Elmer Timon, Wolf Markus, Snippe Evelien, Scholz Urte
Applied Social and Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland.
Clinical Psychology with Focus on Psychotherapy Research, Department of Psychology, University of Zurich, Zurich, Switzerland.
JMIR Ment Health. 2025 Aug 26;12:e74103. doi: 10.2196/74103.
Just-in-time adaptive interventions (JITAIs) aim to provide psychological support during critical moments in daily life.
This preregistered study aims to evaluate the feasibility of a social support JITAI for individuals with subclinical and clinical levels of depressive symptoms awaiting psychotherapy. Triggered by ecological momentary assessment (EMA) reports, the intervention encouraged participants to activate their (digital) social support networks.
A total of 25 participants completed 2689 EMA surveys and received 377 JITAIs over an 18-day intervention period, including a microrandomized trial, to compare 4 strategies to trigger an intervention: fixed cutoff points of distress variables, personalized thresholds (through Shewhart control charts) of distress variables, momentary support need, and no intervention.
The results showed high feasibility, with participants completing 85.37% (2689/3150) of the EMA surveys, exhibiting a low study-related attrition rate (7%; total attrition rate was 17%), and reporting minimal technical issues. Engagement and perceived helpfulness were heterogeneous and moderate, with participants seeking support in one-third of the instances after an intervention was triggered instances. JITAIs triggered by self-reported need for support were rated as more appropriately timed, helpful, and effective for promoting support-seeking behavior compared to those based on distress indicators, despite being triggered less frequently. Barriers, such as time constraints and perceived unavailability of support providers, likely affected support-seeking behavior, as indicated by additional qualitative analyses. Exploratory effectiveness analyses indicated Cohen d effect sizes between 0.06 and 0.14 in reducing distress after JITAIs were received.
The findings of this study demonstrate that a social support JITAI is feasible to implement, with high compliance and minimal technical issues. However, further research is needed to evaluate the JITAI's effectiveness and optimize trigger strategies in addressing individual needs for and barriers to engagement.
即时自适应干预（JITAIs）旨在在日常生活的关键时刻提供心理支持。
这项预先注册的研究旨在评估一种社会支持JITAI对等待心理治疗的亚临床和临床水平抑郁症状个体的可行性。由生态瞬时评估（EMA）报告触发，该干预鼓励参与者激活他们的（数字）社会支持网络。
在为期18天的干预期内，共有25名参与者完成了2689次EMA调查，并接受了377次JITAIs，包括一项微观随机试验，以比较触发干预的4种策略：痛苦变量的固定临界点、痛苦变量的个性化阈值（通过休哈特控制图）、瞬时支持需求和不进行干预。
结果显示出高度的可行性，参与者完成了85.37%（2689/3150）的EMA调查，研究相关的损耗率较低（7%；总损耗率为17%），并且报告的技术问题极少。参与度和感知到的帮助程度存在异质性且适中，参与者在触发干预后的三分之一情况下寻求支持。与基于痛苦指标触发的JITAIs相比，自我报告的支持需求触发的JITAIs被评为时间安排更合适、更有帮助且对促进寻求支持行为更有效，尽管触发频率较低。额外的定性分析表明，时间限制和认为支持提供者不可用等障碍可能影响了寻求支持的行为。探索性有效性分析表明，在接受JITAIs后，痛苦减轻的科恩d效应大小在0.06至0.14之间。
本研究结果表明，社会支持JITAI实施起来是可行的，具有高依从性且技术问题极少。然而，需要进一步研究来评估JITAI的有效性，并优化触发策略以满足个体参与的需求和障碍。
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