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BACKGROUND: Mental health problems are highly prevalent among college students. Most students with poor mental health, however, do not receive professional help. Internet-based self-help formats may increase the utilization of treatment. OBJECTIVE: The aim of this randomized controlled trial was to evaluate the efficacy of an internet-based, app-supported stress management intervention for college students. METHODS: College students (n=150) with elevated levels of stress (Perceived Stress Scale 4-item version, PSS-4 ≥8) were randomly assigned to either an internet- and mobile-based stress intervention group with feedback on demand or a waitlist control group. Self-report data were assessed at baseline, posttreatment (7 weeks), and 3-month follow-up. The primary outcome was perceived stress posttreatment (PSS-4). Secondary outcomes included mental health outcomes, modifiable risk and protective factors, and college-related outcomes. Subgroup analyses were conducted in students with clinically relevant symptoms of depression (Center for Epidemiological Studies' Depression Scale >17). RESULTS: A total of 106 participants (76. 8%) indicated that they were first-time help-seekers, and 77. 3% (intervention group: 58/75; waitlist control group: 58/75) showed clinically relevant depressive symptoms at baseline. Findings indicated significant effects of the intervention compared with the waitlist control group for stress (d=0. 69; 95% CI 0. 36-1. 02), anxiety (d=0. 76; 95% CI 0. 43-1. 09), depression (d=0. 63; 95% CI 0. 30-0. 96), college-related productivity (d=0. 33; 95% CI 0. 01-0. 65), academic work impairment (d=0. 34; 95% CI 0. 01-0. 66), and other outcomes after 7 weeks (posttreatment). Response rates for stress symptoms were significantly higher for the intervention group (69%, 52/75) compared with the waitlist control group (35%, 26/75, P<. 001; number needed to treat=2. 89, 95% CI 2. 01-5. 08) at posttest (7 weeks). Effects were sustained at 3-month follow-up, and similar findings emerged in students with symptoms of depression. CONCLUSIONS: Internet- and mobile-based interventions could be an effective and cost-effective approach to reduce consequences of college-related stress and might potentially attract students with clinically relevant depression who would not otherwise seek help. TRIAL REGISTRATION: German Clinical Trial Register DRKS00010212; http: //www. drks. de/drksweb/navigate. do? navigationId=trial. HTML&TRIALID=DRKS00010212 (Archived by WebCite at http: //www. webcitation. org/6w55Ewhjd).
Harrer et al. (Mon,) studied this question.