Long-Term Results of a Web-Based Guided Self-Help Intervention for Employees With Depressive Symptoms: Randomized Controlled Trial

Abstract

BackgroundDepressive disorders are highly prevalent in the working population and are associated with excessive costs. The evidence for effective worker-directed interventions for employees with depressive symptoms is limited. Treating employees with depressive symptoms via the Internet before they report sick from work could be beneficial and cost saving.ObjectiveIn this study, we tested the effectiveness over the period of 1 year of a Web-based guided self-help intervention, called Happy@Work, for employees with depressive symptoms who were not on sick leave.MethodsA two-arm randomized controlled trial comparing a worker-directed, Web-based, guided self-help intervention to care as usual (CAU) was carried out. We recruited employees from 6 companies via the company’s Intranet and by putting up posters. The inclusion criteria were elevated depressive symptoms as measured by a score ≥16 on the Center for Epidemiologic Studies Depression scale (CES-D) and not being on sick leave. The intervention contained 6 lessons and consisted of problem-solving treatment and cognitive therapy. Participants were asked to submit weekly assignments via the website after completion of a lesson and they received feedback from a coach via the website. Self-report questionnaires on depressive symptoms (CES-D; primary outcome), burnout (Maslach Burnout Inventory, MBI), work performance (Health and Work Performance Questionnaire, HPQ), duration of absenteeism, and anxiety (Hospital Anxiety and Depression Scale, HADS; secondary outcomes), were completed at baseline, posttreatment, and at 6-, and 12-month follow-up. Several subgroup and per-protocol analyses were performed.ResultsA total of 231 employees were randomized to either the intervention group (n=116) or to CAU (n=115). Completion of assessments varied between 54%-74%. Improvement in depressive symptoms between baseline and posttreatment was shown in all participants and these effects sustained over time. However, there were no differences between the 2 groups (adjusted regression coefficient=0.46, 95% CI –2.11 to 3.03, P=.72; Cohen’s d=0.05). Differences between groups were also not significant for the secondary outcomes. No subgroups were identified to show differences between the groups, nor did we find a between-group effect in the per-protocol analyses.ConclusionsThis study showed that a worker-directed, Web-based, guided self-help intervention was not more effective than CAU in reducing depressive symptoms among employees with depressive symptoms who were not on sick leave over the period of 1 year. An intervention for this specific target group might not be necessary because the recovery in the CAU group was comparable to the intervention group and sustained over a 12-month period.Trial RegistrationNederlands Trial Register (NTR): NTR2993; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2993 (Archived by WebCite at http://www.webcitation.org/6PL9pFC0n).

Systematic review of universal and targeted workplace interventions for depression

“…As two studies were published in two different journals, with both papers reporting the same intervention, it was decided to only include the first publication of these papers19 and exclude the later one 20. Another study discussed short-term21 and long-term22 effects of the same data and intervention in two different papers, and therefore were considered as one study. Table 1 and table 2 summarise the description of the included studies.…”

The helpers’ stress: Effectiveness of a web-based intervention for professionals working with trauma survivors in reducing job burnout and improving work engagement

“…Kolejnym programem jest "Happy@Work", interwencja internetowa zaprojektowana dla pracowników cierpiących z powodu objawów depresji [25]. Skła-da się ona z 6 lekcji opartych na założeniach CBT.…”

“…Na podstawie tych wyników można sugerować, że zarówno interaktywne ćwiczenia (moduł wzmacniający przekonania o własnej skuteczności), jak i prezentacja materiałów edukacyjnych dotyczą-cych radzenia sobie z pośrednią ekspozycją na traumę i stresem w pracy (moduł edukacyjny) skutecznie oddziałują na poziom obu zmiennych wynikowych. Także wyniki innych badań potwierdzają, że internetowe interwencje bazujące na różnych podejściach -takich jak CBT [25] czy psychologia pozytywna [24] -są skuteczne w zmniejszaniu nasilenia objawów wypalenia zawodowego i wzmacnianiu zaangażowania w pracę.…”

Internet- and mobile-based stress management for employees with adherence-focused guidance: efficacy and mechanism of change

“…A recent randomized trial found Ebert et al moderate effect sizes with regard to the reduction of depressive symptoms among stressed teachers (6,14), whereas another trial did not find beneficial effects of a problem-solving training on depression or work-related outcomes (15,16). So far, randomized controlled trials (RCT) on internet-based SMI show mixed results with some studies reporting significant results with moderate effects sizes on perceived stress (17)(18)(19) and others yielding non-significant outcomes (20,21).…”