esTOCma, an App Used by Teachers: an RCT

December 22, 2025 updated by: Gemma García-Soriano, University of Valencia

A RCT of a Mobile App (esTOCma) to Improve Mental Health Literacy, Stigmatizing Attitudes Related to OCD, and Confidence in Dealing With Students With OCD in Teachers

The aim of the present study is to assess the efficacy of a mobile application called esTOCma in promoting mental health literacy, reducing stigmatizing attitudes related to the Obsessive-Compulsive Disorder (OCD) and improving teachers' confidence in dealing with students that might have OCD. A parallel, randomized controlled trial with two conditions (experimental and control group) will be carried out in a sample of teachers that work in primary and secondary education. Pre-post changes will be assessed. Experimental group will use the app until they finish it (within a set period of 10 days), whereas control group will do nothing for 10 days. Primarily, it is expected that after the use of the app, participants will show an improvement in OCD-related literacy, stigmatizing attitudes, desired social distance and their comfort, confidence and perceived ability in teaching and handling students with OCD. Secondarily, the investigators hypothesize that experimental group might show a reduction in obsessive-compulsive symptoms.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Adolescence is a critical stage that is associated with a high vulnerability to developing obsessive-compulsive disorder (OCD). Schools are part of the natural developmental context of adolescents, and teachers are involved in their education and personal development. In this sense, teachers play an essential role in the early detection and referral of students with possible obsessional symptoms and will also have to deal with the management of this symptomatology in the classroom. Moreover, teachers often have low knowledge of mental health problems and lack strategies for handling mental symptomatology in the classroom.

esTOCma is a mobile health (mHealth) application that has been developed to promote mental health literacy and reduce stigmatizing attitudes associated with OCD. Previous studies have shown that it is a tool with great potential in terms of intervention on stigma and OCD literacy in the general population. Thus, it could be of great interest to use this app in the field of education, and especially in non-university education since adolescents, a highly vulnerable collective to the development of OCD, spend much of their time in the classroom, and often seek help from school staff.

Study Type

Interventional

Enrollment (Actual)

175

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 Locations

  • Spain
      • Valencia, Spain, 46010
        • University of Valencia/ Universitat de València

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Being a practising teacher in non-university education.
  • Working in the education field as a guidance counsellor, language teacher or therapeutic pedagogue.

Exclusion Criteria:

  • Working in a field other than those mentioned above.
  • Having less than 18 years old.

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: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Use of esTOCma
Experimental group will use esTOCma until they finish it (within a preestablished 10-days period).
Device: Use of esTOCma

Participants of the experimental group will use the esTOCma mobile app until completion, within a set period of 10 days.

EsTOCma is a a serious game with 10 missions where users have to free 10 characters who have been imprisoned by a monster called esTOCma, which metaphorically represents the stigma in OCD. With each mission, users will gain knowledge about OCD and free an imprisoned character until the tenth mission, when they will defeat the monster. This game has three modules: (1) Psychoeducation (missions 1-5), where general information about OCD, OCD treatments and where to seek help is provided; (2) Indirect Contact (missions 6 and 7), which consists of a series of audio-visual recordings in which OCD patients report their symptoms and the impact the disorder has had on their lives; and finally, (3) Cognitive Restructuring (missions 8-10), where common dysfunctional beliefs about OCD and OCD treatment are challenged.
No Intervention: Control group
Control group will do nothing for 10 days.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in general OCD literacy
Time Frame: Through app completion (an estimation of 10 days).
Score change in the knowledge and the attitudes towards obsessive-compulsive disorder measured by the OCD Knowledge Stigma Assessment Scale (OKSAS). It is a self-report ad hoc questionnaire with 24 items and a response scale ranging from 1 "Completely disagree" to 5 "Completely agree". The total score is the sum of the items and higher score indicate more knowledge about the disorder.
Through app completion (an estimation of 10 days).
Change in stigmatizing attitudes related to OCD
Time Frame: Through app completion (an estimation of 10 days).

Score change in stigma will be measured, in association with a vignette, by two questionnaires:

  1. Attribution Questionnaire (AQ-9; Corrigan et al., 2015; Spanish version: Muñoz et al., 2015) is a self-report measure for social stigma. It has a Likert scale ranging from 1 = "Not at all" to 9 = "Very much". Investigators will not use the items corresponding to Coercion, Pity and Avoidance. The higher the score (total and per item), the higher the stigma.
  2. OCD Stigma Measure (OSM; Ponzini et al., 2023) is a self-report measure composed by 16 items that assess OCD-related stereotypes. 11 items will be used in this study. A total score (sum of all the items) is interpreted.

There will be two vignettes that will be randomly assigned. Both portray a student with OCD but one focuses on the contamination content, and the other on the aggression content.
Through app completion (an estimation of 10 days).
Change in desired social distance
Time Frame: Through app completion (an estimation of 10 days).

Score change in desired social distance will be measured by Reported and Intended Behaviour Scale (RIBS; Evans-Lacko et al., 2011; Spanish version: Sayols-Villanueva et al., 2015). It is a self-report measure with 8 items and it inquires about reported and intended behaviour among four different contexts: (1) living with, (2) working with, (3) living nearby and (4) continuing a relationship with someone with a mental health problem. Investigators will use the 4 items corresponding to intended behaviour subscale. Likert scale from 1 "Agree strongly" to 5 " Disagree strongly" and an additional "Don't know" response option. The total score is calculated by adding together the response values, and "Don't know" is coded as a neutral value (i.e. 3).

This questionnaire will be used in association with a vignette.
Through app completion (an estimation of 10 days).
Change in percieved confidence when addressing students with OCD
Time Frame: Through app completion (an estimation of 10 days).

Score change in confidence when addressing students with OCD will be measured using items adapted and translated from previous studies (Jorm et al., 2010; Kutcher et al., 2016; Whitley & Gooderham, 2016). Three dimensions are evaluated separately:

Confidence in interacting, composed of three items with a Likert scale ranging from 1 "Completely disagree" to 5 "Completely agree". The total score will be obtained by summing the item responses.

Confidence in helping, assessed with a single item ("To what extent do you feel capable of helping a student like N?") rated on a 5-point scale ranging from 1 "Slightly/Not at all confident" to 5 "Extremely/Very confident".

Academic confidence, measured with two items rated on a 4-point Likert scale ranging from 1 ("Not at all capable/ Lower academic level") to 4 ("Very capable/Highest academic level"). A total score will be computed by summing both items.
Through app completion (an estimation of 10 days).

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in obsessive-compulsive symptoms
Time Frame: Through app completion (an estimation of 10 days).
Score change in OCD symptoms will be measured by Obsessive-Compulsive Inventory - Revised. The reduced 4-item version (OCI-4; Abramovich et al., 2021) that assesses four dimensions of OCD (washing, checking, ordering, obsessing) will be used. It has a 5-point Likert scale ranging from 0 "Not at all" to 4 "Very much". The items will be added.
Through app completion (an estimation of 10 days).

Collaborators and Investigators

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

Sponsor

University of Valencia

Collaborators

Ministry of Science and Innovation, Spain

Investigators

  • Principal Investigator: Gemma García-Soriano, University of Valencia

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

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)

February 26, 2024

Primary Completion (Actual)

June 30, 2024

Study Completion (Actual)

June 30, 2024

Study Registration Dates

First Submitted

March 21, 2024

First Submitted That Met QC Criteria

March 21, 2024

First Posted (Actual)

March 28, 2024

Study Record Updates

Last Update Posted (Actual)

December 30, 2025

Last Update Submitted That Met QC Criteria

December 22, 2025

Last Verified

December 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • PID2021-124409OB-I00_O3

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

Share all IPD that underlie results in a publication.

IPD Sharing Time Frame

It will be available for 3 months after the publication of the study.

IPD Sharing Access Criteria

Data will be available in a repository website: Zenodo.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

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.

Clinical Trials on Obsessive-Compulsive Disorder

Clinical Trials on Use of esTOCma

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Liberia

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe