Efficacy of the internet-based intervention “Cultivating our resilience” (CORE) for improving resilience and coping strategies in university students: A randomized controlled trial

Abstract

The college stage is marked by high prevalence of mental disorders, particularly anxiety, low mood, and substance abuse. Despite this, many affected students do not receive treatment, underscoring the need for preventive strategies. In respose, the CORE program, an internet-based intervention, was developed to enhance resilience and coping skills among college students. The present study, part of the ICare project (EU-634757), aims to assess the effectiveness of the CORE intervention in improving resilience and reducing symptoms of anxiety and depression in comparison to a Waiting List (WL) condition. The study was registered at ISRCTN (ISRCTN13856522).

In the study the unguided internet-based intervention (CORE) was compared to a WL control group in a multicenter two-arm, single-blind, randomized controlled trial (RCT) conducted in Spain, Germany, and Switzerland. Questionnaire based evaluations occurred at baseline (BL), 8 weeks (post-intervention), 6 and 12 months after randomization. A total of 493 students with low levels of resilience participated in the study.

Participants in the intervention group gained access to an internet-based program aiming to enhance resilience by learning to cope with stressors in daily life, promote self-empowerment, and improve well-being. Participants were instructed to engage in six interactive modules delivered weekly in a sequential order. The program's therapeutic content was developed following the Ryff model of well-being.

The primary outcome measure used was the Connor-Davidson Resilience Scale (CD-RISC-25). Additionally, anxiety and depressive symptomatology, coping strategies, and well-being were measured. Participants in the CORE condition reported a significant increase in resilience compared to WL condition (Differences post-BL: d = 0.34, p = .0005; 6 M-BL: d = 0.24, p = .0171; 12 M-BL: d = 0.33, p = .0031). Although, a general time trend towards improvement in the resilience was observed in both groups. Participants in the CORE condition, compared to those in the WL condition, showed a significant reduction in anxiety symptoms in the short and long term (differences post-BL: d = 0.30, p = .0015; 6 M-BL: d = 0.18, p = .0857; 12 M-BL: d = 0.23, p = .0312) and depression in the short term. Furthermore, participants in CORE condition showed a significant improvement in positive functioning measurements, such as well-being and self-compassion compared to WL condition. (Differences post-BL: d = 0.25, p = .0123; 6 M-BL: d = 0.16, p = .1505; 12 M-BL: d = 0.13, p = .1835).

Adherence to fully complete the intervention was approximately 59 %.

In conclusion, our study revealed promising outcomes for the CORE program, indicating its efficacy. These results position the CORE program as a valuable and validated tool in fostering resilience, offering promising ways for addressing mental health challenges in academic settings.