The springboarD trial: Trial of a self-help intervention to improve functioning and emotional well-being for people with type 2 diabetes

The active intervention ("myCompass") is a fully-automated, self-help, public health intervention, that is tailored to the user and has no therapist input. Real-time self-monitoring of symptoms (e.g., problem moods, thoughts and behaviours) via mobile phone and/or computer/tablet is a key therapeutic feature. Users can self-monitor three symptoms of their choice at any one time, selected from a list of 20, or three that are recommended to them by the program (e.g., confidence, worry, irritability, motivation, diet, and medication use). Each symptom is rated on a 10-point scale (e.g., “how confident do you feel right now”, “how worried do you feel right now”, “how satisfied are you that you have taken your prescribed medication today”). At the time of rating, users also provide contextual information about where they are, what they are doing and who they are with, using a series of drop-down menus. To improve adherence to the intervention users can schedule short message service (SMS) or email reminders to facilitate self-monitoring (frequency of reminders determined by the user); receive and print graphical feedback about their monitoring, including contextual information, on their phone or computer (to monitor change and assist identification of triggers); and elect to receive helpful facts, mental health-care tips or motivational statements by SMS or email. The myCompass program offers evidence-based and interactive psychological modules that users can complete via the internet on their computers. The program contains 12 skill-building modules derived from CBT, Interpersonal Psychotherapy, Problem-solving Therapy and Positive Psychology that cover topics such as Managing Fear and Anxiety, Tackling Unhelpful Thinking, Managing Loss and Major Life Change, and Solving Problems. Each module comprises three 10-minute sessions and includes activities for users to complete on the computer. There are home practice tasks recommended for participants to complete between the weekly online sessions (i.e. completion of one full module per week), which are intended to promote skill generalisation. Users can, however, complete the modules of their choice and at their own pace, and/or those recommended to them by the myCompass program. As part of the myCompass registration process, program users complete a profile questionnaire, responses to which are used to tailor the self-monitoring and module recommendations. Specifically, this questionnaire asks users to rate the extent to which they experience a range of symptoms of depression, anxiety, and stress (e.g., worry, irritability, difficulties with motivation and concentration). Targeting the three highest rated symptoms, in-built algorithms generate personalised feedback to the user about the self-monitoring dimensions and psychological modules that may be of greatest benefit (i.e., each dimension and module is weighted according to its clinical relevance for each symptom, and those with the highest weightings are recommended). Participants will have 8 weeks to undertake the myCompass program, with a 4 week tailing off period. During this 4 week tailing off period, myCompass users will only have access to the real-time self-monitoring of symptoms (e.g., problem moods, thoughts and behaviours), but will not have access to any Module content and activities.