Personalized Prevention of Depression in the Workplace (e-pD-Work) (e-pD-Work)

Prevention of Depression in the Workplace Through a Personalized Intervention Based on Risk Algorithms, ICTs and Decision Support Systems: Randomized Controlled Trial

The main goal is to design, develop and evaluate a personalized intervention to prevent depression in the workplace, based on Information and Communication Technologies (ICTs), predictive risk algorithms and decision support systems (DSS) for employed workers. The specific goals are: 1) to design and develop a DSS, called e-predictD-Work-DSS to elaborate personalized plans to prevent depression and its monitoring in the employed working population; 2) to design and develop an ICT solution that integrates the DSS on the web, a mobile application (App), the predictD risk algorithm, different intervention modules (including a work stress management module) and a monitoring-feedback system; 3) to evaluate the usability, adherence, acceptability and satisfaction of employed working population with the e-pD-Work intervention; 4) to evaluate the effectiveness of the e-pD-Work intervention to reduce the incidence of major depression, depression and anxiety symptoms, the probability of major depression next year and to improve quality of life; 5) to evaluate the cost-effectiveness and cost-utility of the e-pD-Work intervention to prevent depression.

Methods: This a randomized, double-blind, controlled trial with two parallel arms (e-pD-Work vs active m-Health control) and 12 months follow-up. A total of 3,160 depression-free workers, aged between 18 and 55 years old will be recruited in Spain and randomly assigned to one of the two groups in a 1:1 ratio considering a stratification of age (18-29, 30-39, 40-49, 50-55 years) and sex similar to the Spanish population. Participants, interviewers and statisticians will be blinded to participants' allocation. The e-pD-Work intervention is self-guided, has a biopsychosocial approach and is multi-component (9 modules: physical exercise, improve sleep, expand relationships, solve problems, improve communication, assertiveness, decision making, manage thoughts and reduce work stress). The e-pD-Work intervention will be implemented in the smartphone of the workers and pivot on an already validated risk predictive algorithm and a DSS that helps workers to develop their own personalized depression prevention plans. Primary outcome will be the rate of major depression measured by CIDI. As secondary outcomes: depressive and anxiety symptomatology measured by PHQ-9 and GAD-7 respectively, the risk probability of depression measured by the predictD risk algorithm, quality of life measured by SF-12 and EuroQol, and cost-effectiveness and cost-utility.

Study Overview

Status

Active, not recruiting

Conditions

Study Type

Interventional

Enrollment (Actual)

1054

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

      • Málaga, Spain
        • Juan Bellon Saameño

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 55 years (Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Have a paid employement
  • PHQ-9 <10 at baseline

Exclusion Criteria:

  • Not have a smartphone and internet for personal use
  • Sick leave for more than 1 month
  • Unable to speak Spanish
  • Documented terminal illness
  • Documented cognitive impairment
  • Documented serious mental illness (psychosis, bipolar, addictions, etc.)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: e-predicD-Work intervention
In this arm, worker participants will receive an online personalized intervention to prevent depression based on ICTs, risk predictive algorithms and decision support systems (DSS).
The intervention is based on validated risk algorithms to predict depression and includes: 1) Mobile applications as main user's interface; 2) a DSS that helps worker participants to develop their own personalized plans to prevent (PPP) depression; 3) nine intervention modules (the core of the system) including activities to prevent depression, to be proposed by the DSS and chosen by the participants. The intervention is biopsychosocial and multi-component, including the following modules: physical exercise, improve sleep, expand relationships, solve problems, improve communication, assertiveness, decision making, manage thoughts and reduce work stress. Worker participants will implement the recommendations and the tool will monitor these actions, offering feedback to improve their PPP at 6 and 12 months.
Active Comparator: m-Health control
In this arm, worker participants will continue receiving the usual care from their health providers. In addition, they will use an App with the same appearance as the e-predictD-Work App but it will only send weekly short messages about stress and general health that will be extracted from brochures and websites of official agencies.
The intervention consists of an App that weekly send short messages about stress and general health that will be extracted from brochures and websites of official agencies.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Rate of major depression measured by the Composite International Diagnostic Interview (CIDI)
Time Frame: 12 months
Composite International Diagnostic Interview (CIDI) is a structured diagnostic interview that provides current diagnoses of major depression according to DSM
12 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Anxious symptoms measured by the General Anxiety Questionnaire (GAD-7)
Time Frame: 12 months
The General Anxiety Questionnaire (GAD-7) measures generalized anxiety disorder through 7 items, each of which is scored 0 ('not at all') to 3 ('nearly every day'). Low scores are equivalent to less symptoms of anxiety, the scale range is 0 to 21 (7 items).
12 months
Quality of life measured by SF-12
Time Frame: 12 months
The 12-item Short Form (SF-12) measures quality of life related to physical health and quality of life related to mental health. Scores on the scales range from 0 to 100. Higher scores are equivalent to better health-related quality of life.
12 months
Cost-utility
Time Frame: 12 months
It will be conducted from two perspectives: (1) a societal perspective and (2) a National Health System perspective. We will calculate incremental cost-effectiveness ratio (ICER) using the incremental cost (difference in costs between arms) divided by incremental QALYs (difference in QALYs between arms). Quality-adjusted life years (QALYs) will be measured using the EuroQol five questionnaire (EuroQol-5D).
12 months
Depressive symptoms measured by the Patient Health Questionnaire-9 (PHQ-9)
Time Frame: 12 months
The Patient Health Questionnaire-9 (PHQ-9) measures symptoms of depression through 9 items, each of which is scored 0 ('not at all') to 3 ('nearly every day'). Low scores are equivalent to less symptoms of depression, the scale range is 0 to 27 (9 items).
12 months
Probability of depression measured by the Spanish predictD risk algorithm
Time Frame: 12 months
The Spanish predictD risk algorithm reports a probability of suffering depression in the next 12 months measured by 13 risk factors. Scores range from 0% to 100%.
12 months
Satisfaction with paid work measured by an adapted version of the Job Content Instrument
Time Frame: 12 months
The Job Content Instrument measures psychological demands, decision latitude, social support, physical demands, and job insecurity with a total of seven items. The first four are distributed on a 4-point Likert scale ranging from 'Often to Almost never / never), one of them is distributed on a dichotomous scale (yes / no), and the latter on a 4-point Likert scale ranging from 'Not at all to A lot'.
12 months
Acceptability and satisfaction with the interventions (e-predictD-Work intervention and m-Health control) measured by e-Health Impact Questionnaire
Time Frame: 12 months
The e-Health Impact Questionnaire (e-HIQ) assesses the effects of websites containing health information. The e-HIQ questionnaire consists of two independently administered and scored parts. In the first part items represent general attitudes towards using the internet to access health information. In the second part items measure a person's ease with using online information, particularly emphasising a person's openness to learning and gaining support from other peoples experiences. Both parts of the questionnaire have a five point response category for all items ranging from 'Strongly disagree to Strongly agree'.
12 months
Cost-effectiveness
Time Frame: 12 months
It will be conducted from two perspectives: (1) a societal perspective and (2) a National Health System perspective. We will calculate incremental cost-effectiveness ratio (ICER) using the incremental cost (difference in costs between arms) divided by incremental effectiveness (difference in the number of diagnoses of major depression between arms).
12 months
Subgroup analyses
Time Frame: 12 months
Pre-specified subgroup analyses will be conducted according to age, sex, education level, screening lifetime depression, employment type, work sector, years in employment, number of workers in the company, type of employment contract, work schedule, number of weekly hours worked and type of salary, as well as baseline measurements of anxiety and depression symptoms, risk level for depression, physical and mental quality of life, physical activity level, insomnia, social support, assertiveness, troubled relationship, and difficulties communicating or making decisions.
12 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 1, 2021

Primary Completion (Estimated)

August 1, 2024

Study Completion (Estimated)

December 1, 2024

Study Registration Dates

First Submitted

April 21, 2021

First Submitted That Met QC Criteria

April 21, 2021

First Posted (Actual)

April 26, 2021

Study Record Updates

Last Update Posted (Actual)

March 25, 2024

Last Update Submitted That Met QC Criteria

March 22, 2024

Last Verified

March 1, 2024

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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