JMIR Publications

ABSTRACT

Background:

Several systematic reviews and meta-analyses have demonstrated the effectiveness of digital interventions for improving the mental health of university students. However, low rates of engagement with these interventions are an ongoing challenge and can compromise effectiveness. Brief, transdiagnostic, video-based interventions delivered online are capable of targeting key mental health and related issues affecting university students and may be more engaging and accessible for this population.

Objective:

Using a 2-arm randomised controlled trial, this study aimed to evaluate the effectiveness of UVC-Lite, a self-guided, transdiagnostic, video-based internet intervention, relative to an attention-control condition. The primary outcomes were depression and anxiety symptoms. Secondary outcomes included psychological distress, social anxiety symptoms, body appreciation, quality of life, wellbeing, functioning, general self-efficacy, academic self-efficacy and help-seeking. Program usage (intervention uptake and engagement) and satisfaction were also assessed.

Methods:

Participants (N=487) were students recruited from universities across Australia with mild to moderate symptoms of distress, who were randomly allocated to receive either access to the fully automated UVC-Lite intervention for 6 weeks or an attention control condition targeting general health for 6 weeks. The UVC-Lite intervention included 12 modules addressing a range of mental health topics, each comprising a brief animated video and an accompanying exercise. Seven of the 12 modules also included a brief symptom screening quiz. Outcome data were obtained at baseline, post-intervention, and 3- and 6-month follow-up.

Results:

Primary and secondary outcomes were analysed on an intention-to-treat (ITT) basis using mixed models repeated measures analysis of variance. The intervention was not found to be effective relative to the control condition on any of the primary or secondary outcomes. While 67.9% of participants accessed at least 1 module of the intervention, module completion was extremely low. Subgroup analyses among those who engaged with the program (completed at least 1 video) and those with higher baseline distress (DQ5≥15) did not reveal any significant differences between intervention groups over time. However, uptake (accessing at least 1 video) and engagement (completing at least 1 video) was higher among those with higher baseline symptoms. Satisfaction with the intervention was high.

Conclusions:

The UVC-Lite intervention was not found to be effective relative to a control program, although it was associated with high satisfaction among students, and was not associated with symptom deterioration. Given the challenges faced by universities in meeting demand for mental health services, flexible and accessible interventions such as UVC-Lite have significant potential to assist students to manage symptoms of mental health problems. However, low uptake and engagement (particularly among students with lower levels of symptomatology) is a significant challenge that requires further attention. Future studies should examine the effectiveness of the intervention in a more highly symptomatic sample, as well as implementation pathways to optimise effective engagement with the intervention. Clinical Trial: The trial was prospectively registered with the Australian New Zealand Clinical Trials Registry: ACTRN12621000375853.