Addington Elizabeth L, Cummings Peter, Jackson Kathryn, Yang DerShung, Moskowitz Judith T
Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA.
BrightOutcome, Inc., Buffalo Grove, IL USA.
Affect Sci. 2022 Oct 4;4(1):118-130. doi: 10.1007/s42761-022-00135-4. eCollection 2023 Mar.
COVID-19 prompted distress and increased reliance on digital mental health interventions, which previously demonstrated low rates of retention and adherence. This single-arm trial evaluated whether self-guided, web-based, positive affect regulation skills (PARK) were engaging and associated with changes in well-being during the pandemic. Over 6 weeks, PARK delivers brief lessons and practices in skills designed to increase positive emotions: noticing positive events, savoring, gratitude, mindfulness, positive reappraisal, personal strengths, and self-compassion. Patient-Reported Outcome Measurement Information System (PROMIS) computer adaptive tests of anxiety, depression, social isolation, positive affect, and meaning and purpose were administered at baseline, post-intervention, and 6 months after baseline. Retention and usage of PARK were measured by the web-based assessment and intervention platforms. The sample ( = 616) was predominantly female, non-Hispanic, white, and well-educated. Of those who completed baseline, only 42% completed a follow-up assessment; 30% never logged into PARK. Among those who did, 86% used at least one skill, but only 14% completed PARK. Across retention and usage metrics, older age predicted more engagement. In multivariable models, people of color and people with greater baseline anxiety were more likely to complete PARK. All well-being indicators improved over time, with greater improvements in anxiety and social isolation among participants who accessed at least one PARK skill compared to those who did not. Retention and usage rates mirrored pre-pandemic trends, but within this select sample, predictors of engagement differed from prior research. Findings underscore the need for additional efforts to ensure equitable access to digital mental health interventions and research. Trials registration: NCT04367922.
新冠疫情引发了人们的困扰，并增加了对数字心理健康干预措施的依赖，而此前这类措施的留存率和依从率较低。这项单臂试验评估了基于网络的自我引导式积极情绪调节技能（PARK）在疫情期间是否具有吸引力以及是否与幸福感的变化相关。在6周的时间里，PARK提供了旨在增加积极情绪的技能方面的简短课程和练习：注意积极事件、品味、感恩、正念、积极重新评价、个人优势和自我同情。在基线、干预后以及基线后6个月，对患者报告结果测量信息系统（PROMIS）关于焦虑、抑郁、社交隔离、积极情绪以及意义和目的的计算机自适应测试进行了施测。通过基于网络的评估和干预平台来测量PARK的留存率和使用率。样本（n = 616）主要为女性、非西班牙裔白人且受教育程度较高。在完成基线测试的人群中，只有42%完成了随访评估；30%从未登录过PARK。在登录过的人群中，86%使用了至少一项技能，但只有14%完成了PARK课程。在留存率和使用率指标方面，年龄较大者参与度更高。在多变量模型中，有色人种和基线焦虑程度较高的人更有可能完成PARK课程。所有幸福感指标都随时间有所改善，与未使用至少一项PARK技能的参与者相比，使用了至少一项PARK技能的参与者在焦虑和社交隔离方面的改善更大。留存率和使用率反映了疫情前的趋势，但在这个特定样本中，参与度的预测因素与先前的研究有所不同。研究结果强调需要做出更多努力，以确保公平获得数字心理健康干预措施和研究。试验注册号：NCT04367922。
