TY - JOUR

T1 - Internet- and mobile-based stress management for employees with adherence-focused guidance

T2 - Efficacy and mechanism of change

AU - Ebert, David Daniel

AU - Lehr, Dirk

AU - Heber, Elena

AU - Riper, Heleen

AU - Cuijpers, Pim

AU - Berking, Matthias

N1 - Publisher Copyright: © Scandinavian Journal of Work, Environment & Health.

PY - 2016/9

Y1 - 2016/9

N2 - ObjectiveThis randomized controlled trial (RCT) aimed to evaluate the efficacy of an internet-based stress management intervention (iSMI) among employees compared to a 6-month waitlist control group (WLC) with full access to treatment-as-usual.MethodA sample of 264 employees with elevated symptoms of perceived stress (Perceived Stress Scale, PSS-10 ≥22) was assigned to either the iSMI or WLC group. The iSMI consisted of seven sessions and one booster session including problem-solving and emotion regulation techniques. Participants received guidance from an e-coach that focused on improving the adherence to the intervention. Self-report data were assessed at baseline, seven weeks, and six months following randomization. The primary outcome was perceived stress (PSS-10). The secondary outcomes included other relevant mental and work-related health outcomes.ResultsThe iSMI participants showed a significantly higher reduction in perceived stress from baseline to seven weeks [d=0.79, 95% confidence interval (95% CI) 0.54–1.04] and the 6-month follow up (d=0.85, 95% CI 0.59–1.10) compared to controls. Significant moderate-to-large effect sizes were also found for depression, anxiety, emotional exhaustion, sleeping problems, worrying, quality of life (mental health), psychological detachment and emotion regulation skills. Work engagement, quality of life (physical health), absenteeism and presenteeism were not found to significantly differ between the iSMI and WLC groups. Changes in emotion regulation regarding general distress mediated changes in perceived stress.ConclusionThe iSMI investigated in this study was found to be effective in reducing typical symptoms of stress. However, several important work-related health symptoms were not significantly affected by the intervention. Internet-based guided self-help interventions could be an acceptable, effective approach to reduce a range of negative consequences associated with work-related stress. Future studies should investigate the comparative (cost-) effectiveness of guided and unguided stress management interventions.

AB - ObjectiveThis randomized controlled trial (RCT) aimed to evaluate the efficacy of an internet-based stress management intervention (iSMI) among employees compared to a 6-month waitlist control group (WLC) with full access to treatment-as-usual.MethodA sample of 264 employees with elevated symptoms of perceived stress (Perceived Stress Scale, PSS-10 ≥22) was assigned to either the iSMI or WLC group. The iSMI consisted of seven sessions and one booster session including problem-solving and emotion regulation techniques. Participants received guidance from an e-coach that focused on improving the adherence to the intervention. Self-report data were assessed at baseline, seven weeks, and six months following randomization. The primary outcome was perceived stress (PSS-10). The secondary outcomes included other relevant mental and work-related health outcomes.ResultsThe iSMI participants showed a significantly higher reduction in perceived stress from baseline to seven weeks [d=0.79, 95% confidence interval (95% CI) 0.54–1.04] and the 6-month follow up (d=0.85, 95% CI 0.59–1.10) compared to controls. Significant moderate-to-large effect sizes were also found for depression, anxiety, emotional exhaustion, sleeping problems, worrying, quality of life (mental health), psychological detachment and emotion regulation skills. Work engagement, quality of life (physical health), absenteeism and presenteeism were not found to significantly differ between the iSMI and WLC groups. Changes in emotion regulation regarding general distress mediated changes in perceived stress.ConclusionThe iSMI investigated in this study was found to be effective in reducing typical symptoms of stress. However, several important work-related health symptoms were not significantly affected by the intervention. Internet-based guided self-help interventions could be an acceptable, effective approach to reduce a range of negative consequences associated with work-related stress. Future studies should investigate the comparative (cost-) effectiveness of guided and unguided stress management interventions.

KW - Psychology

KW - Mental health

KW - Business psychology

KW - stress management

KW - Intervention

KW - randomized controlled trial

KW - RCT

KW - Stress

KW - Digital media

KW - Internet

KW - internet intervention

UR - http://www.scopus.com/inward/record.url?scp=84986877520&partnerID=8YFLogxK

U2 - 10.5271/sjweh.3573

DO - 10.5271/sjweh.3573

M3 - Journal articles

C2 - 27249161

VL - 42

SP - 382

EP - 394

JO - Scandinavian Journal of Work, Environment and Health

JF - Scandinavian Journal of Work, Environment and Health

SN - 0355-3140

IS - 5

ER -