个性化时间安排和频率提示对医护人员互联网压力恢复干预效果的作用：随机对照试验

Role of Tailored Timing and Frequency Prompts on the Efficacy of an Internet-Delivered Stress Recovery Intervention for Health Care Workers: Randomized Controlled Trial.

作者信息

Nomeikaite Auguste, Gelezelyte Odeta, Böttche Maria, Andersson Gerhard, Kazlauskas Evaldas

机构信息

Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania.

Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.

出版信息

JMIR Ment Health. 2025 Jan 28;12:e62782. doi: 10.2196/62782.

DOI:10.2196/62782

PMID:39874572

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11815303/

Abstract

BACKGROUND

Prompts offer a promising strategy to promote client engagement in internet-delivered cognitive behavioral therapy (ICBT). However, if the prompts do not meet the needs of clients, they can potentially be more obtrusive rather than helpful.

OBJECTIVE

The aim of this study was to test if prompts tailored based on timing and frequency, aligned with preintervention goal setting, can increase usage and the efficacy of a therapist-supported ICBT stress recovery intervention for health care workers.

METHODS

The 2-arm randomized controlled trial included 87 health care workers (99% female, aged 19-68 years: mean 39.61, SD 11.49): 43 in the standard intervention group and 44 in the tailored prompts group. The primary outcome measure was the Recovery Experiences Questionnaire, and the secondary outcomes were the Perceived Stress Scale-4, the Patient Health Questionnaire-4, and the World Health Organization-5 Well-Being Index. The self-report data were collected before the intervention (September 2022), postintervention (October 2022), and 6-month follow-up (May 2023).

RESULTS

The results showed that tailored prompts, although appreciated by the majority (39/40, 98%), did not improve intervention usage indicators, such as the number of logins (t=-0.91; P=.36), modules opened (t=-1.47; P=.15), modules completed (t=-0.71; P=.48), exercises completed (t=-1.05; P=.30), or the time spent using the program (χ=1.1; P=.57). Similarly, tailored prompts did not increase the effects of the intervention in terms of stress recovery skills (Cohen d ranging from 0.31 to 0.85), perceived stress (d=-0.08; -0.70), depression (d=-0.11; -0.38), anxiety (d=-0.32; -0.64), or psychological well-being (d=0.26; 0.46). In addition, the standard intervention group showed greater long-term stress recovery effects than the group using the internet-delivered intervention supplemented by tailored prompts (β=-0.24, P=.03).

CONCLUSIONS

Although the study confirmed the efficacy of the program, the merits of tailored prompts in ICBT for stress recovery were not supported. Future research is needed to test the effects of the stress recovery intervention supplemented by goal setting and tailored prompts.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05553210; https://clinicaltrials.gov/study/NCT05553210.

摘要

背景

提示是一种很有前景的策略，可促进客户参与互联网认知行为疗法（ICBT）。然而，如果提示不能满足客户的需求，它们可能会更具干扰性而非帮助性。

目的

本研究旨在测试根据时间和频率量身定制、与干预前目标设定相一致的提示，是否能提高医疗工作者接受治疗师支持的ICBT压力恢复干预的使用率和疗效。

方法

这项双臂随机对照试验纳入了87名医疗工作者（99%为女性，年龄19 - 68岁：平均39.61岁，标准差11.49）：标准干预组43人，定制提示组44人。主要结局指标是恢复体验问卷，次要结局指标是感知压力量表 - 4、患者健康问卷 - 4和世界卫生组织 - 5幸福指数。自我报告数据在干预前（2022年9月）、干预后（2022年10月）和6个月随访（2023年5月）收集。

结果

结果显示，尽管大多数人（39/40，98%）对定制提示表示赞赏，但它并未改善干预使用指标，如登录次数（t = -0.91；P = 0.36）、打开的模块数（t = -1.47；P = 0.15）、完成的模块数（t = -0.71；P = 0.48）、完成的练习数（t = -1.05；P = 0.30）或使用该程序的时间（χ = 1.1；P = 0.57）。同样，定制提示在压力恢复技能（科恩d值范围为0.31至0.85）、感知压力（d = -0.08；-0.70）、抑郁（d = -0.11；-0.38）、焦虑（d = -0.32；-0.64）或心理健康（d = 0.26；0.46）方面并未增加干预效果。此外，标准干预组在长期压力恢复效果方面比使用定制提示补充的互联网干预组更显著（β = -0.24，P = 0.03）。