Nurse-led Digital Cognitive Behavioral Therapy for Insomnia (dCBT-I) in University Students With Mild to Moderate Mental Health Problems
Nurse-led Digital Cognitive Behavioral Therapy for Insomnia (dCBT-I) in University Students With Mild to Moderate Mental Health Problems: a Pilot Randomized Controlled Trial
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Detaillierte Beschreibung
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Shengzhi Zhao
- Telefonnummer: +852 6561 4500
- E-Mail: lubabezz@connect.hku.hk
Studieren Sie die Kontaktsicherung
- Name: Tsz Kiu Chan
- Telefonnummer: +852 5506 4711
- E-Mail: natctk1@hku.hk
Studienorte
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Hong Kong, Hongkong
- School of Public Health, The University of Hong Kong, 18/F, Metro South Tower 1, 39 Wong Chuk Hang Road, Wong Chuk Hang, Hong Kong
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Kontakt:
- Shengzhi Zhao
- Telefonnummer: +852 6561 4500
- E-Mail: lubabezz@connect.hku.hk
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Hauptermittler:
- Shengzhi Zhao
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Kontakt:
- Tsz Kiu Chan
- Telefonnummer: +852 5506 4711
- E-Mail: natctk1@hku.hk
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
Inclusion Criteria:
- Students aged ≥ 18 years from 22 local higher education institutions (University or Colleges) listed in Education Bureau.
- Screening score indicating mild to moderate anxiety or depression, defined as a GAD-7 score of 5-14 and/or a PHQ-9 score of 5-14 at baseline.
- Screened positive for insomnia symptoms using the Sleep Condition Indicator (SCI) and meeting DSM-5 diagnostic criteria for insomnia disorder.
- Reporting a self-reported sleep efficiency of less than 85% over the past month.
- Able to communicate in Chinese.
Exclusion Criteria:
- Participants who self-reported diagnosis of epilepsy, schizophrenia, or bipolar disorder
- Participants who self-reported current suicidal ideation with intent or a suicide attempt within the past 2 months
- Participants who self-reported current receipt of psychological or behavioral treatment for insomnia from a health professional
- Participants who self-reported participation in an online or digital insomnia treatment programme at the time of enrolment.
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Versorgungsforschung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Single
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
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Experimental: Interventionsgruppe
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At baseline, both groups will receive a 1-on-1 brief sleep health advice developed using guidelines by U.S. Centers for Diseases Control and Prevention and a booklet providing behavioral guidance on lifestyle and environmental factors related to sleep and insomnia.
Following randomization, participants in the intervention group will complete a 2-week chatbot-based daily sleep diary.
Each morning (e.g., 8:00 am), participants will be prompted via Whatsapp message delivered by chatbot to report key sleep parameters from the previous night, including bedtime, wake time, sleep onset latency, number and duration of nocturnal awakenings, total sleep time, and perceived sleep quality.
The collected sleep diary data will be processed by the chatbot to generate tailored and personalized feedback, supporting individualized sleep recommendations and behavioral adjustments.
At the initiation of the intervention, participants will also complete a brief baseline questionnaire to establish personalized treatment goals related to sleep improvement.
Throughout the intervention period, participants will have continuous access to chatbot-delivered support, including adaptive guidance based on diary inputs, reinforcement of recommended sleep strategies, and progress
Participants in the intervention group will also receive cognitive behavioral therapy for insomnia (CBT-I) delivered via an LLM-based chatbot through WhatsApp over a 10-week period.
The intervention is fully automated and available 24/7, with underlying algorithms enabling the delivery of information, therapeutic support, and advice in a personalized and adaptive manner, informed by participants' ongoing inputs and interaction patterns.
The intervention will be structured into 20 chatbot-delivered instant messaging (2 pieces per week).
The therapeutic content is adapted from established CBT-I manuals and led by research nurse, incorporating evidence-based behavioral, cognitive, and educational components.
Behavioral strategies include sleep restriction, stimulus control, and relaxation techniques.
Cognitive components comprise paradoxical intention, cognitive restructuring, mindfulness-based techniques, positive imagery, and strategies for "putting the day to rest."
Educational compone
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Aktiver Komparator: Kontrollgruppe
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At baseline, both groups will receive a 1-on-1 brief sleep health advice developed using guidelines by U.S. Centers for Diseases Control and Prevention and a booklet providing behavioral guidance on lifestyle and environmental factors related to sleep and insomnia.
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Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
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Self-reported insomnia severity
Zeitfenster: 6-month follow-up
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Assessed using the Insomnia Severity Index (ISI).
The ISI is a 7-item self-report instrument that evaluates both nocturnal and daytime symptoms of insomnia, with total scores ranging from 0 to 28, higher scores indicate greater insomnia severity.
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6-month follow-up
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Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Health-related quality of life
Zeitfenster: 3- and 6-month follow-ups
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Assessed using 36-Item Short Form Health Survey [SF-36].
The SF-36 is a 36-item self-reported instrument that measures both Physical Component Scores and Mental Component Scores, with scores ranging from 0 to 100; higher scores indicate better health-related quality of life.
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3- and 6-month follow-ups
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Sleep-related quality of life
Zeitfenster: 3- and 6-month follow-ups
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Assessed using Glasgow Sleep Impact Index [GSII].
The GSII is a 7-item self-report instrument that evaluates the sleep-related quality of life, with total scores ranging from 0 to 28, higher scores indicate lower level of sleep-related quality of life.
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3- and 6-month follow-ups
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Depressive symptoms
Zeitfenster: 3- and 6-month follow-ups
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Assessed using Patient Health Questionnaire-9 [PHQ-9].
The PHQ-9 is a 9-item self-report instrument that evaluates frequency and severity of depressive symptoms, with total scores ranging from 0 to 27, higher scores indicate higher level of depression.
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3- and 6-month follow-ups
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Anxiety symptoms
Zeitfenster: 3- and 6-month follow-ups
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Assessed using Generalized Anxiety Disorder-7 [GAD-7].
The GAD-7 is a 7-item self-report instrument that evaluates the frequency and severity of anxious symptoms, with total scores ranging from 0 to 21, higher scores indicate higher level of anxiety.
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3- and 6-month follow-ups
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Sleep effort
Zeitfenster: 3- and 6-month follow-ups
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Assessed using Glasgow Sleep Effort Scale [GSES].
The GSES is a 7-item self-reported instrument, with scores ranging from 0 to 14, higher scores indicate greater sleep effort.
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3- and 6-month follow-ups
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Pre-sleep arousal
Zeitfenster: 3- and 6-month follow-ups
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Assessed using Pre-Sleep Arousal Scale [PSAS].
The PSAS is a 16-item self-reported instrument consists of two subscales (cognitive arousal and somatic arousal), with scores ranging from 8 to 40 on each subscale, higher scores indicate greater pre-sleep arousal.
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3- and 6-month follow-ups
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Andere Ergebnismessungen
Andere Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
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Recruitment rate
Zeitfenster: Baseline
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Defined as the number of participants divided by the number of eligible university students.
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Baseline
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Retention rate
Zeitfenster: 3- and 6-month follow-ups
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Defined as the number of participants who completed the follow-up divided by the number of participants.
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3- and 6-month follow-ups
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Engagement rate of the interventions
Zeitfenster: 3- and 6-month follow-ups
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Engagement rate will be determined by Instant message (IM) log.
At least 2 times response will be considered as engaged.
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3- and 6-month follow-ups
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Usability for the development of a full-scale trial
Zeitfenster: 3- and 6-month follow-ups
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We will use the 10-item System Usability Scale (SUS) to assess perceived effectiveness, efficiency, and satisfaction of the intervention.
The score of SUS ranges from 0 to 100 and 68 is the threshold to determine the usability for the development of a full-scale trial.
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3- and 6-month follow-ups
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Usability of the chatbot
Zeitfenster: 3- and 6-month follow-ups
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The usability of the chatbot (Cronbach's alpha: 0.90) is measured by the validated 15-item Bot Usability Scale (BUS).
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3- and 6-month follow-ups
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Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Hauptermittler: Shengzhi Zhao, The University of Hong Kong
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Geschätzt)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- dCBT-I in University Students
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Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
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