Text4Hope: Receiving Daily Supportive Text Messages for 3 Months During the COVID-19 Pandemic Reduces Stress, Anxiety, and Depression.

Vincent I.O Agyapong,Marianne Hrabok,Bo Cao,Liana Urichuck,Shireen Surood,Daniel Li,Jasmine M Noble,Kelly Mrklas,Xin-Min Li,Wesley Vuong,April Gusnowski,Reham Shalaby,Andrew J Greenshaw,Russell Greiner,Mark Snaterse

doi:10.1017/dmp.2021.27

Abstract

This study reports on the changes in stress, anxiety, and depressive symptoms of subscribers after 3 months using Text4Hope, a supportive text messaging program designed to provide support during the pandemic. Standardized self-report measures were used to evaluate perceived stress (measured with the Perceived Stress Scale-10 [PSS-10]), anxiety (measured with the General Anxiety Disorder Scale 7 [GAD-7]), and depressive symptoms (measured with the Patient Health Questionnaire [PHQ-9]), at baseline and 3rd month (n = 373). After 3 months of using Text4Hope, subscribers' self-reports revealed significant (p< 0.001) mean score reductions compared with baseline on: the GAD-7 by 22.7%, PHQ-9 by 10.3%, and PSS-10 scores by 5.7%. Reductions in inferred prevalence rates for moderate to high symptoms were also observed, with anxiety demonstrating the largest reduction (15.7%). Observed Text4Hope-related reductions in psychological distress during COVID-19 indicate that Text4Hope is an effective, convenient, and accessible means of implementing a population-level psychological intervention.

Highlights

This study reports on the changes in stress, anxiety, and depressive symptoms of subscribers after 3 months using Text4Hope, a supportive text messaging program designed to provide support during the pandemic
The study hypothesis was that the Text4Hope intervention would result in ≥25% reduction in mean scores and prevalence rates in all 3 factors: the Perceived Stress Scale-10 (PSS-10), General Anxiety Disorder Scale 7 (GAD-7), and Patient Health Questionnaire (PHQ-9) scales at 3rd month versus baseline
With a prediction that daily supportive text messages would result in a 25% reduction in mean PSS-10, GAD-7, and PHQ-9 scores at 3rd month from baseline, a population variance of 5.0 for each scale mean score, a 1-sided significance level α = 0.05, and an acceptable difference between sample mean and population mean score for each scale of zero (μ-μ0 = 0), the estimate was that a sample size of 686 would be sufficient to detect mean differences between the baseline and 3rd month PSS-10, GAD-7, and PHQ-9 scores with a power of 80% (β = 0.2)

Summary

Introduction

This study reports on the changes in stress, anxiety, and depressive symptoms of subscribers after 3 months using Text4Hope, a supportive text messaging program designed to provide support during the pandemic. Methods: Standardized self-report measures were used to evaluate perceived stress (measured with the Perceived Stress Scale-10 [PSS-10]), anxiety (measured with the General Anxiety Disorder Scale 7 [GAD-7]), and depressive symptoms (measured with the Patient Health Questionnaire [PHQ-9]), at baseline and 3rd month (n = 373). Results: After 3 months of using Text4Hope, subscribers’ self-reports revealed significant (p< 0.001) mean score reductions compared with baseline on: the GAD-7 by 22.7%, PHQ-9 by 10.3%, and PSS-10 scores by 5.7%. Conclusions: Observed Text4Hope-related reductions in psychological distress during COVID-19 indicate that Text4Hope is an effective, convenient, and accessible means of implementing a population-level psychological intervention.

Objectives

Methods

Results

Discussion

Conclusion