Increasing engagement with an occupational digital stress management program through the use of an online facilitated discussion group: Results of a pilot randomised controlled trial

Abstract

IntroductionRates of work-related stress, depression and anxiety are high, resulting in reduced work performance and absenteeism. There is evidence that digital mental health interventions delivered in the workplace are an effective way of treating these conditions, but intervention engagement and adherence remain a challenge. Providing guidance can lead to greater engagement and adherence; an online facilitated discussion group may be one way of providing that guidance in a time efficient way. This study compares engagement with a minimally guided digital mental health program (WorkGuru) delivered in the workplace with a discussion group (DG) and without a discussion group (MSG), and with a wait list control (WLC); it was conducted as a pilot phase of a definitive trial.MethodsEighty four individuals with elevated levels of stress from six organisations were recruited to the study and randomised to one of two active conditions (DG or MSG) or a WLC. The program WorkGuru is a CBT based, eight-week stress management intervention that is delivered with minimal guidance from a coach. Data was collected at baseline, post–intervention and at 16-week follow-up via online questionnaires. The primary outcome measure was number of logins. Secondary measures included further engagement measures, and measures of depression, anxiety, stress, comfort and enthusiasm. Quality measures including satisfaction and system usability were also collected.ResultsA greater number of logins was observed for the DG compared with the MSG; this was a medium between group effect size (d = 0.51; 95% CI: − 0.04, 1.05). Small to medium effect size differences were found at T2 in favour of the active conditions compared with the control on the DASS subscales depression, anxiety and stress, and the IWP subscales enthusiasm and comfort. This was largely maintained at T3. Satisfaction with the intervention was high with individuals in the MSG reporting greater satisfaction than individuals in the DG.ConclusionsThis study shows that access to an online facilitated discussion group increases engagement with a minimally supported occupational digital mental health intervention (as defined by the number of logins), but that this doesn't necessarily result in improved psychological outcomes or increased satisfaction when compared to access to the intervention without the group. Access to the web-based program was associated with lower levels of depression, anxiety and stress and an increase in comfort and enthusiasm post intervention; these changes were largely maintained at follow-up.Trial registrationThis trial was registered with ClinicalTrials.gov on March the 18th 2016 NCT02729987 (website link https://clinicaltrials.gov/ct2/show/NCT02729987?term=NCT02729987&rank=1).

Effectiveness of occupational e-mental health interventions: a systematic review and meta-analysis of randomized controlled trials

“…Potential moderators were selected based on theoretical considerations as well as on the insights gained from previous systematic and meta-analysis reviews. For example, previous research showed that participants' characteristics, such as gender, age, and education, as well as the initial level of mental condition of the participants; intervention characteristics, such as the existence of human support (guidance) and psychotherapy type; and study quality would moderate outcomes (10,12,16,18,19,20,26,27,55). In addition, a type of recruitment was coded based on observed methodological differences due to study settings and theoretical considerations that study settings may influence participants' motivation and compliance.…”

“…Thirty-one of the studies conducted recruitment in the workplace, while the remaining twenty studies used open community recruitment and announced their studies via mass media or by cooperating with professional labor organizations or health insurance companies. Treatment duration ranged from brief interventions of 30 minutes (35) to 8 weeks (27,59,60). Some studies offered access to the intervention for three (61)(62)(63)(64), four (65) or six months (48) without specifying the intended treatment duration.…”

“…The interventions were found to be effective for reducing depression and stress with small effects; however, there was no evidence of their effectiveness in anxiety reduction. Carolan et al (27) included 21 randomized control trials (RCT) in a meta-analysis on psychological well-being consisting of studies on stress, anxiety and depression. The authors found a small, statistically significant posttreatment effect on psychological well-being (g=0.37) compared with the control condition.…”

“…Previous systematic reviews on e-mental health interventions for employees have revealed (pooled) effects on stress, depression, and anxiety (26,27). However, these reviews did not investigate how the effectiveness of e-mental health interventions vary across different mental health areas.…”

Employees� Perspectives on the Facilitators and Barriers to Engaging With Digital Mental Health Interventions in the Workplace: Qualitative Study (Preprint)

“…Full details of the trial are reported elsewhere [28][29]. WorkGuru is an eightweek modular program that is based on the principles of cognitive behavioural therapy, positive psychology, mindfulness and problem solving.…”