Intervention Package to Promote Emotion Regulation Strategies in University Students
Condition: Anxiety; Emotion Regulation
MeSH terms: Anxiety Disorders
Study type: Interventional

Summary: 
      The primary aim of the proposed Randomised Control study is to investigate the effects of a
      socially assisted robot (i.e. Purrble) and a co-designed, bespoke Single Session Intervention
      (SSI) on students' anxiety (GAD-7) over the period of the two academic terms (in comparison
      to a wait-listed student group).

      Secondary aims include investigating the effects of the Purrble and SSI on students' emotion
      regulation processes, depressive symptoms, and quantitative and qualitative (interviews)
      measures of engagement with the intervention.
    

Detailed description: 
      Need among college students for accessible mental health support is high: for example, the
      WHO World Mental Health International College Student project involving 13,984 first-year
      college students from eight countries, found that 31% of the respondents screened positive
      for depression, anxiety, or alcohol use disorder. Yet, access to professional support has
      long remained low, with waitlists for counselling on many campuses being weeks to months
      long. Digital technologies, including apps, have been proposed as one possible means of
      'filling in the gaps' in extant mental health care support for college students - but most
      apps suffer from low usability in real-world settings, are not equipped to serve
      in-the-moment coping needs (e.g., they involve user-initiated psychoeducation modules rather
      than opportunities to practice and grow skills when they are needed most) and often show high
      drop-out rates.

      Thus, there is a clear need to harness digital technologies to create usable, engaging,
      evidence-supported mental health supports that may be used flexibly based on when students
      need them most (e.g. when stress levels are particularly high and coping skills most warrant
      deployment); ideally also as an adjunct completing existing counselling service.

      In initial pilot work (n=80, open trial at Oxford) the investigators evaluated one such
      possible tool, Purble, designed to provide a student-centred, in-the-moment emotion
      regulation support. Study goals centred on testing usability/usage patterns during 8-week
      in-situ deployment, perceived usefulness over the same period, and links between use and
      symptoms in high-anxiety university students (GAD7 > 10 at sign-up). The results have been
      promising, with large pre-/post- effects sizes on GAD-7 scores over the period of the term.
      Moreover, the majority of students perceived the Purrble intervention as useful (with 61%
      reporting in the last survey that it helped their mental health) and have reported a range of
      positive outcomes in qualitative interviews (e.g., it helped them calm down and ground
      themselves in the present moment when they are feeling anxious, stressed or lonely; or to be
      more gentle and kind with themselves-rather than harsh and judgmental-when feeling
      overwhelmed).

      However, the open trial pilot study did not include a control or wait-listed group and thus
      more rigorous investigation of these promising effects is needed. In an prior unpowered pilot
      RCT, we tested the procedures that are to be used within this proposed study.
    

Intervention name(s): Purrble+SSI
Intervention type(s): Behavioral
Intervention description(s): Purrble intervention as described above.
Single Session Intervention (SSI) (~30mins) combining the theories of ER with the experiences from students involved in previous studies, and follows a traditional SSI structure (Schleider et al 2020). Specific content has been co-produced with students and experts.
Other intervention name(s): Purrble intervention + Single Session Intervention
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: emotion regulation; anxiety; students; intervention