Effectiveness of the Minder Mobile Mental Health and Substance Use Intervention for University Students: Randomized Controlled Trial (Preprint)
Authors: Vereschagin Melissa , Wang Angel Y , Richardson Chris G , Xie Hui , Munthali Richard J , Hudec Kristen L , Leung Calista , Wojcik Katharine D , Munro Lonna , Halli Priyanka , Kessler Ronald C , Vigo Daniel V 
Published: March 2024

BACKGROUND

University attendance represents a transition period for students that often coincides with the emergence of mental health and substance use challenges. Digital interventions have been identified as a promising means of supporting students due to their scalability, adaptability, and acceptability. <i>Minder</i> is a mental health and substance use mobile app that was codeveloped with university students.

OBJECTIVE

This study aims to examine the effectiveness of the <i>Minder</i> mobile app in improving mental health and substance use outcomes in a general population of university students.

METHODS

A 2-arm, parallel-assignment, single-blinded, 30-day randomized controlled trial was used to evaluate <i>Minder</i> using intention-to-treat analysis. In total, 1489 participants were recruited and randomly assigned to the intervention (n=743, 49.9%) or waitlist control (n=746, 50.1%) condition. The <i>Minder</i> app delivers evidence-based content through an automated chatbot and connects participants with services and university social groups. Participants are also assigned a trained peer coach to support them. The primary outcomes were measured through in-app self-assessments and included changes in general anxiety symptomology, depressive symptomology, and alcohol consumption risk measured using the 7-item General Anxiety Disorder scale, 9-item Patient Health Questionnaire, and US Alcohol Use Disorders Identification Test–Consumption Scale, respectively, from baseline to 30-day follow-up. Secondary outcomes included measures related to changes in the frequency of substance use (cannabis, alcohol, opioids, and nonmedical stimulants) and mental well-being. Generalized linear mixed-effects models were used to examine each outcome.

RESULTS

In total, 79.3% (589/743) of participants in the intervention group and 83% (619/746) of participants in the control group completed the follow-up survey. The intervention group had significantly greater average reductions in anxiety symptoms measured using the 7-item General Anxiety Disorder scale (adjusted group mean difference=−0.85, 95% CI −1.27 to −0.42; <i>P</i>&lt;.001; Cohen <i>d</i>=−0.17) and depressive symptoms measured using the 9-item Patient Health Questionnaire (adjusted group mean difference=−0.63, 95% CI −1.08 to −0.17; <i>P</i>=.007; Cohen <i>d</i>=−0.11). A reduction in the US Alcohol Use Disorders Identification Test–Consumption Scale score among intervention participants was also observed, but it was not significant (<i>P</i>=.23). Statistically significant differences in favor of the intervention group were found for mental well-being and reductions in the frequency of cannabis use and typical number of drinks consumed. A total of 77.1% (573/743) of participants in the intervention group accessed at least 1 app component during the study period.

CONCLUSIONS

In a general population sample of university students, the <i>Minder</i> app was effective in reducing symptoms of anxiety and depression, with provisional support for increasing mental well-being and reducing the frequency of cannabis and alcohol use. These findings highlight the potential ability of e-tools focused on prevention and early intervention to be integrated into existing university systems to support students’ needs.

CLINICALTRIAL

ClinicalTrials.gov NCT05606601; https://clinicaltrials.gov/ct2/show/NCT05606601

INTERNATIONAL REGISTERED REPORT

RR2-10.2196/49364