JMIR Publications

ABSTRACT

Background:

A growing literature supports the use of Internet-based interventions to improve mental health outcomes. However, most programs target specific symptoms or participant groups, and are not tailored to facilitate improvements in mental health and wellbeing, or do not allow for needs and preferences of individual participants. The Be Well Plan, a 5-week facilitated, Internet-based mental health and wellbeing group intervention addresses these gaps, allowing participants to select a range of activities that they can tailor to their specific characteristics, needs and preferences.

Objective:

This study aimed to test whether the Be Well Plan program was effective in improving primary outcomes of mental wellbeing, resilience, anxiety, and depression compared to a waitlist control group during the COVID-19 pandemic; secondary outcomes included self-efficacy, sense of control and cognitive flexibility. The study further sought to examine participants’ engagement and satisfaction with the program.

Methods:

A randomised controlled trial was conducted with two parallel arms, an intervention and a waitlist control group. The intervention involved 5 weekly 2-hour sessions, which were facilitated in group format using Zoom videoconferencing software. University students were recruited via social media posts, lectures, email, flyers, and posters.

Results:

Using an intentional randomisation 2:1 allocation strategy, we recruited 215 participants to the trial (126 intervention, 89 control). Of the participants assigned to the intervention, 75 commenced the program and were included in intention to treat (ITT) analyses. ITT intervention participants attended on average 3.41 sessions (SD = 1.56, median = 4); 55 (60%) attended at least 4 sessions, and 25 (33.3%) attended all 5 sessions. Of the 49 intervention group participants who completed the post-intervention assessment, 47 (95.9%) were either very satisfied (n = 31) or satisfied (n = 16). The ITT analysis for wellbeing, F(1, 162) = 9.65, P = .002 (Cohen’s d = .48), and resilience, F(1, 162) = 7.85, P = .006 (Cohen’s d = 0.44), showed significant Time X Group interaction effects, suggesting that both groups improved over time, but the Be Well Plan group showed significantly greater improvement compared to the waitlist control. A similar pattern of results was observed for depression and anxiety (d = 0.32 and d = 0.37, respectively), as well as the secondary outcomes (self-efficacy, d = 0.50; sense of control, d = 0.42; cognitive flexibility, d = 0.65). Larger effect sizes were observed in the completer analyses. Reliable change analysis showed that the majority of ITT participants (58/75, 77%) demonstrated a significant reliable improvement in at least one of the primary outcomes.

Conclusions:

The Be Well Plan program was effective in improving mental health and wellbeing including mental wellbeing, resilience, depression, and anxiety. Participant satisfaction scores and attendance indicated a high degree of engagement and satisfaction with the program. Clinical Trial: Australian New Zealand Clinical Trial Registry ACTRN12621000180819