Web-Based and Mobile Stress Management Intervention for Employees: A Randomized Controlled Trial

Abstract

BackgroundWork-related stress is highly prevalent among employees and is associated with adverse mental health consequences. Web-based interventions offer the opportunity to deliver effective solutions on a large scale; however, the evidence is limited and the results conflicting.ObjectiveThis randomized controlled trial evaluated the efficacy of guided Web- and mobile-based stress management training for employees.MethodsA total of 264 employees with elevated symptoms of stress (Perceived Stress Scale-10, PSS-10≥22) were recruited from the general working population and randomly assigned to an Internet-based stress management intervention (iSMI) or waitlist control group. The intervention (GET.ON Stress) was based on Lazarus’s transactional model of stress, consisted of seven sessions, and applied both well-established problem solving and more recently developed emotion regulation strategies. Participants also had the opportunity to request automatic text messages on their mobile phone along with the iSMI. Participants received written feedback on every completed session from an e-coach. The primary outcome was perceived stress (PSS-10). Web-based self-report assessments for both groups were scheduled at baseline, 7 weeks, and 6 months. At 12 months, an extended follow-up was carried out for the iSMI group only.ResultsAn intention-to-treat analysis of covariance revealed significantly large effect differences between iSMI and waitlist control groups for perceived stress at posttest (F 1,261=58.08, P<.001; Cohen’s d=0.83) and at the 6-month follow-up (F 1,261=80.17, P<.001; Cohen’s d=1.02). The effects in the iSMI group were maintained at 12-month follow-up.ConclusionsThis Web- and mobile-based intervention has proven effective in reducing stress in employees in the long term. Internet-based stress management interventions should be further pursued as a valuable alternative to face-to-face interventions.Trial RegistrationGerman Clinical Trials Register (DRKS): 00004749; http://drks-neu.uniklinik-freiburg.de/ drks_web/setLocale_EN.do (Archived by WebCite at http://www.webcitation.org/6e8rl98nl)

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

“…Thus, the present study provides further evidence that CBT-based interventions can have enduring effects that go beyond immediate short-term effects, and can also prevent further aggravation of symptoms. Remarkably, the effect sizes for most outcomes were similar to those found in the pilot-evaluation study of the novel intervention (23). Thus, the present study replicated the results of this study in a large-scale randomized controlled trial.…”

“…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). Our group recently conducted a RCT testing the efficacy of an internet-based stress management intervention (iSMI) among employees with heightened levels of perceived stress (22,23). The intervention proved to be effective in reducing perceived stress and other mental and work-related health outcomes.…”

Public Attitudes Toward Guided Internet-Based Therapies: Web-Based Survey Study (Preprint)

“…This might indicate that individuals with stressful lives have problems to adhere to fixed synchronous therapy sessions, and providing asynchronous treatments might help them to get access to psychological treatments, which they would otherwise not utilize. Such an assumption is supported by studies that found high proportions of first-time helpseekers in internet-based stress management programs [76][77][78][79][80]. However, future research is needed to confirm such an assumption.…”

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

“…A recent meta-analysis found that these interventions are effective in increasing psychological wellbeing and workplace effectiveness but that the mean intervention completion (the extent to which participants adhered to the intervention) was 45% with a range of 3% to 95% [17]. Although there are examples of occupational digital mental health interventions that have achieved good adherence [18][19][20][21], uptake of and engagement with these interventions in the workplace clearly remains a pressing concern.…”