Peiper Nicholas Chalmer, Pettitt Adam, Shah Bela, Attwood Oliver, Sivonen Ella, Pfeffer Jeffrey
Department of Epidemiology and Population Health, School of Public Health and Information Sciences, University of Louisville, 485 East Gray Street, Louisville, 40202, United States, 1 5028529453.
Center for Digital Mental Health, University of Oregon, Eugene, United States.
JMIR Form Res. 2025 Aug 7;9:e71828. doi: 10.2196/71828.
Within the past decade, digital coaching programs (DCPs) have emerged as an evidence-based modality to improve mental well-being and emotional intelligence (EI), although there is limited evidence in real-world contexts.
This pragmatic retrospective cohort study aims to determine the preliminary effectiveness of a DCP in improving mental well-being and EI within a real-world context. We hypothesized that there would be a significant increase in mental well-being and EI.
This study included 588 people who voluntarily enrolled in an 8-week, blended care DCP offered through their employers from October 2021 to August 2024. The DCP included routine check-ins and consultations with certified coaches. Participants completed the World Health Organization-Five Well-Being Index (WHO-5) at baseline and then weekly until the end of the program, as well as the Brief Emotional Intelligence Scale-10 (BEIS-10) at baseline and the end of the program. Multivariable linear mixed models examined changes in WHO-5 (biweekly) and BEIS-10 (pre-post) scores, adjusting for age, gender, program engagement, and program completion. Multivariable logistic regression models evaluated correlates of clinically meaningful improvements on the WHO-5 (ie, at least a 10-point improvement). We calculated a reliable change index (RCI) for the BEIS-10 and the proportion of participants meeting the RCI criterion from baseline to end of treatment.
In multivariate linear mixed models adjusting for demographics and program characteristics, we observed a significant increase in WHO-5 scores (baseline x¯=45.6; week 8 x¯=66.3; Cohen's d=1.98; P<.001). Over half of the sample (55.4%) experienced a clinically meaningful improvement on the WHO-5. Multivariable logistic regression found that higher engagement was associated with an increased odds of a clinically meaningful improvement on the WHO-5 (adjusted odds ratio [aOR] 1.002, 95% CI 1.001-1.003), while program noncompletion (aOR 0.27, 95% CI 0.15-0.50) and higher baseline well-being (aOR 0.91, 95% CI 0.89-0.92) were associated with reduced odds. BEIS-10 scores also significantly increased from baseline to the end of the program after adjusting for relevant correlates (baseline x¯=37.6; week 8 x¯=41.2; Cohen's d=1.32; P<.001). The estimated RCI on the BEIS-10 was approximately 5, with 19.7% experiencing a meaningful improvement.
These results demonstrate that DCPs can be a viable option for individuals looking to improve their mental well-being. Additional efforts should focus on establishing reliable change metrics for EI measures. Studies using hybrid effectiveness-implementation trial designs are now needed to further evaluate the real-world effectiveness of this program.
在过去十年中,数字辅导计划(DCPs)已成为一种基于证据的改善心理健康和情商(EI)的方式,尽管在现实环境中的证据有限。
这项务实的回顾性队列研究旨在确定DCP在现实环境中改善心理健康和EI的初步效果。我们假设心理健康和EI会有显著提高。
本研究纳入了588名在2021年10月至2024年8月期间通过雇主自愿参加为期8周的混合护理DCP的人员。DCP包括与认证教练的定期签到和咨询。参与者在基线时完成世界卫生组织-五福指数(WHO-5),然后每周完成一次,直至项目结束,同时在基线和项目结束时完成简短情商量表-10(BEIS-10)。多变量线性混合模型检查WHO-5(每两周一次)和BEIS-10(前后)分数的变化,并对年龄、性别、项目参与度和项目完成情况进行调整。多变量逻辑回归模型评估WHO-5上具有临床意义改善(即至少提高10分)的相关因素。我们计算了BEIS-10的可靠变化指数(RCI)以及从基线到治疗结束达到RCI标准的参与者比例。
在对人口统计学和项目特征进行调整的多变量线性混合模型中,我们观察到WHO-5分数显著增加(基线x¯=45.6;第8周x¯=66.3;科恩d=1.98;P<.001)。超过一半的样本(55.4%)在WHO-5上有临床意义的改善。多变量逻辑回归发现,更高的参与度与WHO-5上有临床意义改善的几率增加相关(调整后的优势比[aOR]1.002,95%CI 1.001-1.003),而未完成项目(aOR 0.27,95%CI 0.15-0.50)和更高的基线幸福感(aOR 0.91,95%CI 0.89-0.92)与几率降低相关。在对相关因素进行调整后,BEIS-10分数从基线到项目结束也显著增加(基线x¯=37.6;第8周x¯=41.2;科恩d=1.32;P<.001)。BEIS-10的估计RCI约为5,19.7%的人有有意义的改善。
这些结果表明,DCP对于希望改善心理健康的个人可能是一个可行的选择。应进一步努力为EI测量建立可靠的变化指标。现在需要使用混合有效性-实施试验设计的研究来进一步评估该项目在现实世界中的有效性。