Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 3, 2023
Date Accepted: Feb 17, 2024
Warning: This is an author submission that is not peer-reviewed or edited.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.
Effects of a Digital Mental Intervention on Perceived Stress and Rumination in Adolescents Aged 13 to 17: A Randomized Controlled Trial
ABSTRACT
Background:
Although adolescents report high levels of stress, they report engaging in few stress management techniques. Consequently, developing effective and targeted programs to help address this transdiagnostic risk factor in adolescence is particularly important. Most stress management programs for adolescents are delivered within schools, and the evidence for these programs is mixed, suggesting a need for alternative options for stress management among adolescents.
Objective:
To test the short-term effects of a digital mental health intervention (DMHI) designed for adolescents on perceived stress and rumination (i.e., brooding).
Methods:
This was a 12-week, two-arm randomized controlled trial of adolescents aged 13 to 17 who presented with elevated levels of perceived stress and brooding. Participants were randomly assigned to engage with a self-guided DMHI for adolescents (Happify for Teens) or to a waitlist control, and completed measures of perceived stress, brooding, optimism, sleep disturbance, and loneliness at baseline, 4 weeks, 8 weeks, and 12 weeks. Changes in outcomes between the intervention and waitlist control groups were assessed using repeated-measures multilevel models.
Results:
Of the 303 participants included in data analyses, 132 were assigned to the intervention and 171 to the waitlist. There were significantly greater improvements in the intervention condition for perceived stress (intervention 95% CI: -1.82 – -1.19, p<.001; control 95% CI: -0.44 – 0.26, p=.607), brooding (intervention: 95% CI: -1.00 – -0.68, p<.001; waitlist: 95% CI: -0.47 – -0.12; p=.001), and loneliness (intervention: 95% CI: -1.2 – -0.73, p<.001; control: 95% CI: -0.64 – -0.12, p=.005) over the 12-week study period. Changes in optimism and sleep disturbance were not significantly different across groups (ps≥.096).
Conclusions:
Happify for Teens was effective at reducing perceived stress, rumination, and loneliness among adolescents over 12 weeks, when compared to a waitlist control group. Our data reveal the potential benefits of DMHIs for adolescents, which may present a more scalable, destigmatized, and cost-effective alternative to school-based programs. Clinical Trial: Trial Registration: Clinicaltrials.gov: NCT04567888 International Registered Report Identifier (IRRID): RR1-10.2196/18578
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