Effectiveness of a Self-guided Mobile Application in Improving Wellbeing and Stress Coping
Condition: Stress
Study type: Interventional

Summary: 
      Excessive and chronic stress is a major public global health concern. Young adults are at
      particular risk to experience heightened stress because of life transitions. Short
      skills-focused self-guided applications (SGA) on mobile phones are a cost-effective and
      scalable way to equip users with better stress-coping skills, but many SGA stress-coping
      programmes are not evidence-based, existing research is flawed with methodological problems
      and is also predominantly conducted in Western countries. Questions also remain for whom SGAs
      work (moderators) and by which pathways (mediators).

      This study is a randomised-controlled trial (RCT) that evaluates the effectiveness of a
      recently developed mobile-phone SGA in improving stress coping in young adults.

      Hypothesis 1: The intervention group will report significantly lower stress symptoms at
      post-intervention and 1-month follow-up compared to the control group.

      Hypothesis 2: Coping self-efficacy will mediate the expected relationship between the use of
      the Stress-SGA and lower stress symptoms, i.e. people with higher coping self-efficacy will
      benefit more from the Stress-SGA than those with lower coping self-efficacy.

      Hypothesis 3: Psychological mindedness will moderate the expected relationship between the
      use of Stress-SGA and lower stress symptoms, i.e. people high in psychological mindedness
      will benefit more from the Stress-SGA than those with lower psychological mindedness.
    

Detailed description: 
      Procedure:

      Participants will sign up for the study via a survey link posted on the university's
      recruitment sites, where they will first read through the Participant Information Sheet,
      which contains information about the study such as study aims, methods, benefits and risks,
      the confidentiality of data, and contact information of the investigators. If participants
      agree to participate, they will provide their consent on the online consent form. Thereafter,
      they will proceed to complete a series of self-report measures on an online survey platform
      (baseline ratings). The online survey consists of the primary outcome measures on stress
      (PSM-9, PHQ-9 & GAD7), secondary outcome measures on coping self-efficacy and psychological
      mindedness (CSES & PM), and demographic information (age, gender).

      Next, participants will be randomly assigned to either the intervention or active control
      condition and guided to download the SGA on their personal mobile devices from the Apple App
      Store or Google Play Store. A number code will be provided to them to unlock the app
      according to their assigned condition. The SGA is developed by Intellect Pte Ltd, a Singapore
      based technology firm that collaborates with the supervisor of the study. Participants in the
      intervention condition will take part in the 8-day stress management program while those in
      the active control condition will take part in the 8-day cooperation learning program. Both
      programs will involve content education and short daily activities, averaging about five
      minutes, to fulfil a series of tasks aimed at improving their wellbeing. Daily reminders to
      complete the program will be sent via text messages by the researcher to participants. All
      participants will be instructed to refrain from engaging in any self-guided wellbeing apps
      other than the given SGA during the duration of the study, lasting from the beginning until
      the end of the 1-month follow-up. This minimises potential confounding effects.

      Upon completion of the 8-day program, participants will receive a survey link to complete the
      same questionnaires and in addition, will fill out the App Engagement Scale. One month upon
      completion of the SGA, participants will be emailed the survey link to the self-report
      measures again, along with the debrief and an information sheet explaining the main purposes
      of the study. All participants will be given a link to access the complete version of the
      SGA, providing them with access to all the wellbeing programs available for their personal
      use. Participants will be reimbursed with either course credit or a small monetary fee for
      their time and effort..
    

Intervention name(s): Self-guided program on stress coping; Self-guided program on cooperation
Intervention type(s): Device; Device
Intervention description(s): This is an 8-day program that provides psychoeducation on the negative effects of stress and effective stress-management skills to combat stress. Guided by principles of CBT, the program targets the thoughts and behaviours of participants and equips them with skills to alter negative cognitions pertaining to stress. Participants are engaging with a series of exercises involving reflection and mindfulness where they are required to spot and write down their stressors, the negative thoughts associated with the stressors, as well as positive affirmations. Participants will also be taught breathing exercises and are encouraged to practice them during 2 check-ins.; The 8-day program on cooperation aims to provide psychoeducation for participants to understand and improve collaboration and interpersonal relationships. Short quizzes and practice exercises on feedback-giving will be included. The time and duration of the cooperation SGA is matched to the stress-coping SGA to ensure that participants spend a similar amount of time and effort across both the intervention and active-control conditions.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Single (Participant)
Primary purpose: Supportive Care