Effectiveness of an Internet- and App-Based Intervention for College Students With Elevated Stress: Randomized Controlled Trial

Research output: Journal contributionsJournal articlesResearchpeer-review

Standard

Effectiveness of an Internet- and App-Based Intervention for College Students With Elevated Stress: Randomized Controlled Trial. / Harrer, Mathias; Adam, Sophia Helen; Fleischmann, Rebecca Jessica et al.
In: Journal of Medical Internet Research, Vol. 20, No. 4, e136, 23.04.2018.

Research output: Journal contributionsJournal articlesResearchpeer-review

Harvard

Harrer, M, Adam, SH, Fleischmann, RJ, Baumeister, H, Auerbach, R, Bruffaerts, R, Cuijpers, P, Kessler, RC, Berking, M, Lehr, D & Ebert, DD 2018, 'Effectiveness of an Internet- and App-Based Intervention for College Students With Elevated Stress: Randomized Controlled Trial', Journal of Medical Internet Research, vol. 20, no. 4, e136. https://doi.org/10.2196/jmir.9293

APA

Harrer, M., Adam, S. H., Fleischmann, R. J., Baumeister, H., Auerbach, R., Bruffaerts, R., Cuijpers, P., Kessler, R. C., Berking, M., Lehr, D., & Ebert, D. D. (2018). Effectiveness of an Internet- and App-Based Intervention for College Students With Elevated Stress: Randomized Controlled Trial. Journal of Medical Internet Research, 20(4), Article e136. https://doi.org/10.2196/jmir.9293

Vancouver

Harrer M, Adam SH, Fleischmann RJ, Baumeister H, Auerbach R, Bruffaerts R et al. Effectiveness of an Internet- and App-Based Intervention for College Students With Elevated Stress: Randomized Controlled Trial. Journal of Medical Internet Research. 2018 Apr 23;20(4):e136. doi: 10.2196/jmir.9293

Bibtex

@article{6af4c501db934c49952751931ac64bd1,
title = "Effectiveness of an Internet- and App-Based Intervention for College Students With Elevated Stress: Randomized Controlled Trial",
abstract = "Background: Mental health problems are highly prevalent among college students. Most students with poor mental health, however, do not receive professional help. Internet-based self-help formats may increase the utilization of treatment. Objective: The aim of this randomized controlled trial was to evaluate the efficacy of an internet-based, app-supported stress management intervention for college students. Methods: College students (n=150) with elevated levels of stress (Perceived Stress Scale 4-item version, PSS-4 =8) were randomly assigned to either an internet- and mobile-based stress intervention group with feedback on demand or a waitlist control group. Self-report data were assessed at baseline, posttreatment (7 weeks), and 3-month follow-up. The primary outcome was perceived stress posttreatment (PSS-4). Secondary outcomes included mental health outcomes, modifiable risk and protective factors, and college-related outcomes. Subgroup analyses were conducted in students with clinically relevant symptoms of depression (Center for Epidemiological Studies' Depression Scale >17). Results: A total of 106 participants (76.8%) indicated that they were first-time help-seekers, and 77.3% (intervention group: 58/75; waitlist control group: 58/75) showed clinically relevant depressive symptoms at baseline. Findings indicated significant effects of the intervention compared with the waitlist control group for stress (d=0.69; 95% CI 0.36-1.02), anxiety (d=0.76; 95% CI 0.43-1.09), depression (d=0.63; 95% CI 0.30-0.96), college-related productivity (d=0.33; 95% CI 0.01-0.65), academic work impairment (d=0.34; 95% CI 0.01-0.66), and other outcomes after 7 weeks (posttreatment). Response rates for stress symptoms were significantly higher for the intervention group (69%, 52/75) compared with the waitlist control group (35%, 26/75, P<.001; number needed to treat=2.89, 95% CI 2.01-5.08) at posttest (7 weeks). Effects were sustained at 3-month follow-up, and similar findings emerged in students with symptoms of depression. Conclusions: Internet- and mobile-based interventions could be an effective and cost-effective approach to reduce consequences of college-related stress and might potentially attract students with clinically relevant depression who would not otherwise seek help. Trial Registration: German Clinical Trial Register DRKS00010212; http://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00010212 (Archived by WebCite at http://www.webcitation.org/6w55Ewhjd).",
keywords = "randomized controlled trial, stress, psychological, depression, telemedicine, students, help-seeking behavior, Psychology",
author = "Mathias Harrer and Adam, {Sophia Helen} and Fleischmann, {Rebecca Jessica} and Harald Baumeister and Randy Auerbach and Ronny Bruffaerts and Pim Cuijpers and Kessler, {Ronald C.} and Matthias Berking and Dirk Lehr and Ebert, {David Daniel}",
note = "Funding Information: The study was partly funded by BARMER, a major health care insurance company in Germany. Publisher Copyright: {\textcopyright} Mathias Harrer, Sophia Helen Adam, Rebecca Jessica Fleischmann, Harald Baumeister, Randy Auerbach, Ronny Bruffaerts, Pim Cuijpers, Ronald C Kessler, Matthias Berking, Dirk Lehr, David Daniel Ebert.",
year = "2018",
month = apr,
day = "23",
doi = "10.2196/jmir.9293",
language = "English",
volume = "20",
journal = "Journal of Medical Internet Research",
issn = "1439-4456",
publisher = "JMIR Publications Inc.",
number = "4",

}

RIS

TY - JOUR

T1 - Effectiveness of an Internet- and App-Based Intervention for College Students With Elevated Stress

T2 - Randomized Controlled Trial

AU - Harrer, Mathias

AU - Adam, Sophia Helen

AU - Fleischmann, Rebecca Jessica

AU - Baumeister, Harald

AU - Auerbach, Randy

AU - Bruffaerts, Ronny

AU - Cuijpers, Pim

AU - Kessler, Ronald C.

AU - Berking, Matthias

AU - Lehr, Dirk

AU - Ebert, David Daniel

N1 - Funding Information: The study was partly funded by BARMER, a major health care insurance company in Germany. Publisher Copyright: © Mathias Harrer, Sophia Helen Adam, Rebecca Jessica Fleischmann, Harald Baumeister, Randy Auerbach, Ronny Bruffaerts, Pim Cuijpers, Ronald C Kessler, Matthias Berking, Dirk Lehr, David Daniel Ebert.

PY - 2018/4/23

Y1 - 2018/4/23

N2 - Background: Mental health problems are highly prevalent among college students. Most students with poor mental health, however, do not receive professional help. Internet-based self-help formats may increase the utilization of treatment. Objective: The aim of this randomized controlled trial was to evaluate the efficacy of an internet-based, app-supported stress management intervention for college students. Methods: College students (n=150) with elevated levels of stress (Perceived Stress Scale 4-item version, PSS-4 =8) were randomly assigned to either an internet- and mobile-based stress intervention group with feedback on demand or a waitlist control group. Self-report data were assessed at baseline, posttreatment (7 weeks), and 3-month follow-up. The primary outcome was perceived stress posttreatment (PSS-4). Secondary outcomes included mental health outcomes, modifiable risk and protective factors, and college-related outcomes. Subgroup analyses were conducted in students with clinically relevant symptoms of depression (Center for Epidemiological Studies' Depression Scale >17). Results: A total of 106 participants (76.8%) indicated that they were first-time help-seekers, and 77.3% (intervention group: 58/75; waitlist control group: 58/75) showed clinically relevant depressive symptoms at baseline. Findings indicated significant effects of the intervention compared with the waitlist control group for stress (d=0.69; 95% CI 0.36-1.02), anxiety (d=0.76; 95% CI 0.43-1.09), depression (d=0.63; 95% CI 0.30-0.96), college-related productivity (d=0.33; 95% CI 0.01-0.65), academic work impairment (d=0.34; 95% CI 0.01-0.66), and other outcomes after 7 weeks (posttreatment). Response rates for stress symptoms were significantly higher for the intervention group (69%, 52/75) compared with the waitlist control group (35%, 26/75, P<.001; number needed to treat=2.89, 95% CI 2.01-5.08) at posttest (7 weeks). Effects were sustained at 3-month follow-up, and similar findings emerged in students with symptoms of depression. Conclusions: Internet- and mobile-based interventions could be an effective and cost-effective approach to reduce consequences of college-related stress and might potentially attract students with clinically relevant depression who would not otherwise seek help. Trial Registration: German Clinical Trial Register DRKS00010212; http://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00010212 (Archived by WebCite at http://www.webcitation.org/6w55Ewhjd).

AB - Background: Mental health problems are highly prevalent among college students. Most students with poor mental health, however, do not receive professional help. Internet-based self-help formats may increase the utilization of treatment. Objective: The aim of this randomized controlled trial was to evaluate the efficacy of an internet-based, app-supported stress management intervention for college students. Methods: College students (n=150) with elevated levels of stress (Perceived Stress Scale 4-item version, PSS-4 =8) were randomly assigned to either an internet- and mobile-based stress intervention group with feedback on demand or a waitlist control group. Self-report data were assessed at baseline, posttreatment (7 weeks), and 3-month follow-up. The primary outcome was perceived stress posttreatment (PSS-4). Secondary outcomes included mental health outcomes, modifiable risk and protective factors, and college-related outcomes. Subgroup analyses were conducted in students with clinically relevant symptoms of depression (Center for Epidemiological Studies' Depression Scale >17). Results: A total of 106 participants (76.8%) indicated that they were first-time help-seekers, and 77.3% (intervention group: 58/75; waitlist control group: 58/75) showed clinically relevant depressive symptoms at baseline. Findings indicated significant effects of the intervention compared with the waitlist control group for stress (d=0.69; 95% CI 0.36-1.02), anxiety (d=0.76; 95% CI 0.43-1.09), depression (d=0.63; 95% CI 0.30-0.96), college-related productivity (d=0.33; 95% CI 0.01-0.65), academic work impairment (d=0.34; 95% CI 0.01-0.66), and other outcomes after 7 weeks (posttreatment). Response rates for stress symptoms were significantly higher for the intervention group (69%, 52/75) compared with the waitlist control group (35%, 26/75, P<.001; number needed to treat=2.89, 95% CI 2.01-5.08) at posttest (7 weeks). Effects were sustained at 3-month follow-up, and similar findings emerged in students with symptoms of depression. Conclusions: Internet- and mobile-based interventions could be an effective and cost-effective approach to reduce consequences of college-related stress and might potentially attract students with clinically relevant depression who would not otherwise seek help. Trial Registration: German Clinical Trial Register DRKS00010212; http://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00010212 (Archived by WebCite at http://www.webcitation.org/6w55Ewhjd).

KW - randomized controlled trial

KW - stress

KW - psychological

KW - depression

KW - telemedicine

KW - students

KW - help-seeking behavior

KW - Psychology

UR - http://www.scopus.com/inward/record.url?scp=85047549982&partnerID=8YFLogxK

U2 - 10.2196/jmir.9293

DO - 10.2196/jmir.9293

M3 - Journal articles

C2 - 29685870

VL - 20

JO - Journal of Medical Internet Research

JF - Journal of Medical Internet Research

SN - 1439-4456

IS - 4

M1 - e136

ER -

Documents

DOI

Recently viewed

Publications

  1. Diversity and spatio-temporal dynamics of dead wood in a temperate near-natural beech forest (Fagus sylvatica)
  2. More than only skin deep: Appearance self-concept predicts most of secondary school students’ self-esteem
  3. Rapid upwards spread of non-native plants in mountains across continents
  4. Forgetting fire
  5. The impact of (social) anchors on Prospect Theory's value function
  6. Approaching bolt load retention behaviour of AS41 through compliance and creep deformation
  7. Effect of the gap width in AZ31 magnesium alloy joints obtained by friction stir welding
  8. Lagrangian perspectives on turbulent superstructures in Rayleigh-Bénard convection
  9. Effects of preschoolers' storybook exposure and literacy environments on lower level and higher level language skills
  10. Verification of measuring the bearing clearance using kurtosis, recurrences and neural networks and comparison of these approaches
  11. Experimental investigation of temperature distribution during wire-based laser metal deposition of the Al-Mg alloy 5087
  12. The predictive chameleon
  13. Simulation of the quench sensitivity of the aluminum alloy 6082
  14. CoLab
  15. On the approximation of transport phenomena
  16. Numerical approach for the evaluation of seam welding criteria in extrusion processes
  17. Understanding of capacity in 3rd grade
  18. Global decoupling of functional and phylogenetic diversity in plant communities
  19. I'm lonely, can't you tell?
  20. The valuation of ecosystem services
  21. Generalising IRT to Discriminate Between Examinees
  22. Knowledge Graph Question Answering Leaderboard
  23. Effects of grade retention on achievement and self-concept in science and mathematics
  24. Mindfulness and cognitive-behavioral strategies for psychological detachment
  25. Multimodal algebra learning
  26. Valuing beaches for beauty and recreation only? Uncovering perception bias through a hashtag analysis
  27. Sunspot equilibria in a monetary real business cycle model
  28. Freie Berufe im Mikrozensus II - Einkommen und Einkommensverteilung
  29. Three-dimensional microstructural analysis of Mg-Al-Zn alloys by synchrotron-radiation-based microtomography
  30. Statistical analysis
  31. Reliability and validity of the self-report version of the Strengths and Difficulties Questionnaire (SDQ) in primary school children
  32. Design of flat slabs for punching - European and North American practices
  33. Towards 3D Process Simulation for In Situ Hybridization of Fiber-Metal-Laminates (FML)
  34. Financing behavior in new ventures - Evidence from Germany
  35. Patterns of entrepreneurial career development
  36. Determination of rutin in green tea infusions using square-wave voltammetry with a rigid carbon-polyurethane composite electrode
  37. Compressive strength and hot deformation behavior of TX32 magnesium alloy with 0.4% Al and 0.4% Si additions
  38. Relations between idle time, exhaustion, and engagement at work
  39. Credit Constraints and Margins of Import
  40. An Adaptive Lyapunovs Internal PID Regulator in Automotive Applications
  41. Timing, fragmentation of work and income inequality
  42. Differences in labor supply to monopsonistic firms and the gender pay gap
  43. Numerical determination of heat distribution and castability simulations of as cast Mg-Al alloys
  44. Determinants of promotions in an internal labour market
  45. Threshold stress during tensile and compressive creep in AE42 magnesium alloy
  46. LC-QuAD 2.0
  47. Numerical simulation of friction extrusion