AUTHOR=Harrer Mathias , Apolinário-Hagen Jennifer , Fritsche Lara , Drüge Marie , Krings Ludwig , Beck Korinna , Salewski Christel , Zarski Anna-Carlotta , Lehr Dirk , Baumeister Harald , Ebert David Daniel 

TITLE=Internet- and App-Based Stress Intervention for Distance-Learning Students With Depressive Symptoms: Protocol of a Randomized Controlled Trial

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 10 - 2019

YEAR=2019

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2019.00361

DOI=10.3389/fpsyt.2019.00361

ISSN=1664-0640

ABSTRACT=Background. Mental disorders are highly prevalent among university students. Distance-learning students are particularly burdened, and have limited access to conventional university health services. Interventions for stress are sought-after in distance learners, and may help increase treatment coverage. Internet-based interventions have been shown to be effective in preventing and treating depression, but it remains unclear if interventions directed at academic stress also have this potential. 

Aim: The trial presented here investigates the effectiveness of an Internet- and App-based stress intervention in distance-learning students with elevated levels of depression.

Methods. A sample of N = 200 students of a large German distance university with elevated levels of depression (CES-D ≥ 16) will be randomly assigned to either an Internet- and App-based stress management intervention group (IG) or a control group (CG) receiving an Internet-based psychoeducational program for academic stress. The IG consists of eight Internet-based sessions promoting stress management skills using cognitive-behavioral and problem-solving techniques. A mobile App will be employed to facilitate training transfer. Self-report data will be assessed at baseline (T0), post-treatment (T1; 7 weeks) and 3-month follow-up (T2). Potential moderators will be assessed at baseline. The primary outcome is depression (CES-D) post-treatment. Secondary outcomes include mental health outcomes, modifiable risk and protective factors, and academic outcomes. Data will be analysed on an intention-to-treat principle along with sensitivity analyses to assess the robustness of findings. Additional health economic analyses will be conducted.

Discussion. Results will provide the basis to assess the acceptance and effectiveness of Internet-delivered stress interventions in distance-learning students with symptoms of depression.

Ethics and Dissemination. The study has been reviewed and approved by the University of Erlangen-Nuremberg ethics committee (Erlangen, Germany; 33_17 Bc). Results of the study will be disseminated through peer-reviewed publications. 

Trial registration. German Clinical Trial Registration (DRKS): DRKS00011800 (https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00011800)