Study on Understanding the Overall Effectiveness of Mindline.sg on Improving Mental Health Literacy, Quality of Life and Economic Outcomes
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 242
- Locations
- 1
- Primary Endpoint
- Mental health symptoms by 21-item Depression, Anxiety and Stress Scale (DASS-21)
Study Overview
Brief Summary
This study aims to evaluate the effectiveness of mindline.sg, a digital mental health platform, in improving mental health literacy, emotional wellbeing, quality of life, and economic outcomes among adults in Singapore. We will conduct a randomized controlled trial (RCT) with two phases: an initial screening and a 1-month intervention. Eligible participants, identified based on mental health symptom scores, will be randomly assigned to either an intervention group using mindline.sg or a control group receiving standard mental health information.
The intervention group will receive weekly prompts to engage with key features of the platform, including psychoeducation, positive psychology tools, emotion regulation exercises, and access to digital navigation for mental health services. Participants in both groups will complete surveys at baseline, post-intervention, and two months post-intervention, measuring outcomes such as mental health symptoms, resilience, wellbeing, emotion regulation, mental health literacy, and work performance. We expect mindline.sg users to show greater improvements across mental health and quality of life indicators, increased mental health literacy, and better work productivity compared to controls. This study will provide evidence on the utility of digital mental health tools in supporting population mental wellbeing and inform future digital mental health strategies in Singapore and similar contexts.
Detailed Description
The primary hypothesis is:
- Participants in the intervention group using mindline.sg will show significantly greater improvements in mental health outcomes, quality of life, and work productivity at post-intervention (T1) and 3-month follow-up (T2), compared to the control group.
Secondary hypotheses include:
- Intervention participants will demonstrate increased resilience, better emotion regulation, and more positive attitudes and behaviors toward mental health help-seeking compared to the control group.
- Participants in the intervention group will show higher usage and engagement with digital mental health features and report higher perceived helpfulness of tools.
- The mindline.sg intervention will be cost-effective compared to the control condition, considering improvements in mental health and productivity outcomes relative to platform costs.
The study will use a randomized controllled trial design. Participants will be assigned to either: (1) A control group (receiving a mental health information pamphlet), or (2) An intervention group (using mindline.sg). Primary outcomes include mental health status, quality of life, economic and productivity measures, and user engagement metrics.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Health Services Research
- Masking
- Double (Participant, Care Provider)
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Aged at least 21 years or at least 18 years old if National of University student
- •Have lived in Singapore for at least 2 years
- •Have not received a formal diagnosis of a psychiatric disorder
- •Not currently receiving any form of mental health treatment (e.g., counselling)
- •Fluent in English
- •Participants from screening whose DASS-21 scores are mild or moderate for any one of the sub scales.
Exclusion Criteria
- •- Those who do not meet the inclusion criteria will be screened and excluded.
Arms & Interventions
Intervention
In the intervention group, participants will be encouraged to use Mindline.sg for four weeks. Each week, participants will receive a reminder to complete certain activities on the website and a quiz to measure completion of activities.
Intervention: mindline.sg (Behavioral)
Control
In the control group, participants will receive mental health literacy materials based on standard materials given out in Singapore. At the end-of-study debrief, control group participants will be directed to the mindline.sg website so they can benefit from it.
Outcomes
Primary Outcomes
Mental health symptoms by 21-item Depression, Anxiety and Stress Scale (DASS-21)
Time Frame: Screening, baseline, 4 weeks after baseline, 12 weeks after baseline
The Depression, Anxiety and Stress Scale - 21 Items (DASS-21) is a set of three self-report scales designed to measure the emotional states of depression, anxiety and stress. Each of the three DASS-21 scales contains 7 items, divided into subscales with similar content. The depression scale assesses dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest / involvement, anhedonia and inertia. The anxiety scale assesses autonomic arousal, skeletal muscle effects, situational anxiety, and subjective experience of anxious affect. The stress scale is sensitive to levels of chronic non-specific arousal. It assesses difficulty relaxing, nervous arousal, and being easily upset / agitated, irritable / over-reactive and impatient. Scores for depression, anxiety and stress are calculated by summing the scores for the relevant items. Higher scores indicate higher severity of symptoms.
Quality of Life by 6-item EQ-5D-5L scale
Time Frame: Baseline, 4 weeks after baseline, 12 weeks after baseline
The 5-level EQ-5D version (EQ-5D-5L) was introduced by the EuroQol Group in 2009 to improve the instrument's sensitivity and to reduce ceiling effects, as compared to the EQ-5D-3L. The EQ-5D-5L essentially consists of 2 pages: the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS). The descriptive system comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state.
Work productivity by WHO-HPQ measure of absenteeism and presenteeism
Time Frame: 4 weeks after baseline, 12 weeks after baseline
Absenteeism questions included both sickness absence and non-sickness absence. The questions asked about the number of days in the past 1 year that participants were absent due to health-related problem and non-health-related conditions separately. The questions about presenteeism asked the number of days in the past 1 year that participants had come to work while sick, felt they should take sick leave or were incapable of working with full performance.
Mental health symptoms by 21-item Depression, Anxiety and Stress Scale (DASS-21)
Time Frame: Screening, baseline, 4 weeks after baseline, 12 weeks after baseline
The Depression, Anxiety and Stress Scale - 21 Items (DASS-21) is a set of three self-report scales designed to measure the emotional states of depression, anxiety and stress. Each of the three DASS-21 scales contains 7 items, divided into subscales with similar content. The depression scale assesses dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest / involvement, anhedonia and inertia. The anxiety scale assesses autonomic arousal, skeletal muscle effects, situational anxiety, and subjective experience of anxious affect. The stress scale is sensitive to levels of chronic non-specific arousal. It assesses difficulty relaxing, nervous arousal, and being easily upset / agitated, irritable / over-reactive and impatient. Scores for depression, anxiety and stress are calculated by summing the scores for the relevant items. Higher scores indicate higher severity of symptoms.
Quality of Life by 6-item EQ-5D-5L scale
Time Frame: Baseline, 4 weeks after baseline, 12 weeks after baseline
The 5-level EQ-5D version (EQ-5D-5L) was introduced by the EuroQol Group in 2009 to improve the instrument's sensitivity and to reduce ceiling effects, as compared to the EQ-5D-3L. The EQ-5D-5L essentially consists of 2 pages: the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS). The descriptive system comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state.
Work productivity by WHO-HPQ measure of absenteeism and presenteeism
Time Frame: 4 weeks after baseline, 12 weeks after baseline
Absenteeism questions included both sickness absence and non-sickness absence. The questions asked about the number of days in the past 1 year that participants were absent due to health-related problem and non-health-related conditions separately. The questions about presenteeism asked the number of days in the past 1 year that participants had come to work while sick, felt they should take sick leave or were incapable of working with full performance.
Secondary Outcomes
- Attitudes, knowledge and behaviours regarding mental health and help-seeking by the Mental Help Seeking Attitudes Scale (MHSAS)(Baseline, 4 weeks after baseline, 12 weeks after baseline)
- Positive psychology by the Cantril Ladder and the WHO-5 Wellbeing Index(Baseline, 4 weeks after baseline, 12 weeks after baseline)
- Emotion regulation by DERS-18(Baseline, 4 weeks after baseline, 12 weeks after baseline)
- Self-reported usage patterns of mindline.sg(Baseline, during intervention, 4 weeks after baseline, 12 weeks after baseline)
- Cost-effectiveness of mindline.sg(Baseline, 4 weeks after baseline, 12 weeks after baseline)
- Self-reported usage patterns of mindline.sg(Baseline, during intervention, 4 weeks after baseline, 12 weeks after baseline)
- Resilience by 10-item Connor-Davidson Resilience Scale(Baseline, 4 weeks after baseline, 12 weeks after baseline)
- Attitudes, knowledge and behaviours regarding mental health and help-seeking by the Mental Help Seeking Attitudes Scale (MHSAS)(Baseline, 4 weeks after baseline, 12 weeks after baseline)
- Positive psychology by the Cantril Ladder and the WHO-5 Wellbeing Index(Baseline, 4 weeks after baseline, 12 weeks after baseline)
- Emotion regulation by DERS-18(Baseline, 4 weeks after baseline, 12 weeks after baseline)
- Cost-effectiveness of mindline.sg(Baseline, 4 weeks after baseline, 12 weeks after baseline)
Investigators
Jean Liu
Associate Director
Centre for Evidence and Implementation Singapore Ltd