Implementation trial II: Clinical outcomes and acceptability of an internet-delivered intervention for anxiety and depression delivered as part of routine care for university students in Australia

IF 3.6 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES Internet Interventions-The Application of Information Technology in Mental and Behavioural Health Pub Date : 2024-11-21 DOI:10.1016/j.invent.2024.100789

Blake F. Dear , Andreea I. Heriseanu , Bareena Johnson , Letitia Norton , Helen Nguyen , Ali Richards , Sheldon Pace , Nickolai Titov

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Abstract

Background

University students report high levels of psychological distress, which is a contributor to poorer academic, social and health outcomes. There is increasing interest in the use of internet-delivered psychological treatments in student counselling services as a strategy improving access to psychological care at scale. However, to date, few large-scale prospective effectiveness trials of internet-delivered psychological treatment have been conducted in “real world” settings with university student populations.

Aim

To investigate the effectiveness and acceptability of a brief transdiagnostic internet-delivered cognitive behavioural therapy (iCBT) intervention for anxiety and depression when delivered as part of routine care by the counselling service of an Australian university.

Design

A large, prospective, single-group Phase IV clinical trial.

Method

Students engaging with the university counselling service between 2018 and 2023 (N = 845; 8.5% of those presenting to the service) were given the option to receive the intervention based on their clinical needs and preferences. Students completed standardised measures of depression and anxiety severity at pre-treatment, each week of the intervention, and post-treatment. A subsample (n = 426) also completed the measures at 3-month follow-up.

Results

Over a 5-year period, 700 students participated in the intervention and 489 provided data at post-treatment. Significant reductions in depression symptoms (% reduction = 27%, Hedges' g = 0.35) and anxiety (% reduction = 37%, Hedges' g = 0.61) were observed, alongside high levels of satisfaction (>70%) and adherence (68%). Over 50% of students had clinically significant improvements in symptom severity, and symptom deterioration was observed in <15% of students.

Conclusion

The results of the current trial provide support for the effectiveness and acceptability of internet-delivered psychological interventions provided as part of routine care to university students with symptoms of anxiety and depression.

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实施试验 II：作为澳大利亚大学生常规护理的一部分，通过互联网提供焦虑和抑郁干预的临床结果和可接受性

背景大学生的心理困扰程度很高，这也是学业、社交和健康状况较差的一个原因。越来越多的人开始关注在学生咨询服务中使用互联网提供的心理治疗方法，并将其作为一种改善心理治疗可及性的策略。目的研究澳大利亚一所大学的心理咨询服务机构在常规治疗中使用简短的跨诊断网络认知行为疗法（iCBT）干预焦虑和抑郁的有效性和可接受性。设计一项大型、前瞻性、单组IV期临床试验。方法2018年至2023年期间参与大学咨询服务的学生（N = 845；占服务对象的8.5%）可根据其临床需求和偏好选择接受干预。学生们在治疗前、干预期间的每周和治疗后完成了抑郁和焦虑严重程度的标准化测量。结果在 5 年的时间里，共有 700 名学生参与了干预，其中 489 人提供了治疗后的数据。抑郁症状（减少率 = 27%，赫奇斯 g = 0.35）和焦虑症状（减少率 = 37%，赫奇斯 g = 0.61）显著减少，同时满意度（70%）和坚持率（68%）也很高。50%以上的学生症状严重程度有了明显改善，15%的学生症状恶化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health Medicine-Health Informatics

CiteScore

6.50

自引率

9.30%

发文量

审稿时长

6 weeks

期刊介绍： Official Journal of the European Society for Research on Internet Interventions (ESRII) and the International Society for Research on Internet Interventions (ISRII). The aim of Internet Interventions is to publish scientific, peer-reviewed, high-impact research on Internet interventions and related areas. Internet Interventions welcomes papers on the following subjects: • Intervention studies targeting the promotion of mental health and featuring the Internet and/or technologies using the Internet as an underlying technology, e.g. computers, smartphone devices, tablets, sensors • Implementation and dissemination of Internet interventions • Integration of Internet interventions into existing systems of care • Descriptions of development and deployment infrastructures • Internet intervention methodology and theory papers • Internet-based epidemiology • Descriptions of new Internet-based technologies and experiments with clinical applications • Economics of internet interventions (cost-effectiveness) • Health care policy and Internet interventions • The role of culture in Internet intervention • Internet psychometrics • Ethical issues pertaining to Internet interventions and measurements • Human-computer interaction and usability research with clinical implications • Systematic reviews and meta-analysis on Internet interventions