Accepted for/Published in: JMIR Mental Health
Date Submitted: Jul 11, 2020
Date Accepted: Nov 30, 2020
Date Submitted to PubMed: Dec 9, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Mental Health Response to the COVID-19 Pandemic: Effectiveness of a Daily Supportive Text Message (Text4Hope) Program at Six Weeks in Reducing Stress, Anxiety, and Depression, and Impact of Demographic Factors and Self-isolation Status
ABSTRACT
Background:
Background:
In addition to the obvious medical (physical) impact of COVID-19, threats to mental health, psychological safety, and well-being are evident. Provision of support for these challenges is complicated by the high number of people requiring support and the need to maintain physical distancing. Text4Hope, a daily supportive texting messaging program was launched in Canada to mitigate the negative mental health impacts of the pandemic amongst Canadians.
Objective:
Objective:
This paper aimed to describe the changes in stress, anxiety, and depression levels after 6-weeks of exposure to daily supportive text messages. Additionally, we aimed to identify associations between some demographic variables as well as self-isolation/self-quarantine status and the changes in stress, anxiety and depression levels.
Methods:
Methods:
Self-administered, online, empirically-supported questionnaires were used to assess demographic and clinical characteristics of subscribers. Perceived stress, anxiety, and depression were measured with the Perceived Stress Scale (PSS), the Generalized Anxiety Disorder-7 (GAD-7) scale and the Patient Health Questionnaire-9 (PHQ-9) at baseline and 6-week time points. Moderate/high perceived stress, suspected GAD and MDD were assessed using cut-off scores of PSS ≥ 14, GAD-7 ≥ 10, and PHQ-9 ≥ 10, respectively. By the six-weeks into the program, 688 participants completed the questionnaires at both time points.
Results:
Results:
At the 6-week time point, there were statistically significant reductions in mean scores on the PSS and GAD-7 scale but not the PHQ-9 scale. Effect sizes were small overall. There were statistically significant reductions in the prevalence rates for moderate/high stress, likely GAD, and likely MDD for the group that completed both the baseline and 6-week assessments and also for all subscribers. The biggest reduction in prevalence rates was for anxiety; 12.4% for those who completed both the baseline and 6-week surveys and 14.8% for all subscribers.
Conclusions:
Conclusion: Text4Hope is a convenient, cost-effective, and accessible means for implementing a population-level psychological intervention, overall demonstrating comparable to superior outcomes compared to other remote interventions. This program demonstrated significant reduction in anxiety and stress during the COVD-19 pandemic and could be used as a population level mental health intervention during natural disasters and other emergencies. Clinical Trial: The study protocol was approved by the Research and Ethics Board of the University of Alberta (Pro00086163).
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.