Introduction: Meta-analytic evidence confirms a range of in- terventions, including mindfulness, physical activity and sleep hygiene, can reduce psychological distress in university stu- dents. However, it is unclear which intervention is most ef- fective. Artificial intelligence (AI) driven adaptive trials may be an efficient method to determine what works best and for whom. The primary purpose of the study is to rank the effec- tiveness of mindfulness, physical activity, sleep hygiene and an active control on reducing distress, using a multi-arm con- textual bandit-based AI-adaptive trial method. Furthermore, the study will explore which interventions have the largest ef- fect for students with different levels of baseline distress sever- ity. Methods and analysis: The Vibe Up study is a pragmatically-oriented, decentralised AI-adaptive group se- quential randomised controlled trial (RCT) comparing the ef- fectiveness of one of three brief, two week digital self-guided interventions (mindfulness, physical activity, or sleep hygiene) or active control (ecological momentary assessment) in reduc- ing self-reported psychological distress in Australian univer- sity students. The adaptive trial methodology involves up to 12 sequential mini-trials that allow for the optimisation of al- location ratios. The primary outcome is change in psycho- logical distress (DASS-21 total score) from pre-intervention to post-intervention. Secondary outcomes include change in depression, anxiety, and stress (measured by DASS-21 sub- scales) from pre-intervention to post-intervention. Planned contrasts will compare the four groups (i.e., the three interven- tion and control) using self-reported psychological distress at pre-specified time points for interim analyses. The study aims to determine the best performing intervention, as well as rank- ing of other interventions. Ethics and dissemination: Ethical approval was sought and obtained from the UNSW Sydney Human Research Ethics Committee (HREC A, HC200466). A trial protocol adhering to the requirements of the Guideline for Good Clinical Prac- tice [1] was prepared for and approved by the Sponsor, UNSW Sydney (Protocol number: HC200466_CTP). Registration details: The trial is registered with the Australian New Zealand Clinical Trials Registry (AC- TRN12621001223820).
IntroductionMeta-analytical evidence confirms a range of interventions, including mindfulness, physical activity and sleep hygiene, can reduce psychological distress in university students. However, it is unclear which intervention is most effective. Artificial intelligence (AI)-driven adaptive trials may be an efficient method to determine what works best and for whom. The primary purpose of the study is to rank the effectiveness of mindfulness, physical activity, sleep hygiene and an active control on reducing distress, using a multiarm contextual bandit-based AI-adaptive trial method. Furthermore, the study will explore which interventions have the largest effect for students with different levels of baseline distress severity.Methods and analysisThe Vibe Up study is a pragmatically oriented, decentralised AI-adaptive group sequential randomised controlled trial comparing the effectiveness of one of three brief, 2-week digital self-guided interventions (mindfulness, physical activity or sleep hygiene) or active control (ecological momentary assessment) in reducing self-reported psychological distress in Australian university students. The adaptive trial methodology involves up to 12 sequential mini-trials that allow for the optimisation of allocation ratios. The primary outcome is change in psychological distress (Depression, Anxiety and Stress Scale, 21-item version, DASS-21 total score) from preintervention to postintervention. Secondary outcomes include change in physical activity, sleep quality and mindfulness from preintervention to postintervention. Planned contrasts will compare the four groups (ie, the three intervention and control) using self-reported psychological distress at prespecified time points for interim analyses. The study aims to determine the best performing intervention, as well as ranking of other interventions.Ethics and disseminationEthical approval was sought and obtained from the UNSW Sydney Human Research Ethics Committee (HREC A, HC200466). A trial protocol adhering to the requirements of the Guideline for Good Clinical Practice was prepared for and approved by the Sponsor, UNSW Sydney (Protocol number: HC200466_CTP).Trial registration numberACTRN12621001223820.
Advances in smartphone technology have allowed people to access mental healthcare via digital apps from wherever and whenever they choose. University students experience a high burden of mental health concerns. Although these apps improve mental health symptoms, user engagement has remained low. Studies have shown that users can be subgrouped based on unique characteristics that just-in-time adaptive interventions (JITAIs) can use to improve engagement. To date, however, no studies have examined the effect of the COVID-19 pandemic on these subgroups. Here, we use machine learning to examine user subgroup characteristics across three COVID-19-specific timepoints: during lockdown, immediately following lockdown, and three months after lockdown ended. We demonstrate that there are three unique subgroups of university students who access mental health apps. Two of these, with either higher or lower mental well-being, were defined by characteristics that were stable across COVID-19 timepoints. The third, situational well-being, had characteristics that were timepoint-dependent, suggesting that they are highly influenced by traumatic stressors and stressful situations. This subgroup also showed feelings and behaviours consistent with burnout. Overall, our findings clearly suggest that user subgroups are unique: they have different characteristics and therefore likely have different mental healthcare goals. Our findings also highlight the importance of including questions and additional interventions targeting traumatic stress(ors), reason(s) for use, and burnout in JITAI-style mental health apps to improve engagement.
Random Fourier features (RFF) are a popular set of tools for constructing low-dimensional approximations of translation-invariant kernels, allowing kernel methods to be scaled to big data. Apart from their computational advantages, by working in the spectral domain random Fourier features expose the translation invariant kernel as a density function that may, in principle, be manipulated directly to tune the kernel. In this paper we propose selecting the density function from a reproducing kernel Hilbert space to allow us to search the space of all translation-invariant kernels. Our approach, which we call tuned random features (TRF), achieves this by approximating the density function as the RKHS-norm regularised least-squares best fit to an unknown ``true'' optimal density function, resulting in a RFF formulation where kernel selection is reduced to regularised risk minimisation with a novel regulariser. We derive bounds on the Rademacher complexity for our method showing that our random features approximation method converges to optimal kernel selection in the large N,D limit. Finally, we prove experimental results for a variety of real-world learning problems, demonstrating the performance of our approach compared to comparable methods.
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