Smartphone App to Address Loneliness Among College Students: Pilot Randomized Controlled Trial.
Smartphone App to Address Loneliness Among College Students: Pilot Randomized Controlled Trial.
复制标题
智能手机应用程序解决大学生的孤独感：飞行员随机对照试验。
DOI：
10.2196/21496
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发表时间：
2020-10-20
影响因子：
5.2
通讯作者：
Ramo DE
中科院分区：
文献类型：
--
作者：
Bruehlman-Senecal E;Hook CJ;Pfeifer JH;FitzGerald C;Davis B;Delucchi KL;Haritatos J;Ramo DE
孤独是大学校园里一个普遍而重要的问题。青年期的长期孤独是并发和未来心理健康问题和磨耗的风险因素，使大学成为获得支持的关键时期。认知和行为干预有望减少孤独感，并可通过技术广泛传播。这项随机对照试验旨在检验智能手机应用程序Nod的初始有效性、可行性和可取性，该应用程序旨在提供认知和行为技能建设练习，以减少大学过渡期间的孤独感。在新生入学指导期间在线招募一年级大学生（N=221，平均年龄18.7岁，59%为女性），并随机分为两组，一组立即获得Nod（实验组，N= 100），另一组在4周后获得Nod（对照组，N= 121）。这款应用通过全自动的“社交挑战”来传授技能，这些活动旨在建立社交联系；(2)反思，简短的认知重构练习；(3)鼓励建立社会联系的成长心态的学生评价。主要意向治疗分析用于比较第4周自我评估的孤独感、抑郁症状和其他心理健康状况以及大学适应结果，控制这些变量的基线值。还进行了分析，以验证以下假设：对于基线时心理脆弱程度较高（即基线时抑郁症状和孤独感较高）的参与者，治疗效果尤其明显。第四周的留存率为97%，参与者平均浏览了36.7页的应用内容。第4周孤独感的状态差异无统计学意义（F1, 211=0.05， P= 0.82; ηp2 < 0.001）。然而，病情-基线抑郁相互作用对预测第4周孤独感有显著影响（f1209 =9.65， P= 0.002; ηp2 = 0.04）。简单斜率分析表明，基线抑郁对对照组受试者第4周孤独感有正向预测作用（r=0.30, t209=3.81， P< 0.001），但对实验组受试者无正向预测作用（r= -0.09, t209= -0.84， P= 0.40），这表明Nod缓冲了基线抑郁得分高的受试者在季度中期孤独感加剧的影响。同样，在其他第4周的结果中没有显着的病情差异。然而，基线脆弱性对第4周抑郁症状、睡眠质量和大学适应指标（如感知社会支持和校园归属感）有调节作用。虽然Nod暴露对整个样本的结果没有影响，但这些结果提供了它对弱势学生有益的初步证据。这项试验的结果表明，通过移动应用程序提供的认知和行为技能可以缓冲心理脆弱的大学生的孤独感和抑郁症状，以及其他负面的大学适应结果。未来的工作将致力于提高应用程序的参与度，并解决其他关键人群的孤独感。ClinicalTrials.gov NCT04164654;https://clinicaltrials.gov/ct2/show/NCT04164654
Loneliness is a widespread and significant problem on college campuses. Prolonged loneliness in young adulthood is a risk factor for concurrent and future mental health problems and attrition, making college a critical time for support. Cognitive and behavioral interventions show promise for decreasing loneliness and can be widely disseminated through technology. This pilot randomized controlled trial was conducted to examine the initial efficacy, feasibility, and desirability of a smartphone app, Nod, designed to deliver cognitive and behavioral skill-building exercises to reduce loneliness during the transition to college. First-year college students (N=221, mean age 18.7 years, 59% female) were recruited online during incoming student orientation, and randomized to either receive immediate access to Nod (experimental group, n=100) or access after 4 weeks (control group, n=121). The app delivered skills via fully automated (1) “social challenges,” suggested activities designed to build social connections; (2) reflections, brief cognitive reframing exercises; and (3) student testimonials that encouraged a growth mindset toward social connection building. Main intention-to-treat analyses were used to compare the conditions on self-assessed loneliness, depressive symptoms, and other mental health and college adjustment outcomes at week 4, controlling for baseline values on those variables. Analyses were also performed to test the hypothesis that the treatment benefits would be particularly pronounced for participants with heightened psychological vulnerability at baseline (ie, higher baseline depressive symptoms and loneliness). Retention was 97% at week 4, and participants viewed an average 36.7 pages of app content. There were no significant condition differences in loneliness at week 4 (F1, 211=0.05, P=.82; ηp2 <.001). However, there was a significant condition-by-baseline depression interaction to predict week-4 loneliness (F1,209=9.65, P=.002; ηp2 =.04). Simple slope analyses indicated that baseline depression positively predicted week-4 loneliness among control participants (r=0.30, t209=3.81, P<.001), but not among experimental participants (r=–0.09, t209=–0.84, P=.40), suggesting that Nod buffered participants with high baseline depression scores from experiencing heightened midquarter loneliness. Similarly, there were no significant condition differences in other week-4 outcomes. However, moderation by baseline vulnerability was found for week-4 depressive symptoms, sleep quality, and indices of college adjustment (eg, perceived social support and campus belonging). Although Nod exposure did not impact outcomes for the full sample, these results provide initial evidence of its benefit for vulnerable students. The results of this trial suggest that cognitive and behavioral skills delivered via a mobile app can buffer psychologically vulnerable college students against heightened loneliness and depressive symptoms, as well as other negative college adjustment outcomes. Future work will aim to improve upon app engagement, and to address loneliness among other key populations. ClinicalTrials.gov NCT04164654; https://clinicaltrials.gov/ct2/show/NCT04164654
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DOI：
10.1111/jcpp.12125
发表时间：
2014
期刊：
Journal of child psychology and psychiatry, and allied disciplines
影响因子：
--
作者：
Baum KT;Desai A;Field J;Miller LE;Rausch J;Beebe DW
通讯作者：
Beebe DW
影响因子：
2.4
作者：
Dickens, Leah R.
通讯作者：
Dickens, Leah R.
影响因子：
4
作者：
Christensen, PN;Kashy, DA
通讯作者：
Kashy, DA
影响因子：
19.9
作者：
Cacioppo, John T.;Hawkey, Louise C.
通讯作者：
Hawkey, Louise C.
DOI：
10.21037/mhealth.2018.03.02
发表时间：
2018-01-01
期刊：
mHealth
影响因子：
--
作者：
Chandrashekar, Pooja
通讯作者：
Chandrashekar, Pooja