Web-Based and Mobile Stress Management Intervention for Employees: A Randomized Controlled Trial

Elena Heber, Dirk Lehr, David Daniel Ebert, Matthias Berking, Heleen Riper, Elena Heber, Dirk Lehr, David Daniel Ebert, Matthias Berking, Heleen Riper

Abstract

Background: Work-related stress is highly prevalent among employees and is associated with adverse mental health consequences. Web-based interventions offer the opportunity to deliver effective solutions on a large scale; however, the evidence is limited and the results conflicting.

Objective: This randomized controlled trial evaluated the efficacy of guided Web- and mobile-based stress management training for employees.

Methods: A total of 264 employees with elevated symptoms of stress (Perceived Stress Scale-10, PSS-10≥22) were recruited from the general working population and randomly assigned to an Internet-based stress management intervention (iSMI) or waitlist control group. The intervention (GET.ON Stress) was based on Lazarus's transactional model of stress, consisted of seven sessions, and applied both well-established problem solving and more recently developed emotion regulation strategies. Participants also had the opportunity to request automatic text messages on their mobile phone along with the iSMI. Participants received written feedback on every completed session from an e-coach. The primary outcome was perceived stress (PSS-10). Web-based self-report assessments for both groups were scheduled at baseline, 7 weeks, and 6 months. At 12 months, an extended follow-up was carried out for the iSMI group only.

Results: An intention-to-treat analysis of covariance revealed significantly large effect differences between iSMI and waitlist control groups for perceived stress at posttest (F1,261=58.08, P<.001; Cohen's d=0.83) and at the 6-month follow-up (F1,261=80.17, P<.001; Cohen's d=1.02). The effects in the iSMI group were maintained at 12-month follow-up.

Conclusions: This Web- and mobile-based intervention has proven effective in reducing stress in employees in the long term. Internet-based stress management interventions should be further pursued as a valuable alternative to face-to-face interventions.

Trial registration: German Clinical Trials Register (DRKS): 00004749; http://drks-neu.uniklinik-freiburg.de/ drks_web/setLocale_EN.do (Archived by WebCite at http://www.webcitation.org/6e8rl98nl).

Keywords: Internet; mental health; randomized controlled trial; stress; stress management; work.

Conflict of interest statement

Conflicts of Interest: DL, DE, and MB are stakeholders of the Institute for Online Health Training, which aims to transfer scientific knowledge related to this research into routine health care. EH is an employee at this Institute. The Institute was founded in January 2015. At the time of planning, conducting, and evaluating the study, it did not yet exist.

Figures

Figure 1
Figure 1
Flow of participants.
Figure 2
Figure 2
Levels of perceived stress (means and SDs) according to the PSS-10 for the iSMI and WLC groups at all assessment points for the ITT sample at pre-test (T1), post-test (T2), 6 months (T3), and 12 months (T4, iSMI only) (asterisks indicate P<.001).

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