Testing a scalable web and smartphone based intervention to improve depression, anxiety, and resilience: A randomized controlled trial
Keywords:online intervention, well-being, depressive symptoms, anxiety symptoms, resilience, randomized controlled trial
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.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution Non-Commercial No Derivatives License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. The license prevents others from using the work for profit without the express consent of the author(s). The license also prevents the creation of derivative works without the express consent of the author(s). Note that derivative works are very similar in nature to the original. Merely quoting (and appropriately referencing) a passage of a work is not making a derivative of it.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).