Feasibility of a Personal Health Technology-Based Psychological Intervention for Men with Stress and Mood Problems: Randomized Controlled Pilot Trial

Abstract

BackgroundWork-related stress is a significant problem for both people and organizations. It may lead to mental illnesses such as anxiety and depression, resulting in increased work absences and disabilities. Scalable interventions to prevent and manage harmful stress can be delivered with the help of technology tools to support self-observations and skills training.ObjectiveThe aim of this study was to assess the feasibility of the P4Well intervention in treatment of stress-related psychological problems. P4Well is a novel intervention which combines modern psychotherapy (the cognitive behavioral therapy and the acceptance and commitment therapy) with personal health technologies to deliver the intervention via multiple channels, includinggroup meetings, Internet/Web portal, mobile phone applications, and personal monitoring devices.MethodsThis pilot study design was a small-scale randomized controlled trial that compared the P4Well intervention with a waiting list control group. In addition to personal health technologies for self-assessment, the intervention consisted of 3 psychologist-assisted group meetings. Self-assessed psychological measures through questionnaires were collected offline pre- and post-intervention, and 6 months after the intervention for the intervention group. Acceptance and usage of technology tools were measured with user experience questionnaires and usage logs.ResultsA total of 24 subjects were randomized: 11 participants were followed up in the intervention group (1 was lost to follow-up) and 12 participants did not receive any intervention (control group). Depressive and psychological symptoms decreased and self-rated health and working ability increased. All participants reported they had benefited from the intervention. All technology tools had active users and 10/11 participants used at least 1 tool actively. Physiological measurements with personal feedback were considered the most useful intervention component.ConclusionsOur results confirm the feasibility of the intervention and suggest that it had positive effects on psychological symptoms, self-rated health, and self-rated working ability. The intervention seemed to have a positive impact on certain aspects of burnout and job strain, such as cynicism and over-commitment. Future studies need to investigate the effectiveness, benefits, and possible problems of psychological interventions which incorporate new technologies.Trial RegistrationThe Finnish Funding Agency for Technology and Innovation (TEKES), Project number 40011/08

Ecological momentary interventions for depression and anxiety

“…EMIs intended to reduce depression do so through interventions aimed at various proximal outcomes such as engagement in pleasurable activities (Ly et al, 2014), increasing positive emotions (Tugade & du Pont, 2014), or other pathways. EMIs for depression have also made use of diverse conceptual treatment strategies including acceptance and commitment therapy (Ahtinen et al, 2013;Lappalainen et al, 2013;Ly, Dahl, Carlbring, & Andersson, 2012) and interpersonal therapy (Dagoo et al, 2014), but the majority have been cognitive-behavioral in focus including cognitive-behavioral therapy (CBT), behavioral activation (Burns et al, 2011), relaxation (Grassi, Preziosa, Villani, & Riva, 2007), and self-monitoring (Agyapong, Ahern, McLoughlin, & Farren, 2012). A recent meta-analysis of EMI studies reviewed those targeting symptoms of depression as well as other mental health outcomes including anxiety, perceived stressed, and positive psychological functioning (Versluis, Verkuil, Spinhoven, van der Ploeg, & Brosschot, 2016).…”

Applicability of acceptance and commitment therapy-based mobile app in depression nursing

“…The app was originally designed as a toolkit of exercises to (1) teach psychological flexibility through the ACT processes and skills and (2) support learning ACT as a daily habit. Similar methods and exercises had previously been studied in treatment of depression symptoms with web-based interventions [27,28,37,38]. The app was available for the Android platform at the time of the study (September 2013).…”

Measuring the Implementation of Behavioral Intervention Technologies: Recharacterization of Established Outcomes (Preprint)

“…For instance, Lappalainen and colleagues evaluated the feasibility of an adjunctive BIT for workplace stress reduction that included the use of activity monitors. [50] Researchers collected usage logs directly from an online portal to determine whether users accessed the technologies during the study.…”