@Article{info:doi/10.2196/22107,
author="Ebert, David Daniel
and Franke, Marvin
and Zarski, Anna-Carlotta
and Berking, Matthias
and Riper, Heleen
and Cuijpers, Pim
and Funk, Burkhardt
and Lehr, Dirk",
title="Effectiveness and Moderators of an Internet-Based Mobile-Supported Stress Management Intervention as a Universal Prevention Approach: Randomized Controlled Trial",
journal="J Med Internet Res",
year="2021",
month="Dec",
day="22",
volume="23",
number="12",
pages="e22107",
keywords="stress management intervention; universal prevention; occupational health; moderators",
abstract="Background: Emerging evidence indicates the effectiveness of internet-based mobile-supported stress management interventions (iSMIs) in highly stressed employees. It is yet unclear, however, whether iSMIs are also effective without a preselection process in a universal prevention approach, which more closely resembles routine occupational health care. Moreover, evidence for whom iSMIs might be suitable and for whom not is scarce. Objective: The aim of this study was to evaluate the iSMI GET.ON Stress in a universal prevention approach without baseline inclusion criteria and to examine the moderators of the intervention effects. Methods: A total of 396 employees were randomly assigned to the intervention group or the 6-month waiting list control group. The iSMI consisted of 7 sessions and 1 booster session and offered no therapeutic guidance. Self-report data were assessed at baseline, 7 weeks, and at 6 months following randomization. The primary outcome was perceived stress. Several a priori defined moderators were explored as potential effect modifiers. Results: Participants in the intervention group reported significantly lower perceived stress at posttreatment (d=0.71, 95{\%} CI 0.51-0.91) and at 6-month follow-up (d=0.61, 95{\%} CI 0.41-0.81) compared to those in the waiting list control group. Significant differences with medium-to-large effect sizes were found for all mental health and most work-related outcomes. Resilience (at 7 weeks, P=.04; at 6 months, P=.01), agreeableness (at 7 weeks, P=.01), psychological strain (at 6 months, P=.04), and self-regulation (at 6 months, P=.04) moderated the intervention effects. Conclusions: This study indicates that iSMIs can be effective in a broad range of employees with no need for preselection to achieve substantial effects. The subgroups that might not profit had extreme values on the respective measures and represented only a very small proportion of the investigated sample, thereby indicating the broad applicability of GET.ON Stress. Trial Registration: German Clinical Trials Register DRKS00005699; https://www.drks.de/DRKS00005699 ",
issn="1438-8871",
doi="10.2196/22107",
url="https://www.jmir.org/2021/12/e22107",
url="https://doi.org/10.2196/22107",
url="http://www.ncbi.nlm.nih.gov/pubmed/34941541"
}