Abstract
IntroductionRates of work-related stress, depression and anxiety are high, resulting in reduced work performance and absenteeism. There is evidence that digital mental health interventions delivered in the workplace are an effective way of treating these conditions, but intervention engagement and adherence remain a challenge. Providing guidance can lead to greater engagement and adherence; an online facilitated discussion group may be one way of providing that guidance in a time efficient way. This study compares engagement with a minimally guided digital mental health program (WorkGuru) delivered in the workplace with a discussion group (DG) and without a discussion group (MSG), and with a wait list control (WLC); it was conducted as a pilot phase of a definitive trial. MethodsEighty four individuals with elevated levels of stress from six organisations were recruited to the study and randomised to one of two active conditions (DG or MSG) or a WLC. The program WorkGuru is a CBT based, eight-week stress management intervention that is delivered with minimal guidance from a coach. Data was collected at baseline, post–intervention and at 16-week follow-up via online questionnaires. The primary outcome measure was number of logins. Secondary measures included further engagement measures, and measures of depression, anxiety, stress, comfort and enthusiasm. Quality measures including satisfaction and system usability were also collected. ResultsA greater number of logins was observed for the DG compared with the MSG; this was a medium between group effect size (d=0.51; 95% CI: −0.04, 1.05). Small to medium effect size differences were found at T2 in favour of the active conditions compared with the control on the DASS subscales depression, anxiety and stress, and the IWP subscales enthusiasm and comfort. This was largely maintained at T3. Satisfaction with the intervention was high with individuals in the MSG reporting greater satisfaction than individuals in the DG. ConclusionsThis study shows that access to an online facilitated discussion group increases engagement with a minimally supported occupational digital mental health intervention (as defined by the number of logins), but that this doesn't necessarily result in improved psychological outcomes or increased satisfaction when compared to access to the intervention without the group. Access to the web-based program was associated with lower levels of depression, anxiety and stress and an increase in comfort and enthusiasm post intervention; these changes were largely maintained at follow-up. Trial registrationThis trial was registered with ClinicalTrials.gov on March the 18th 2016 NCT02729987 (website link https://clinicaltrials.gov/ct2/show/NCT02729987?term=NCT02729987&rank=1).
Highlights
Rates of work-related stress, depression and anxiety are high, resulting in reduced work performance and absenteeism
A randomised controlled trial (RCT) of a digital mental health intervention delivered in the workplace reported that only 5% of participants started one or more of the modules (Boiler et al, 2014), and a trial of digital mindfulness delivered in a workplace reported that between 42% and 52% of all participants in the active conditions never logged on to the program (Allexandre et al, 2016)
The trial was conducted to examine the effect of an online facilitated discussion group on engagement with a minimally supported digital stress management intervention delivered to employees, and to look at the estimated potential effectiveness of the program
Summary
Rates of work-related stress, depression and anxiety are high, resulting in reduced work performance and absenteeism. Small to medium effect size differences were found at T2 in favour of the active conditions compared with the control on the DASS subscales depression, anxiety and stress, and the IWP subscales enthusiasm and comfort. Conclusions: This study shows that access to an online facilitated discussion group increases engagement with a minimally supported occupational digital mental health intervention (as defined by the number of logins), but that this doesn't necessarily result in improved psychological outcomes or increased satisfaction when compared to access to the intervention without the group. A randomised controlled trial (RCT) of a digital mental health intervention delivered in the workplace reported that only 5% of participants started one or more of the modules (Boiler et al, 2014), and a trial of digital mindfulness delivered in a workplace reported that between 42% and 52% of all participants in the active conditions never logged on to the program (Allexandre et al, 2016). Carolan et al (2017) found that the mean highest reported completion across 19 studies in their meta-analysis was 45% with a range of 3% to 95%
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