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JMIR Res Protoc. 2017 Dec 18;6(12):e231. doi: 10.2196/resprot.8061.

Direct to Public Peer Support and e-Therapy Program Versus Information to Aid Self-Management of Depression and Anxiety: Protocol for a Randomized Controlled Trial.

Author information

1
National Institute for Health Research: Collaboration for Leadership in Applied Health Research and Care East Midlands, University of Nottingham, Nottingham, United Kingdom.
2
Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
3
Nottinghamshire Healthcare NHS Foundation Trust, Institute of Mental Health, Nottingham, United Kingdom.
4
National Institute for Health Research: MindTech Healthcare Technology Co-operative, Institute of Mental Health, Triumph Road, Nottingham, United Kingdom.
5
Centre for Academic Mental Health, School of Social & Community Medicine, University of Bristol, Bristol, United Kingdom.
6
Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
7
Division of Epidemiology & Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
#
Contributed equally

Abstract

BACKGROUND:

Regardless of geography or income, effective help for depression and anxiety only reaches a small proportion of those who might benefit from it. The scale of the problem suggests a role for effective, safe, anonymized public health-driven Web-based services such as Big White Wall (BWW), which offer immediate peer support at low cost.

OBJECTIVE:

Using Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) methodology, the aim of this study was to determine the population reach, effectiveness, cost-effectiveness, and barriers and drivers to implementation of BWW compared with Web-based information compiled by UK's National Health Service (NHS, NHS Choices Moodzone) in people with probable mild to moderate depression and anxiety disorder.

METHODS:

A pragmatic, parallel-group, single-blind randomized controlled trial (RCT) is being conducted using a fully automated trial website in which eligible participants are randomized to receive either 6 months access to BWW or signposted to the NHS Moodzone site. The recruitment of 2200 people to the study will be facilitated by a public health engagement campaign involving general marketing and social media, primary care clinical champions, health care staff, large employers, and third sector groups. People will refer themselves to the study and will be eligible if they are older than 16 years, have probable mild to moderate depression or anxiety disorders, and have access to the Internet.

RESULTS:

The primary outcome will be the Warwick-Edinburgh Mental Well-Being Scale at 6 weeks. We will also explore the reach, maintenance, cost-effectiveness, and barriers and drivers to implementation and possible mechanisms of actions using a range of qualitative and quantitative methods.

CONCLUSIONS:

This will be the first fully digital trial of a direct to public online peer support program for common mental disorders. The potential advantages of adding this to current NHS mental health services and the challenges of designing a public health campaign and RCT of two digital interventions using a fully automated digital enrollment and data collection process are considered for people with depression and anxiety.

TRIAL REGISTRATION:

International Standard Randomized Controlled Trial Number (ISRCTN): 12673428; http://www.controlled-trials.com/ISRCTN12673428/12673428 (Archived by WebCite at http://www.webcitation.org/6uw6ZJk5a).

KEYWORDS:

anxiety; depression; online; peer support; self-management

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