JMIR Publications

ABSTRACT

Background:

Nearly one in two adults in the Netherlands experiences a mental health condition during their lifetime. Given limited mental healthcare capacity, workplace-based prevention offers an important opportunity to prevent mental health problems.

Objective:

This study evaluates two World Health Organization preventive interventions adapted for the Dutch workplace within a multilevel prevention approach. The primary aims are to determine whether: (1) the Dutch adaptation of Advancing Supervisor Capabilities for Mental Health at Work (ASCEND), a supervisor training, improves supervisors’ confidence in addressing employee mental health problems and related outcomes; and (2) Doing What Matters in Times of Stress (DWM), an online, low-intensity psychological intervention, reduces employee depression-anxiety symptoms and improves related outcomes. Secondary objectives are to evaluate the implementation, economic outcomes, and scalability of both interventions, and assess whether combining ASCEND and DWM improves employee mental health and productivity more than either intervention alone.

Methods:

This study uses a sequential cluster randomized controlled design comprising two consecutive cluster randomized controlled trials (cRCTs) in Dutch organizations from various sectors. cRCT-1 evaluates ASCEND among supervisors and their direct reports, and cRCT-2 evaluates DWM among employees. Separate eligibility criteria apply to each trial. Organizations or organizational units of similar sizes serve as clusters and are randomized twice in a parallel-group superiority design. In cRCT-1, 74 clusters are allocated 1:1 to ASCEND (n=37) or control (n=37). In cRCT-2, the same clusters are allocated 1:1 to DWM plus care as usual (CAU; n=37) or CAU only (n=37). Assessments in cRCT-1 occur at baseline, post-intervention, and 1- and 3-month follow-up; in cRCT-2, assessments occur at baseline, and 1 week and 3 months post-intervention. Qualitative implementation data will also be collected.

Results:

Recruitment is ongoing and expected to be completed in November 2026. The first participant was enrolled in cRCT-1 on 14 May 2025 and in cRCT-2 on 19 May 2025. To date, 76 clusters have been included, with study initiation pending for some due to varying start dates. As of July 2026, cRCT-1 has enrolled 307 supervisors and 141 direct reports across 44 clusters, and cRCT-2 has enrolled 178 employees across 39 clusters. The study is part of the Horizon Europe ADVANCE project. The Scientific and Ethical Review Board of the Faculty of Behavioural and Movement Sciences, VU Amsterdam, approved cRCT-1 procedures (VCWE-2026-123), and the Medical Ethics Committee of Amsterdam University Medical Centre granted a non-medical waiver for cRCT-1 (2024.0846) and approved the procedures of cRCT-2 (2024.0852).

Conclusions:

This study will provide evidence on the effectiveness, implementation, cost-effectiveness, and scalability of workplace interventions and the added value of combining supervisor- and employee-level interventions to inform workplace mental health prevention strategies in the Netherlands. Clinical Trial: cRCT-1 (ID: NCT06989398, https://clinicaltrials.gov/study/NCT06989398) on 25/05/2025; cRCT-2 (ID: NCT06979089, https://clinicaltrials.gov/study/NCT06979089) on 18/05/2025.