%0 Journal Article
%@ 1438-8871
%I JMIR Publications
%V 26
%N 
%P e50071
%T Effectiveness of a Smartphone-Based Stress Management Program for Depression in Hospital Nurses During COVID-19 in Vietnam and Thailand: 2-Arm Parallel-Group Randomized Controlled Trial
%A Watanabe,Kazuhiro
%A Tran,Thuy Thi Thu
%A Sripo,Narisara
%A Sakuraya,Asuka
%A Imamura,Kotaro
%A Boonyamalik,Plernpit
%A Sasaki,Natsu
%A Tienthong,Thanate
%A Asaoka,Hiroki
%A Iida,Mako
%A Nguyen,Quynh Thuy
%A Nguyen,Nga Thi
%A Vu,Son Thai
%A Ngo,Thuy Thi
%A Luyen,Tham Thi
%A Nguyen,Long Duc
%A Nguyen,Nga Thi Viet
%A Nguyen,Binh Thanh
%A Matsuyama,Yutaka
%A Takemura,Yukie
%A Nishi,Daisuke
%A Tsutsumi,Akizumi
%A Nguyen,Huong Thanh
%A Kaewboonchoo,Orawan
%A Kawakami,Norito
%+ Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan, 81 3 5800 9621, nkawakami@m.u-tokyo.ac.jp
%K digital mental health intervention
%K unguided program
%K universal prevention
%K health care workers
%K nurses
%K COVID-19
%K depression
%K mobile phone
%D 2024
%7 30.8.2024
%9 Original Paper
%J J Med Internet Res
%G English
%X Background: During the COVID-19 pandemic, health care professionals experienced high levels of depression. However, extant research has not highlighted effective internet-based psychological interventions to improve the mental health in this population during the pandemic. It remains unclear whether self-guided, internet-based cognitive behavioral therapy (iCBT) programs are effective in improving the mental health of health care workers during the COVID-19 pandemic. Objective: The aim of this study was to evaluate the effectiveness of a smartphone-based iCBT stress management program for reducing the depression experienced by nurses in Vietnam and Thailand. Methods: From March to April 2022, a 2-arm, parallel-group randomized controlled trial was implemented. One arm offered a 7-week self-guided iCBT program, and the other offered treatment as usual as a control arm. Full-time nurses were recruited from 6 hospitals: 2 hospitals in Vietnam and 4 hospitals in Thailand. The primary outcome of this program was the severity of depression measured by the Depression Anxiety Stress Scale-21 items. Follow-up surveys were conducted to measure the change in depression severity at 3 months (July-August 2022) and at 6 months (October-November 2022) after baseline. Mixed modeling for repeated measures was used to test the effects of the intervention compared with the control for the follow-up. Results: A total of 1203 nurses were included in this study: 602 in the intervention group and 601 in the control group. The follow-up rate at 3 and 6 months ranged from 85.7% (515/601) to 87.5% (527/602). The completion rate for the program was 68.1% (410/602). The group difference in depression was significant at the 3-month follow-up (coefficient=–0.92, 95% CI –1.66 to –0.18; P=.02) and nonsignificant at the 6-month follow-up (coefficient=–0.33, 95% CI –1.11 to 0.45; P=.41). The estimated effect sizes were –0.15 and –0.06 at the 3- and 6-month follow-ups, respectively. Conclusions: Our study shows that the smartphone-based iCBT program was effective in reducing depression at the 3-month follow-up among hospital nurses in Vietnam and Thailand during the COVID-19 pandemic. However, the effect size was small, and therefore, these results may not be clinically meaningful. Trial Registration: UMIN Clinical Trials Registry UMIN000044145; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000050128 International Registered Report Identifier (IRRID): RR2-10.20944/preprints202303.0450.v1 
%R 10.2196/50071
%U https://www.jmir.org/2024/1/e50071
%U https://doi.org/10.2196/50071