TY - JOUR

T1 - Efficacy and cost-effectiveness of a web-based and mobile stress-management intervention for employees

T2 - Design of a randomized controlled trial

AU - Heber, Elena

AU - Ebert, David Daniel

AU - Lehr, Dirk

AU - Nobis, Stephanie

AU - Berking, Matthias

AU - Riper, Heleen

N1 - Funding Information: We would like to acknowledge the European Union (EFRE) for funding this project within the Lueneburg Innovation Incubator, TM 1.1 (project number: CCI 2007DE161PR001). Additionally, this study is funded by the health insurance company “Barmer GEK”, which provides financial support for the payments of the eCoaches. Furthermore, we would like to acknowledge our colleagues Hanne Thiart and Torsten Tarnowski for contributing to the development of the intervention.

PY - 2013/7/15

Y1 - 2013/7/15

N2 - Background: Work-related stress is associated with a variety of mental and emotional problems and can lead to substantial economic costs due to lost productivity, absenteeism or the inability to work. There is a considerable amount of evidence on the effectiveness of traditional face-to-face stress-management interventions for employees; however, they are often costly, time-consuming, and characterized by a high access threshold. Web-based interventions may overcome some of these problems yet the evidence in this field is scarce. This paper describes the protocol for a study that will examine the efficacy and cost-effectiveness of a web-based guided stress-management training which is based on problem solving and emotion regulation and aimed at reducing stress in adult employees. Methods. The study will target stressed employees aged 18 and older. A randomized controlled trial (RCT) design will be applied. Based on a power calculation of d=.35 (1-β of 80%, α =.05), 264 participants will be recruited and randomly assigned to either the intervention group or a six-month waitlist control group. Inclusion criteria include an elevated stress level (Cohen's Perceived Stress Scale-10 ≥ 22) and current employment. Exclusion criteria include risk of suicide or previously diagnosed psychosis or dissociative symptoms. The primary outcome will be perceived stress, and secondary outcomes include depression and anxiety. Data will be collected at baseline and seven weeks and six months after randomization. An extended follow up at 12 months is planned for the intervention group. Moreover, a cost-effectiveness analysis will be conducted from a societal perspective and will include both direct and indirect health care costs. Data will be analyzed on an intention-to-treat basis and per protocol. Discussion. The substantial negative consequences of work-related stress emphasize the necessity for effective stress-management trainings. If the proposed internet intervention proves to be (cost-) effective, a preventative, economical stress-management tool will be conceivable. The strengths and limitations of the present study are discussed. Trial registration. German Register of Clinical Studies (DRKS): DRKS00004749.

AB - Background: Work-related stress is associated with a variety of mental and emotional problems and can lead to substantial economic costs due to lost productivity, absenteeism or the inability to work. There is a considerable amount of evidence on the effectiveness of traditional face-to-face stress-management interventions for employees; however, they are often costly, time-consuming, and characterized by a high access threshold. Web-based interventions may overcome some of these problems yet the evidence in this field is scarce. This paper describes the protocol for a study that will examine the efficacy and cost-effectiveness of a web-based guided stress-management training which is based on problem solving and emotion regulation and aimed at reducing stress in adult employees. Methods. The study will target stressed employees aged 18 and older. A randomized controlled trial (RCT) design will be applied. Based on a power calculation of d=.35 (1-β of 80%, α =.05), 264 participants will be recruited and randomly assigned to either the intervention group or a six-month waitlist control group. Inclusion criteria include an elevated stress level (Cohen's Perceived Stress Scale-10 ≥ 22) and current employment. Exclusion criteria include risk of suicide or previously diagnosed psychosis or dissociative symptoms. The primary outcome will be perceived stress, and secondary outcomes include depression and anxiety. Data will be collected at baseline and seven weeks and six months after randomization. An extended follow up at 12 months is planned for the intervention group. Moreover, a cost-effectiveness analysis will be conducted from a societal perspective and will include both direct and indirect health care costs. Data will be analyzed on an intention-to-treat basis and per protocol. Discussion. The substantial negative consequences of work-related stress emphasize the necessity for effective stress-management trainings. If the proposed internet intervention proves to be (cost-) effective, a preventative, economical stress-management tool will be conceivable. The strengths and limitations of the present study are discussed. Trial registration. German Register of Clinical Studies (DRKS): DRKS00004749.

KW - Psychology

KW - Depression

KW - Internetintervention

KW - Efficacy

KW - Work-related stress

KW - Occupational health

KW - Stressmanagement

KW - Cost-effectiveness

KW - Cost-effectiveness

KW - Depression

KW - Efficacy

KW - Internet intervention

KW - Occupational health

KW - Prevention

KW - Stress management

KW - Work-related stress

UR - http://www.scopus.com/inward/record.url?scp=84880112078&partnerID=8YFLogxK

UR - https://www.mendeley.com/catalogue/1a1131ea-2ef2-3cb0-ab6f-7ece1385bdd5/

U2 - 10.1186/1471-2458-13-655

DO - 10.1186/1471-2458-13-655

M3 - Journal articles

C2 - 23855376

VL - 13

JO - BMC Public Health

JF - BMC Public Health

SN - 1471-2458

IS - 1

M1 - 655

ER -