闭式预试验随机对照试验设计。参与者被随机分为接受人工支持的干预组(n = 29)、接受自动化支持的干预组(n = 26)或等待列表组(n = 28)。主要结局分别为心理韧性和幸福感,通过康纳 - 戴维森心理韧性量表和彭伯顿幸福指数进行测量。次要结局包括抑郁、焦虑、自尊和压力的测量指标。结局通过在线问卷进行自我评估。进行了意向性分析和符合方案分析。

结果

所有参与者在心理韧性及相关结局方面均有显著改善,包括等待列表组出现了意外的改善。组内和组间效应大小从小到中等,人工支持组的组内效应通常大于自动化支持组。共有36名参与者开始该项目,平均完成了46.46%。参与者总体上对该项目满意,并认为其易于使用。

结论

研究结果支持了该干预措施的可行性。人工和自动化支持具有同等益处的初步证据需要通过更大样本的进一步研究来证实。本研究结果将为全面试验的开展提供信息,从中可能得出更强有力的结论。

试验注册

国际标准随机对照试验编号(ISRCTN)11866034;http://www.isrctn.com/ISRCTN11866034。

国际注册报告识别号(IRRID):RR2 - 10.1016/j.invent.2019.100254。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf99/7688384/2c2f39b34f89/formative_v4i11e20167_fig1.jpg

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