Testing an Online Coping Skills Intervention for People Living with Chronic Illness During the Covid-19 Pandemic

The proposed study is a pilot randomized controlled trial with a wait-list control group. The study will investigate the effect of a brief one-week online intervention on depression, anxiety, and stress among adults living with chronic illness during the COVID-19 pandemic in New Zealand. This study is designed according to the CONSORT guidelines. Forty-six participants will be recruited from online communities (e.g., Facebook support groups, organisation mailing lists) by an advertisement/flyer with a link to the intervention website. Participants will be encouraged to snowball recruit, i.e. to send the recruitment link to people they know who might be eligible for this study. Interested participants will be requested to click on a link on the intervention website which takes them to REDCap (a secure research website) (Harris et al., 2019; Harris et al., 2009) for the purposes of providing online consent and filling out baseline questionnaires. This page will allow participants to read and download the Participant Information Sheet, complete online consent, and complete the baseline questionnaires once they have consented. Once participants have consented and completed the baseline questionnaire they will be randomised into either the waitlist group or the intervention group. The waitlist group will receive an email stating that they will receive further information in 4-weeks’ time. The intervention group will receive an email containing the link for the intervention and the password to access it. Intervention group participants will then be asked to access this website each day for seven days. This will take approximately 20 minutes each day. Throughout this week, they will receive 2 emails or texts reminding them to complete the intervention. Three weeks after the intervention (4 weeks from completing the baseline questionnaire) participants in the intervention group will receive an email with a link to the follow-up questionnaire on REDCap (Harris et al., 2019; Harris et al., 2009) to complete. In contrast, the waitlist group will receive an email stating that they are in the waitlist group. They will be asked to continue with their usual care for the next 4 weeks, after which they will receive an email with a link to complete the follow-up questionnaire on REDCap. After completing this follow-up questionnaire they will then receive the link and password to the intervention and be asked to access this website each day for seven days. Four weeks after completing the first follow up questionnaire (8 weeks from completing the baseline questionnaire), participants in the waitlist group will receive an email with a link to the final follow-up questionnaire to complete on REDCap. The study website will contain the Participant Information Sheet and the link to consent and sign up for the study, acknowledgments of resources used, contacts for support (eg Lifeline and Youthline), how to contact the researchers, and the online intervention. The online intervention consists of 7 modules with one module being completed each day. Each module includes a section of psychoeducation around ACT and its core principles. This can either be read by the participant or there is the option of listening to an audio file of it. This information is then followed by a short (5-10min) video that practises some ACT aligned coping skills. The modules are completely self-directed with some follow along activities. The intervention has been created by a Masters in Health Psychology student and a team of health psychologists. The modules are: Introduction to ACT and its application to chronic illness during a pandemic, defusion, being present and mindful, our observing mind, values, committed action, and acceptance. The videos include relaxation (breathing, progressive muscle relaxation, and visualisation), a short meditation, self-compassion, goal setting, and gratitude. Individual adherence to this intervention is monitored by a self-report question in the 4 week follow up questionnaire. Overall adherence to the intervention is measured by the feedback question which is completed after each module (i.e. if module 1 feedback was completed 30 times then adherence would be 30/46 participants adhered to module 1). An additional focus group will be conducted to explore more in-depth feedback of this intervention. We will conduct two 1.5hr focus groups which will be facilitated by the student researcher and a PhD student who has experience in focus groups