“Intellect”, A Brief Self-Guided Application on a Mobile Phone Improves Stress Coping in University Students: A Randomized Controlled Trial with an Active Control and a 1-Month Follow-up (Preprint)

Abstract

Excessive and chronic stress is a major global health concern, especially for young adults. Short skills-focused self-guided applications (SGAs) on smartphones are a cost-effective and scalable way to improve stress coping skills at the population level.

We aimed to evaluate (a) The effectiveness of a recently developed stress coping SGA (“Intellect”) in improving stress coping skills, relative to an active control group, and (b) to examine Psychological Mindedness (PM) and Coping Self-Efficacy (CSE) as two potential moderators of this predicted relationship to identify students who benefit the most from the stress coping SGA.

University students (N = 321) were randomly assigned to either an 8-day SGA on stress coping or an active-control group. Self-report measures were obtained at baseline, post-intervention and 1-month follow-up. The primary outcome was psychological stress (Psychological Stress Measure, PSM-9). Secondary outcomes were anxiety (Generalized Anxiety Disorder, GAD-7), and depressive symptoms (Patient-Health Questionnaire, PHQ-9). Psychological mindedness (Psychological Mindedness Scale, PMS) and coping self-efficacy (Coping Self-Efficacy Scale, CSES) were assessed at baseline as potential moderators.

The final participants (N = 264) included 188 females, 66 males, 7 non-binary, and 3 others with a mean age of 22.5 years. The intervention group reported significantly lower stress (ηp2 = .018, P = .029) and anxiety levels (ηp2 = .019, P = .026) at post-intervention relative to the active control group. The effects on stress levels remained statistically significant at 1-month follow-up (ηp2 = .015, P =.05). Students with the lowest coping self-efficacy and highest psychological mindedness experienced the fastest decline in stress levels (β = 6.37; 95% Cl 2.98 - 9.75). No intervention effects were found on depression levels at post-intervention and follow-up.

We found evidence that the “Intellect” Stress Coping SGA is effective in reducing stress and anxiety levels in university students. Stress coping SGAs are cost-effective, brief, scalable and can make an important contribution to public mental health.

ClinicalTrials.gov NCT04978896