Testing a scalable web and smartphone based intervention to improve depression, anxiety, and resilience: A randomized controlled trial

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Acacia C. Parks
Allison L. Williams
Michele M. Tugade
Kara E. Hokes
Ryan D. Honomichl
Ran D. Zilca

Abstract

Psychological interventions targeting wellbeing can reliably increase wellbeing and decrease depressive symptoms. However, only a handful of studies have implemented wellbeing interventions online, and those studies have largely done so in a way that prioritizes experimental control over realism and scalability. We sought to take existing wellbeing interventions with established efficacy and to evaluate their impact when translated into a format that is publicly accessible, scalable, and designed with the goal of engaging users. Participants in this fully online trial were first-time registrants of the Happify platform, a fully automated web and mobile wellbeing intervention grounded in positive psychology, cognitive-behavioral therapy, and mindfulness-based stress reduction, which has offered wellbeing programs to over 3 million registrants to date. Consenting participants were randomly assigned to access the full Happify platform or a psychoeducation comparison condition and further categorized by their usage during the study: recommended usage (a minimum of 2-3 activities per week) or low usage (usage less than the recommended level). Participants were assessed on depressive symptoms, anxiety symptoms, and a composite measure of resilience at baseline and 8 weeks later. Participants who used Happify at the recommended level reported fewer depressive and anxiety symptoms and greater resilience after 8 weeks than participants who used Happify at a low level or participants who used the psychoeducation condition at any level. The Happify group also experienced greater rates of reduction in depression and anxiety symptom severity category, and had a greater net benefit (% users who improved minus % users who deteriorated), compared to the other groups. The results of this study suggest a successful first attempt at implementing and scaling a comprehensive package of lab-tested wellbeing interventions without losing efficacy.

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