TY  - JOUR
AU  - Watanabe, Kazuhiro
AU  - Tran, Thuy Thi Thu
AU  - Sripo, Narisara
AU  - Sakuraya, Asuka
AU  - Imamura, Kotaro
AU  - Boonyamalik, Plernpit
AU  - Sasaki, Natsu
AU  - Tienthong, Thanate
AU  - Asaoka, Hiroki
AU  - Iida, Mako
AU  - Nguyen, Quynh Thuy
AU  - Nguyen, Nga Thi
AU  - Vu, Son Thai
AU  - Ngo, Thuy Thi
AU  - Luyen, Tham Thi
AU  - Nguyen, Long Duc
AU  - Nguyen, Nga Thi Viet
AU  - Nguyen, Binh Thanh
AU  - Matsuyama, Yutaka
AU  - Takemura, Yukie
AU  - Nishi, Daisuke
AU  - Tsutsumi, Akizumi
AU  - Nguyen, Huong Thanh
AU  - Kaewboonchoo, Orawan
AU  - Kawakami, Norito
PY  - 2024
DA  - 2024/8/30
TI  - 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
JO  - J Med Internet Res
SP  - e50071
VL  - 26
KW  - digital mental health intervention
KW  - unguided program
KW  - universal prevention
KW  - health care workers
KW  - nurses
KW  - COVID-19
KW  - depression
KW  - mobile phone
AB  - 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 
SN  - 1438-8871
UR  - https://www.jmir.org/2024/1/e50071
UR  - https://doi.org/10.2196/50071
DO  - 10.2196/50071
ID  - info:doi/10.2196/50071
ER  -