Depression Clinical Trial
Official title:
The Efficacy of a Mobile Application for Treating Depression and Anxiety Symptoms in University Students
This was a 12-week, parallel randomised controlled trial, including a 6-week follow-up. The trial compared a group of university students (N = 84) receiving a mobile CBT application intervention ("Feel Stress Free") to a wait-list control group (N = 84) receiving no intervention. Participants were asked to complete the Hospital Anxiety and Depression Scale (HADS) and the Patient Health Questionnaire (PHQ-9) at baseline (as part of the screening questionnaire) and then fortnightly for the 12 weeks. Although blinding was not possible owing to the nature of a wait list control group, researchers did not have any face-to-face contact with the participants, as recruitment and participation in the study was entirely completed online.
This project aimed to test the effectiveness of an application-based computerised Cognitive
Behavioural Therapy (cCBT) intervention named "Feel Stress Free" at reducing depression and
anxiety symptoms in a sample of UK university students.
This was a 12-week, parallel randomised controlled trial, comparing a group of university
students (N = 84) receiving the mobile intervention to a wait-list control group (N = 84)
receiving no intervention.
Recruitment took place within the four universities partnered with Thrive UK, all located in
London and the South East of England: University College London, University of Roehampton,
University of Buckingham and School of Oriental and African Studies (University of London).
Recruitment was via the student union or student welfare services of each university, using
email advertisements, poster advertisements, personal referrals from student welfare staff,
and social media (Twitter and Facebook). The study was conducted entirely online, with all
communication between trial personnel and participants via standardised emails.
Participants were instructed to sign up to the trial by navigating to a web page and
inserting their email address. They were then sent links to the participant information
sheet and consent form. Once they had given their consent, they were sent the screening
questionnaire. Randomisation occurred in blocks of 30 - each time 30 eligible participants
had completed the screening questionnaire, they were randomised by an independent
statistician, with an equal number of participants allocated to each arm.
Participants in the intervention group received a link to download the "Feel Stress Free"
application free of charge, and participants in the control group were informed that they
would receive access to the application when the trial was over. Those in the intervention
group were asked to use the app at least once per week for 15 minutes for the 6 weeks of the
main trial, and then as often as preferred for the follow-up period. The "Feel Stress Free"
application consists of relaxation activities such as breathing exercises, progressive
muscle relaxation and meditation, as well as relaxing mini-games, uplifting messages and
negative thought tracking. Users are prompted daily to measure and track their mood, and
activity recommendations are given if needed.
All participants were asked to complete the Hospital Anxiety and Depression Scale and
Patient Health Questionnaire fortnightly for the 12 weeks, with the screening questionnaire
taken as 'week 0'. They were sent reminders throughout the week if they did not do so. The
HADS is a measure of the severity of anxiety and depression symptoms that an individual is
experiencing, and the PHQ is a measure of the severity of depression symptoms an individual
is experiencing. Both are suitable for use in the general population.
All questionnaires were completed via a secure email link, using Participant IDs assigned at
the beginning of the trial. All data were anonymised when stored, and each participant was
provided with a contact email address, which was used to seek help regarding the study or to
withdraw. Whilst it was not possible to blind trial personnel, owing to the nature of a wait
list control group, there was no face-to-face or personalised contact between trial
personnel and participants, unless a participant sent a query email.
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