背景:越来越多的文献支持使用基于互联网的干预措施来改善心理健康结果。然而,大多数计划针对特定的症状或参与者群体,并且不适合促进心理健康和福祉的改善,或者不考虑个体参与者的需求和偏好。BeWellPlan,一个为期5周的小组,基于互联网的心理健康和福祉团体干预解决了这些差距,允许参与者选择一系列他们可以根据自己的特定特征定制的活动,需要,和偏好。
目的:本研究旨在测试BeWellPlan计划在改善心理健康的主要结果方面是否有效,弹性,焦虑,与COVID-19大流行期间的候诊者对照组相比,抑郁症;次要结果包括自我效能感,一种控制感,和认知灵活性。该研究进一步旨在检查参与者对该计划的参与度和满意度。
方法:一项随机对照试验(RCT)有2个平行组,干预和等待列表对照组。干预涉及5个每周2小时的会议,使用Zoom视频会议软件以组格式促进。大学生是通过社交媒体帖子招募的,讲座,电子邮件,传单,和海报。
结果:使用有意随机化2:1分配策略,我们招募了215名参与者(n=126,58.6%,干预组;n=89,41.4%,waitlist控制组)。在分配到干预组的126名参与者中,75(59.5%)开始了该计划,并纳入了改良的意向治疗(mITT)分析。MITT干预参与者参加了会议,平均而言,3.41次会议(标准差1.56,中位数4);55次(73.3%)参加了至少4次会议,25人(33.3%)出席了所有5次会议。在完成干预后评估的49名干预组参与者中,47(95.9%)非常满意(n=31,66%)或满意(n=16,34%)。幸福感(F1,162=9.65,P=.002,Cohend=0.48)和韧性(F1,162=7.85,P=.006,Cohend=0.44)的mITT分析显示出显著的时间×群体交互效应,表明两组都随着时间的推移而改善,但是BeWell计划(干预)组显示出比等待名单对照组明显更大的改善。对于抑郁和焦虑观察到类似的结果模式(Cohend=0.32和0.37),以及次要结果(自我效能感,科恩d=0.50;控制感,科恩d=0.42;认知灵活性,Cohend=0.65).在完成者分析中观察到较大的效应大小。可靠的变化分析显示,大多数mITT参与者(58/75,77.3%)在至少1个主要结果中显示出显着的可靠改善。
结论:BeWellPlan计划在改善心理健康和幸福感方面是有效的,包括心理健康,弹性,抑郁症,和焦虑。参与者满意度得分和出勤率表明对该计划的参与度和满意度很高。
背景:澳大利亚新西兰临床试验注册ACTRN12621000180819;https://tinyurl.com/2p8da5sk.
BACKGROUND: A growing literature supports the use of internet-based interventions to improve mental health outcomes. However, most programs target specific symptoms or participant groups and are not tailored to facilitate improvements in mental health and well-being or do not allow for needs and preferences of individual participants. The Be Well Plan, a 5-week group-facilitated, internet-based mental health and well-being group intervention addresses these gaps, allowing participants to select a range of activities that they can tailor to their specific characteristics, needs, and preferences.
OBJECTIVE: This study aims to test whether the Be Well Plan program was effective in improving primary outcomes of mental well-being, resilience, anxiety, and depression compared to a waitlist control group during the COVID-19 pandemic; secondary outcomes included self-efficacy, a sense of control, and cognitive flexibility. The study further seeks to examine participants\' engagement and satisfaction with the program.
METHODS: A randomized controlled trial (RCT) was conducted with 2 parallel arms, an intervention and a waitlist control group. The intervention involved 5 weekly 2-hour sessions, which were facilitated in group format using Zoom videoconferencing software. University students were recruited via social media posts, lectures, emails, flyers, and posters.
RESULTS: Using an intentional randomization 2:1 allocation strategy, we recruited 215 participants to the trial (n=126, 58.6%, intervention group; n=89, 41.4%, waitlist control group). Of the 126 participants assigned to the intervention group, 75 (59.5%) commenced the program and were included in modified intention-to-treat (mITT) analyses. mITT intervention participants attended, on average, 3.41 sessions (SD 1.56, median 4); 55 (73.3%) attended at least 4 sessions, and 25 (33.3%) attended all 5 sessions. Of the 49 intervention group participants who completed the postintervention assessment, 47 (95.9%) were either very satisfied (n=31, 66%) or satisfied (n=16, 34%). The mITT analysis for well-being (F1,162=9.65, P=.002, Cohen d=0.48) and resilience (F1,162=7.85, P=.006, Cohen d=0.44) showed significant time × group interaction effects, suggesting that both groups improved over time, but the Be Well Plan (intervention) group showed significantly greater improvement compared to the waitlist control group. A similar pattern of results was observed for depression and anxiety (Cohen d=0.32 and 0.37, respectively), as well as the secondary outcomes (self-efficacy, Cohen d=0.50; sense of control, Cohen d=0.42; cognitive flexibility, Cohen d=0.65). Larger effect sizes were observed in the completer analyses. Reliable change analysis showed that the majority of mITT participants (58/75, 77.3%) demonstrated a significant reliable improvement in at least 1 of the primary outcomes.
CONCLUSIONS: The Be Well Plan program was effective in improving mental health and well-being, including mental well-being, resilience, depression, and anxiety. Participant satisfaction scores and attendance indicated a high degree of engagement and satisfaction with the program.
BACKGROUND: Australian New Zealand Clinical Trial Registry ACTRN12621000180819; https://tinyurl.com/2p8da5sk.