J. Med. Internet Res. - Multilevel growth curve analyses of treatment effects of a Web-based intervention for stress reduction: randomized controlled trial.

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Resumo

CKGROUND: Stress is commonly experienced by many people and it is a contributing factor to many mental and physical health conditions, However, few efforts have been made to develop and test the effects of interventions for stress.OBJECTIVE: The aim of this study was to examine the effects of a Web-based stress-reduction intervention on stress, investigate mindfulness and procrastination as potential mediators of any treatment effects, and test whether the intervention is equally effective for females as males, all ages, and all levels of education.METHODS: We employed a randomized controlled trial in this study. Participants were recruited online via Facebook and randomly assigned to either the stress intervention or a control condition. The Web-based stress intervention was fully automated and consisted of 13 sessions over 1 month. The controls were informed that they would get access to the intervention after the final data collection. Data were collected at baseline and at 1, 2, and 6 months after intervention onset by means of online questionnaires. Outcomes were stress, mindfulness, and procrastination, which were all measured at every measurement occasion.RESULTS: A total of 259 participants were included and were allocated to either the stress intervention (n=126) or the control condition (n=133). Participants in the intervention and control group were comparable at baseline; however, results revealed that participants in the stress intervention followed a statistically different (ie, cubic) developmental trajectory in stress levels over time compared to the controls. A growth curve analysis showed that participants in the stress intervention (unstandardized beta coefficient [B]=-3.45, P=.008) recovered more quickly compared to the control group (B=-0.81, P=.34) from baseline to 1 month. Although participants in the stress intervention did show increases in stress levels during the study period (B=2.23, P=.008), long-term stress levels did decrease again toward study end at 6 months (B=-0.28, P=.009). Stress levels in the control group, however, remained largely unchanged after 1 month (B=0.29, P=.61) and toward 6 months (B=-0.03, P=.67). Mediation analyses showed nonlinear (ie, cubic) specific indirect effects of mindfulness and a linear specific indirect effect of procrastination on stress. In simple terms, the intervention increased mindfulness and decreased procrastination, which was related to lower stress levels. Finally, the effect of the stress intervention was independent of participants' gender, age, or education.CONCLUSIONS: The results from this randomized controlled trial suggest that a Web-based intervention can reduce levels of stress in a normal population and that both mindfulness and procrastination may be important components included in future eHealth interventions for stress.TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN): 25619675; http://controlled-trials.com/ISRCTN25619675 (Archived by Webcite at http://www.webcitation.org/6FxB1gOKY).

Resumo Limpo

ckground stress common experienc mani peopl contribut factor mani mental physic health condit howev effort made develop test effect intervent stressobject aim studi examin effect webbas stressreduct intervent stress investig mind procrastin potenti mediat treatment effect test whether intervent equal effect femal male age level educationmethod employ random control trial studi particip recruit onlin via facebook random assign either stress intervent control condit webbas stress intervent fulli autom consist session month control inform get access intervent final data collect data collect baselin month intervent onset mean onlin questionnair outcom stress mind procrastin measur everi measur occasionresult total particip includ alloc either stress intervent n control condit n particip intervent control group compar baselin howev result reveal particip stress intervent follow statist differ ie cubic development trajectori stress level time compar control growth curv analysi show particip stress intervent unstandard beta coeffici b p recov quick compar control group b p baselin month although particip stress intervent show increas stress level studi period b p longterm stress level decreas toward studi end month b p stress level control group howev remain larg unchang month b p toward month b p mediat analys show nonlinear ie cubic specif indirect effect mind linear specif indirect effect procrastin stress simpl term intervent increas mind decreas procrastin relat lower stress level final effect stress intervent independ particip gender age educationconclus result random control trial suggest webbas intervent can reduc level stress normal popul mind procrastin may import compon includ futur ehealth intervent stresstrial registr intern standard random control trial number isrctn httpcontrolledtrialscomisrctn archiv webcit httpwwwwebcitationorgfxbgoki

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