CORE Condition, Healthy Lifestyle Psychoeducational Program, Waiting List Control
Conditions
Keywords
Resilience, University students, Prevention, Online intervention
Brief summary
This study aims to evaluate the effectiveness and efficiency of this intervention protocol applied to three populations of Spanish-speaking university students (Spain, Argentina and Mexico). The purpose of this paper is to present the protocol designed to carry out the randomised controlled study (RCT).
Detailed description
This study is a multi-country randomized controlled trial (RCT) with three groups comparing efficacy of unguided Internet-based intervention for students low on resilience with three conditions: a) unguided web-based resilience intervention (CORE); 2) Healthy lifestyle psychoeducationalprogram (HLP); and 3) Care as usual condition (CAU). Online- and telephone assessments will be conducted at pre- and post-intervention, and at 6- and 12-month follow-up (see Figure 1). Participants will be randomized in a 1:1 ratio. Randomization will be stratified according to trial site. The aim of this trial is to evaluate the efficiency and effectiveness of an Internet-based programme developed to promote resilience and coping skills among at-risk university students in Spain, Argentina and Mexico. The specific aims are: 1. To provide a preventative online intervention for enhancing resilience for decreasing symptoms of depression and anxiety and for increasing wellbeing 2. To evaluate the effectiveness and acceptability of CORE program in a randomized controlled trial compared with two conditions, Healthy lifestyle (HTP) and care as usual (CAU). 3. To analyze feasible strategies to implement CORE and to identify possible implementation barriers from final users, professionals of University counseling services and the University authorities in three Spanish-speaking countries.
Interventions
BEHAVIORALCognitive Behavioral Therapy
The training protocol consists of 6 weekly modules: 0.Welcome:Introduction module to the program, with an explanation about the tools and the way to use CORE 1. Psychoeducation: Explanation of psychological wellbeing and the concept of resilience 2. Autonomy, building my way: Enhancement of autonomy 3. Mindfulness and self-compassion:Training in mindfulness, savoring, and an attitude of self-compassion 4. Overcoming obstacles: Development of coping strategies to deal with daily difficulties in life 5. Connecting to others:Acknowledge the relevance of relationships and how they can be helpful in the construction of well-being 6. Purpose in life and personal growth:Approach the future with a positive attitude, planning goals for the future.
BEHAVIORALHealthy lifestyle
1. Beginning of a lifestyle change The patient will learn to identify healthy and risky behaviors and recognize obstacles that prevent them from adopting a healthy lifestyle. 2. Physical activity The importance of moving on and activating behavior will be taught through regular exercise information to improve mood. 3. Diet This module is dedicated to teaching the importance of diet for good physical and mental health. The Mediterranean diet will be taken as an example for a balanced and balanced diet, because it does not differ from the habits of other countries. 4. Sleep The importance of good sleep will be addressed with information and strategies for understanding the relationship between sleep and overall health.
Sponsors
Universitat Jaume I
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* University students with a standard deviation score below the sample mean on the Connor-Davidson Resilience Scale (CDRISC-25). * Adequate knowledge to understand and read Spanish and/or be Spanish-speaking. * Internet access and computer skills.
Exclusion criteria
* University students who are on a waiting list for psychotherapy or who are or have been undergoing psychotherapy in the last 12 months. * Individuals with a current or past psychotic or bipolar disorder. * Individuals at risk of suicide.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Connor-Davidson's Resilience Scale (CDRISC; Connor and Davidson, 2003) | Up to 3 months | Assesses stress coping skills using a 25-item self-report questionnaire that use a 5-point Likert scale from 0 to 4 (0 = strongly disagree, 4 = strongly agree). Scores range from 0 to 100, with higher scores reflecting greater resilience. Score from pre-intervention to post-intervention and 3 months follow-ups. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The Ryff Scales of Psychological Well-Being - 29 items (PWBS-29; Ryff, 1989) | Up to 3 months | Is an instrument for measuring the faces of psychological well-being, including the 6 dimensions of the Ryff model (autonomy, self-acceptance, mastery of the environment, personal growth, positive relationships with others and purpose in life). Response scores range from 1 to 6 (1 = strongly disagree, 6 = strongly agree). Score from pre-intervention to post-intervention and 3 months follow-ups. |
| The Patient Health Questionnaire (PHQ-9; Kroenke et al., 2001) | Up to 3 months | Is a questionnaire to examine and diagnose patients with depressive disorders, consisting of 9 items measured on a scale of 0 to 3 (0 = not at all, 3 = almost every day). Total scores range from 0 to 27. The severity cut-off points for depression are 5, 10, 15 and 20 and represent respectively the thresholds for mild, moderate, moderately severe and severe depression. Score from pre-intervention to post-intervention and 3 months follow-ups. |
| Responses to Positive Affect questionnaire (RPA; Feldman et al., 2008) | Up to 3 months | is a questionnaire that assesses the responses to positive affective states and consists of 17 items. Items are rated on a 4-point scale, ranging from 1 (almost never) to 4 (almost always). The original measure consists of three factor-analytically derived subscales: Dampening, Self-focused positive rumination, and Emotion-focused positive rumination. |
| Positive and Negative Effects Program (PANAS) (Watson et al., 1988) | Up to 3 months | PANAS evaluates two independent dimensions: positive affect (PANAS+) and negative affect (PANAS-). It consists of 20 items divided into 10 range items for each dimension is from 10 to 50. Score from pre-intervention to post-intervention and 3 months follow-ups. |
| The Generalized Anxiety Disorder Questionnaire (GAD-7; Spitzer et al., 2006) | Up to 3 months | Is used to detect the presence of the symptoms of Generalized Anxiety Disorder (GAD) according to DSM-IV. It is a one-dimensional self-administered scale and although it does not provide a definitive diagnosis of GAD, it is an efficient, fast to apply, reliable and valid instrument for detecting symptoms of an anxiety disorder. The scoring scale is 0 to 3 (0 = nothing, 3 = almost every day), adding up to 0 to 21 points. They are four severity cut-off points (minimum = 0 to 4, mild = 5 to 9, moderate = 10 to 14, serious = 14 to 20) and represent the minimum to severe general anxiety thresholds. Score from pre-intervention to post-intervention and 3 months follow-ups. |
| The Perceived Stress Scale - 4 items (PSS-4; Cohen et al., 1983) | Up to 3 months | Assess the extent to which recent life situations are considered stressful (Cohen et al., 1983) using a 4-item self-report questionnaire. It is a Likert scale from 1 to 5 (1 = never, 5 = very often). PSS-4 is a short version that has been used for telephone interviews or study conditions requiring short versions. Score from pre-intervention to post-intervention and 3 months follow-ups. |
| Self-compassion Scale - Short Form (SCS-SF; Raes et al., 2011) | Up to 3 months | is designed to assess general self-compassion (total score) and 3 facets of this construct: common humanity (SCSCH), mindfulness (SCS-M), and self-kindness (SCS-SK) (Raes et al., 2011). This version is shorter than the original version of 26-item SCS (Neff, 2003). It contains 6 subscales representing positive and negative aspects of each facet (Raes et al., 2011). A 5-point Likert-type scale is used, ranging from 1 to 5 (1 = almost never, 5 = almost always). Score from pre-intervention to post-intervention and 3 months follow-ups. |
| The Credibility and Expectancy Questionnaire (CEQ; Devilly and Borkovec, 2000) | Up to 4 weeks | evaluates factors of patient expectations and credibility about the treatment. This self-report consists of 6 items with answer choices rated on a 10-point scale and on a scale of 1-100%. Score pre-intervention |
| Client Satisfaction Questionnaire (CSQ; Attkisson and Greenfield, 1996; Larsen et al., 1979) | Up to 8 weeks | The Client Satisfaction Questionnaire (CSQ) assesses the level of client satisfaction with health services. There are several versions of the CSQ, the longest version contains 31 items and the shortest has 8 items. The questionnaire is based on 8 questions that must be answered at the end of their stay in the service on the basis of an analogovisual scale. Each question is evaluated between 1 and 4 points and satisfaction is directly related to the number of points, so that the sum of place to a semi-quantitative variable that takes values between 8 and 32 points. The response scale is: csq\_q1: 4=Excellent; 3=Good; 2= Regular; 1= Bad csq\_q2: 1= No, definitely; 2= In very few cases; 3= Yes in general; 4=Yes definitely csq\_q3: 4=Almost all; 3=Most; 2=Only a few; 1=None csq\_q4: 1=No definitely; 2=No, I don't think so; 3= Yes, I think so; 4= Yes, definitely csq\_q5: 1=Nothing satisfied; 2= Indifferent or moderately unsatisfied; 3=Moderately satisfied; 4=Very satisfied csq\_q6: 4=If |
| Working Alliance Inventory for Technology Based Interventions (WAI-TECH; Kiluk et al., 2014) | Up to 8 weeks | is a questionnaire that evaluates the therapeutic alliance between the technological tool and the patient. It covers two dimensions of the working alliance: (1) therapeutic objectives and (2) tasks. It consists of 8 items on a 5-point Likert scale from 1 to 5 (1 = never, 5 = always). Score from post-treatment |
| Overall Anxiety Severity and Impairment Scale (OASIS; Norman et al. 2006) | Up to 8 weeks | It is a 5-item questionnaire, with a score of 0 to 4, that evaluates the frequency and severity of anxiety symptoms. The instrument also provides measures related to anxiety symptoms such as avoidance, work, academy, social and daily life disabilities. According to a psychometric analysis it has good internal consistency (α =.80), test-test reliability (k =.82) and convergent validity. Score from pre-intervention to post-intervention |
| Overall Depression Severity and Impairment Scale (ODSIS; Bentley, et. Al 2014). | Up to 8 weeks | It is a self-report measure with five items that assess experiences related to depression, measuring its frequency and severity, as well as the level of avoidance behaviors, interference between work, school and home, and associated social. The internal consistency of the scale has proven to be excellent, with a Cronbach alpha between 0.91 and 0.94 and good convergent and discriminant validity. Score from pre-intervention to post-intervention |
| Openness to the future Scale (OF)(Botella et a.l, 2018 ) | Up to 3 months | It is a scale consisting of 10 items of scores ranging from 1 to 5 on a likert scale and assesses expectations and positive affectivity towards the future, which includes five domains: (1) Illusion of control (2) Acceptance (3) Commitment to life and planning (4) Positive orientation towards the future (5) Self-efficacy towards the future. |
| 10-Item Big Five Inventory (BFI-10; Rammstedt and John, 2007) | Up to 4 weeks | was developed to provide a personality inventory for research environments with extreme time constraints. This questionnaire is an abridged version of the 44-item BFI. This is a 5-step scale from 1 to 5 (1 = strongly disagree, 5 = strongly agree). Score pre-intervention |
Other
| Measure | Time frame | Description |
|---|---|---|
| Socio-demographic data | Up to 4 weeks | Measurements of sociodemographic variables are included: sex, household size and income, age, marital status, employment status, total population of the place of residence, nationality, level of education and living situation. In addition, health-related variables will be measured: presence of psychological disorders (past and present) and whether treatment is currently being carried out. Score from pre-intervention |
Countries
Argentina, Mexico, Spain
Outcome results
None listed