Examining the Efficacy of Acceptance and Commitment Therapy (ACT) Microinterventions for Distressed First-Generation College Students
Condition: Psychological Distress; Self-Assessment; Mood Change
Study type: Interventional
Phase: Phase 1

Summary: 
      This research study aims to evaluate the feasibility, safety, and effectiveness of a
      micro-randomized acceptance and commitment therapy-based (ACT-based) intervention that is
      delivered to distressed first-generation college students.
    

Detailed description: 
      The transition to college is associated with a number of changes in health behaviors and
      mental health functioning, with 50% of college students meeting criteria for a psychiatric
      disorder. In particular, first-generation college students may be at particular risk for
      increased stress and mental health difficulties. The development of effective
      psychotherapeutic interventions is essential in providing adequate care to young adults
      during the transitional years of college. Delivery of these interventions via acceptable and
      feasible modalities for this population is also of utmost importance so that utilization and
      engagement are prioritized. Brief interventions have been a point of emphasis in recent years
      from the perspective of patient and provider efficiency, as well as many studies indicating
      effectiveness of brief interventions in creating and sustaining clinical levels of change.

      The current study seeks to evaluate the effectiveness of brief interventions delivered via a
      smartphone app, or "microinterventions", based in Acceptance and Commitment Therapy (ACT).
      ACT is a cognitive-behavioral therapy that seeks to promote psychological flexibility. ACT is
      transdiagnostic, meaning that it is designed to target human suffering, rather than a
      particular psychological or physical disorder. ACT targets experiential avoidance, which is
      the inability or unwillingness to make contact with painful experiences (e.g., thoughts,
      emotions, memories. Avoidance provides short-term relief, but exacerbates the long-term
      experience of the avoided stimulus in terms of intensity and duration. The microintervention
      in this study will consist of one of 84 prompts that aim to target one of 6 processes
      targeted in ACT. For example, one prompt is "Do your current actions align with what matters
      most to you?" Delivery of these prompts (e.g., whether and when to deliver which prompt) is
      randomized to allow for secondary analyses of optimal delivery of the microintervention in
      addition to primary analyses of its effectiveness.
    

Intervention name(s): compACT Intervention
Intervention type(s): Behavioral
Intervention description(s): The mobile intervention in this study consists of two components: 1) self-monitoring and 2) an ACT-based microintervention.
Self-monitoring: twice daily, participants will complete self-reports of distress, depressive symptoms, and activity through the mobile app Lorevimo.
Microintervention: The microintervention will consist of one of 84 prompts that aim to target one of 6 processes targeted in ACT (contacting the present moment, defusion, acceptance, self-as-context, values, and committed action). At each time-point, participants have a 50% chance of receiving a microintervention question along with the daily self-monitoring assessments.
Allocation: Randomized
Intervention model: Single Group Assignment
Intervention model description: This study uses a design known as a microrandomized trial. Whereas a multi-arm trial randomizes a subject to an intervention group only once at the start of the study, a microrandomized trial repeatedly randomizes a subject to an intervention group throughout the study. In addition to an overall effect of an intervention on proximal outcomes, a microrandomized trial allows one to determine if the effect is modified by momentary factors (e.g., current mood, day of the week, day in the study).
For the present study, every subject has a equal chance of being assigned to one of two intervention groups at each of 84 time points (2 daily x 42 days). At each time point, the two intervention groups are to either receive a prompt based on Acceptance and Commitment Therapy (ACT) or not receive such a prompt. Regardless of the assigned group, subjects are asked to assess their mood, stress, and activity at every time point prior to assignment to intervention group.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Acceptance and commitment therapy; Micro-intervention; Mobile intervention