TY - JOUR AU - Vereschagin, Melissa AU - Wang, Angel Y AU - Richardson, Chris G AU - Xie, Hui AU - Munthali, Richard J AU - Hudec, Kristen L AU - Leung, Calista AU - Wojcik, Katharine D AU - Munro, Lonna AU - Halli, Priyanka AU - Kessler, Ronald C AU - Vigo, Daniel V PY - 2024 DA - 2024/3/27 TI - Effectiveness of the Minder Mobile Mental Health and Substance Use Intervention for University Students: Randomized Controlled Trial JO - J Med Internet Res SP - e54287 VL - 26 KW - mental health KW - substance use KW - college students KW - mobile interventions KW - digital interventions KW - randomized controlled trial KW - mobile phone AB - Background: University attendance represents a transition period for students that often coincides with the emergence of mental health and substance use challenges. Digital interventions have been identified as a promising means of supporting students due to their scalability, adaptability, and acceptability. Minder is a mental health and substance use mobile app that was codeveloped with university students. Objective: This study aims to examine the effectiveness of the Minder mobile app in improving mental health and substance use outcomes in a general population of university students. Methods: A 2-arm, parallel-assignment, single-blinded, 30-day randomized controlled trial was used to evaluate Minder using intention-to-treat analysis. In total, 1489 participants were recruited and randomly assigned to the intervention (n=743, 49.9%) or waitlist control (n=746, 50.1%) condition. The Minder app delivers evidence-based content through an automated chatbot and connects participants with services and university social groups. Participants are also assigned a trained peer coach to support them. The primary outcomes were measured through in-app self-assessments and included changes in general anxiety symptomology, depressive symptomology, and alcohol consumption risk measured using the 7-item General Anxiety Disorder scale, 9-item Patient Health Questionnaire, and US Alcohol Use Disorders Identification Test–Consumption Scale, respectively, from baseline to 30-day follow-up. Secondary outcomes included measures related to changes in the frequency of substance use (cannabis, alcohol, opioids, and nonmedical stimulants) and mental well-being. Generalized linear mixed-effects models were used to examine each outcome. Results: In total, 79.3% (589/743) of participants in the intervention group and 83% (619/746) of participants in the control group completed the follow-up survey. The intervention group had significantly greater average reductions in anxiety symptoms measured using the 7-item General Anxiety Disorder scale (adjusted group mean difference=−0.85, 95% CI −1.27 to −0.42; P<.001; Cohen d=−0.17) and depressive symptoms measured using the 9-item Patient Health Questionnaire (adjusted group mean difference=−0.63, 95% CI −1.08 to −0.17; P=.007; Cohen d=−0.11). A reduction in the US Alcohol Use Disorders Identification Test–Consumption Scale score among intervention participants was also observed, but it was not significant (P=.23). Statistically significant differences in favor of the intervention group were found for mental well-being and reductions in the frequency of cannabis use and typical number of drinks consumed. A total of 77.1% (573/743) of participants in the intervention group accessed at least 1 app component during the study period. Conclusions: In a general population sample of university students, the Minder app was effective in reducing symptoms of anxiety and depression, with provisional support for increasing mental well-being and reducing the frequency of cannabis and alcohol use. These findings highlight the potential ability of e-tools focused on prevention and early intervention to be integrated into existing university systems to support students’ needs. Trial Registration: ClinicalTrials.gov NCT05606601; https://clinicaltrials.gov/ct2/show/NCT05606601 International Registered Report Identifier (IRRID): RR2-10.2196/49364 SN - 1438-8871 UR - https://www.jmir.org/2024/1/e54287 UR - https://doi.org/10.2196/54287 UR - http://www.ncbi.nlm.nih.gov/pubmed/38536225 DO - 10.2196/54287 ID - info:doi/10.2196/54287 ER -