Effectiveness and Moderators of an Internet-Based Mobile-Supported Stress Management Intervention as a Universal Prevention Approach: Randomized Controlled Trial

Abstract

Background Emerging evidence indicates the effectiveness of internet-based mobile-supported stress management interventions (iSMIs) in highly stressed employees. It is yet unclear, however, whether iSMIs are also effective without a preselection process in a universal prevention approach, which more closely resembles routine occupational health care. Moreover, evidence for whom iSMIs might be suitable and for whom not is scarce. Objective The aim of this study was to evaluate the iSMI GET.ON Stress in a universal prevention approach without baseline inclusion criteria and to examine the moderators of the intervention effects. Methods A total of 396 employees were randomly assigned to the intervention group or the 6-month waiting list control group. The iSMI consisted of 7 sessions and 1 booster session and offered no therapeutic guidance. Self-report data were assessed at baseline, 7 weeks, and at 6 months following randomization. The primary outcome was perceived stress. Several a priori defined moderators were explored as potential effect modifiers. Results Participants in the intervention group reported significantly lower perceived stress at posttreatment (d=0.71, 95% CI 0.51-0.91) and at 6-month follow-up (d=0.61, 95% CI 0.41-0.81) compared to those in the waiting list control group. Significant differences with medium-to-large effect sizes were found for all mental health and most work-related outcomes. Resilience (at 7 weeks, P=.04; at 6 months, P=.01), agreeableness (at 7 weeks, P=.01), psychological strain (at 6 months, P=.04), and self-regulation (at 6 months, P=.04) moderated the intervention effects. Conclusions This study indicates that iSMIs can be effective in a broad range of employees with no need for preselection to achieve substantial effects. The subgroups that might not profit had extreme values on the respective measures and represented only a very small proportion of the investigated sample, thereby indicating the broad applicability of GET.ON Stress. Trial Registration German Clinical Trials Register DRKS00005699; https://www.drks.de/DRKS00005699

The Efficacy of a Web-Based Stress Management Intervention for Employees Experiencing Adverse Working Conditions and Occupational Self-efficacy as a Mediator: Randomized Controlled Trial

“…Moreover, the participation significantly increased occupational self-efficacy that was shown to be a relevant mediator in the efficacy of the SMI on stress reduction. These results support findings of another RCT on the same SMI showing significant effects on occupational self-efficacy [34] and positive associations between stress levels and self-efficacy [30]. The obtained results for the effort-reward imbalance tie well with mixed effects found in studies on the same SMI for the effort-reward imbalance ratio [34] and for efforts and rewards evaluated as separate outcomes [45], demonstrating that web-based SMIs enfold substantially larger effects on individuals' health compared with perceived working conditions and organizational characteristics [17].…”

“…Studies on occupational self-efficacy have demonstrated positive associations with job performance, employee satisfaction, employability, and work commitment, and negative relationships with job insecurity [32,33]. A study on the same SMI that was examined in this randomized controlled trial (RCT) provided first evidence for effects on occupational self-efficacy [34], while the previously stated need for research on self-efficacy as a mechanism of change in an occupational SMI has not been addressed yet [35]. Moreover, there is no evidence on the effects of occupational self-efficacy on the perception of adverse working conditions yet despite the assumption that self-efficacy as a function of self-regulation conducive to health relies on successful exchange of efforts and rewards [36].…”

Digital training for building resilience: Systematic review, meta‐analysis, and meta‐regression

“…Only two studies (Ebert et al, 2021;Harrer et al, 2018) specifically focussed their training on stress. As the majority of the training focuses on psychological stress, these may not benefit individuals who are alternative forms of stress (e.g., physiological stresses).…”

A Web-Based Stress Management Intervention for University Students in Indonesia (Rileks): Feasibility Study Using a Pretest-Posttest Design

“…Compared to the GET.ON Stress and StudiCare Stress interventions, Rileks’ adherence rate of 15% for its core modules still falls behind. Studies of the GET.ON Stress intervention revealed an adherence rate range of 41.9% to 71.8% for its modules [ 24 - 26 , 58 , 59 ]. While the StudiCare Stress adherence rate was reported to be high, on average, the participants completed 74.7% of the intervention [ 60 ].…”