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基于网络的“五种幸福方式”干预措施促进幸福感和心理健康的随机对照试验。

A Web-Based Intervention Using "Five Ways to Wellbeing" to Promote Well-Being and Mental Health: Randomized Controlled Trial.

机构信息

Promenta Research Centre, Department of Psychology, University of Oslo, Oslo, Norway.

Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway.

出版信息

JMIR Ment Health. 2024 May 20;11:e49050. doi: 10.2196/49050.

Abstract

BACKGROUND

Compromised well-being and mental health problems pose a significant threat to individuals and societies worldwide. Resource-intensive psychological treatments alone cannot alleviate this burden. There is a need for low-cost, evidence-based interventions aimed at preventing illness and promoting well-being. Five activity domains appear to be linked with well-being promotion across populations: connecting with others, being active, taking notice, learning, and being generous/giving. The activities mentioned are part of the Five Ways to Wellbeing framework and the web-based intervention Five Ways to Wellbeing for All (5waysA).

OBJECTIVE

This randomized controlled trial aims to test the effects of the 5waysA intervention, a web-based, low-cost, well-being-promoting measure targeting the general population. To date, the Five Ways to Wellbeing framework has not been tested in this specific format. The 5waysA intervention comprises 2 webinars and SMS text message reminders delivered over a 10-week period.

METHODS

In 2021, a total of 969 study participants from various regions across Norway were openly recruited through a web page. They were then randomly assigned to either an intervention group or 1 of 2 waiting list control groups, namely, active or passive. Self-reported life satisfaction (Satisfaction With Life Scale [SWLS]), flourishing (Flourishing Scale [FS]), positive emotions, anxiety, and depression symptoms (Hopkins Symptom Checklist-8 [HSCL-8]) were assessed before the intervention, at 4 weeks into the intervention, and 1-2 weeks after the intervention (over 10 weeks). Data analysis was conducted using linear mixed (multilevel) models.

RESULTS

After 10 weeks, 453 participants (171 in the intervention group and 282 in the waiting list control group) were assessed on outcome variables, with a dropout rate of 53.2% (516/969). Results revealed a significantly greater increase in the intervention group compared with the controls for SWLS (b=0.13, 95% CI 0.03-0.23; P=.001), FS (b=0.19, 95% CI 0.08-0.30; P=.001), positive emotions (b=0.43, 95% CI 0.27-0.60; P<.001), and these factors combined into a global well-being measure (b=0.28, CI 0.16-0.39; P<.001). Effect sizes (Cohen d) for the well-being outcomes ranged from 0.30 to 0.49. In addition, a significant decrease in anxiety and depressive symptoms was observed (b=-0.17, 95% CI -0.30 to -0.04; P=.001) with an effect size (Cohen d) of -0.20.

CONCLUSIONS

The findings suggest that the web-based 5waysA intervention could serve as an effective approach for enhancing well-being and mental health within the general population. This study offers individuals, policy makers, and local stakeholders an accessible and potentially cost-effective well-being intervention that could be easily implemented.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04784871; https://clinicaltrials.gov/study/NCT04784871.

摘要

背景

全球范围内,人们的幸福感和心理健康问题受到了严重威胁,这给个人和社会都带来了巨大挑战。仅依靠资源密集型的心理治疗手段,无法缓解这一负担。我们需要一种低成本、基于证据的干预措施,以预防疾病和促进幸福感。有五个活动领域似乎与促进幸福感有关,包括与他人建立联系、积极活动、关注、学习和慷慨大方/给予。提到的活动是“五种幸福生活方式”框架和基于网络的“全民五种幸福生活方式”(5waysA)干预措施的一部分。

目的

本随机对照试验旨在测试 5waysA 干预措施的效果,这是一种基于网络的、低成本的、针对普通人群的幸福感促进措施。迄今为止,“五种幸福生活方式”框架尚未以这种特定形式进行过测试。5waysA 干预措施包括 2 次网络研讨会和通过短信发送的提醒,为期 10 周。

方法

2021 年,共有 969 名来自挪威各地的研究参与者通过网页公开招募。然后,他们被随机分配到干预组或 2 个等待名单对照组之一,即主动组或被动组。在干预前、干预 4 周时和干预后 1-2 周(共 10 周)评估自我报告的生活满意度(生活满意度量表 [SWLS])、繁荣度(繁荣量表 [FS])、积极情绪、焦虑和抑郁症状(霍普金斯症状清单-8 [HSCL-8])。数据分析采用线性混合(多水平)模型进行。

结果

10 周后,对 453 名参与者(干预组 171 名,等待名单对照组 282 名)进行了结局变量评估,失访率为 53.2%(516/969)。结果显示,与对照组相比,干预组在 SWLS(b=0.13,95%CI 0.03-0.23;P=.001)、FS(b=0.19,95%CI 0.08-0.30;P=.001)、积极情绪(b=0.43,95%CI 0.27-0.60;P<.001)方面的得分显著增加,这些因素共同构成了一个整体的幸福感衡量指标(b=0.28,CI 0.16-0.39;P<.001)。幸福感结果的效应大小(Cohen d)范围为 0.30 至 0.49。此外,焦虑和抑郁症状也显著减轻(b=-0.17,95%CI -0.30 至 -0.04;P=.001),效应大小(Cohen d)为-0.20。

结论

研究结果表明,基于网络的 5waysA 干预措施可能是提高普通人群幸福感和心理健康的有效方法。本研究为个人、政策制定者和当地利益相关者提供了一种易于实施的、具有成本效益的幸福感干预措施。

临床试验注册

ClinicalTrials.gov NCT04784871;https://clinicaltrials.gov/study/NCT04784871。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee90/11148523/9b4090a3f747/mental_v11i1e49050_fig1.jpg

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