Abstract
BackgroundPromoting well-being and preventing poor mental health in young people is a major global priority. Building emotional competence skills via a mobile app may be an effective, scalable and acceptable way to do this. A particular risk factor for anxiety and depression is elevated worry and rumination (repetitive negative thinking, RNT). An app designed to reduce RNT may prevent future incidence of depression and anxiety.Method/designThe Emotional Competence for Well-Being in Young Adults study developed an emotional competence app to be tested via randomised controlled trials in a longitudinal prospective cohort. This off-shoot study adapts the app to focus on targeting RNT (worry, rumination), known risk factors for poor mental health. In this study, 16–24 year olds in the UK, who report elevated worry and rumination on standardised questionnaires are randomised to (i) receive the RNT-targeting app immediately for 6 weeks (ii) a waiting list control who receive the app after 6 weeks. In total, the study will aim to recruit 204 participants, with no current diagnosis of major depression, bipolar disorder or psychosis, across the UK. Assessments take place at baseline (pre-randomisation), 6 and 12 weeks post-randomisation. Primary endpoint and outcome for the study is level of rumination assessed on the Rumination Response Styles Questionnaire at 6 weeks. Worry, depressive symptoms, anxiety symptoms and well-being are secondary outcomes. Compliance, adverse events and potentially mediating variables will be carefully monitored.DiscussionThis trial aims to better understand the benefits of tackling RNT via an mobile phone app intervention in young people. This prevention mechanism trial will establish whether targeting worry and rumination directly via an app provides a feasible approach to prevent depression and anxiety, with scope to become a widescale public health strategy for preventing poor mental health and promoting well-being in young people.Trial registrationClinicalTrials.gov, NCT04950257. Registered 6 July 2021 – Retrospectively registered.
Highlights
DiscussionThis trial aims to better understand the benefits of tackling Repetetive Negative Thinking (RNT) via an mobile phone app intervention in young people
Promoting well-being and preventing poor mental health in young people is a major global priority
This trial aims to better understand the benefits of tackling Repetetive Negative Thinking (RNT) via an mobile phone app intervention in young people. This prevention mechanism trial will establish whether targeting worry and rumination directly via an app provides a feasible approach to prevent depression and anxiety, with scope to become a widescale public health strategy for preventing poor mental health and promoting well-being in young people
Summary
Improving the mental health of young people has recently been identified as a global health priority [4, 70]. The identification of effective prevention interventions can be achieved by developing interventions that target known mechanisms for vulnerability to mental health disorders and evaluating whether they effectively reduce this vulnerability factor using prevention mechanism trials [55] This trial is one such prevention mechanism trial and will test as proof-of-concept whether the self-help app is effective at reducing RNT (worry and rumination), which are proven risk factors for multiple mental health problems. If the self-help app is effective at reducing worry and rumination, this will suggest that the intervention may be of value for long-term prevention and is worthy of further longer-term investigation.
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