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Cognitive-Behavioural & Mindfulness-Based Online Programs for Female Sexual Dysfunction

Not Applicable
Completed
Conditions
Female Sexual Dysfunction
Interventions
Behavioral: Mindfulness-Based Therapy - Online (MBT-O)
Behavioral: Cognitive-Behavioural Therapy - Online (CBT-O)
Registration Number
NCT05168371
Lead Sponsor
University of British Columbia
Brief Summary

Female sexual dysfunction (FSD) affects approximately one-third of women worldwide and is linked to negative physical, psychological, and interpersonal outcomes. Although both cognitive-behavioral therapy and mindfulness-based therapy are effective treatments for FSD, face-to-face treatments can be costly and are inaccessible to many people in remote areas. The goal of the current study is to pilot a randomized controlled trial to examine the effectiveness of and satisfaction with two online interventions for FSD. Women will be randomized to an online cognitive-behavioral program, an online mindfulness-based program, or a wait-list control group. Treatment will be administered entirely online and last 8-12 weeks. Women will meet weekly via Zoom with a navigator who will provide individualized support.

Detailed Description

HYPOTHESES:

1. Compared to women in the wait-list control arm, women in the CBT and MBT arms will have significant post-treatment and follow-up improvements in self-report measures of the primary outcomes: (a) sexual distress and (b) sexual desire.

2. Compared to women in the wait-list control arm, women in the CBT and MBT arms will have significant post-treatment and follow-up improvements in self-report measures of the secondary outcomes: (a) overall sexual function, (b) sexual satisfaction, (c) relational sexual concern, (d) satisfaction with life, and (e) relationship satisfaction.

3. Improvements in depression, sexual avoidance, and sexual consequences will significantly mediate improvements in primary outcomes at all post-treatment assessment points.

4. Higher levels of baseline relationship satisfaction, higher levels of partner involvement, more positive baseline expectations about treatment efficacy, higher levels of treatment compliance, and perceiving higher levels of empathy and effectiveness from navigators will predict greater improvements in primary outcomes at post-treatment and follow-up.

5. Baseline personality will moderate intervention effects at post-treatment and follow-up.

6. Women in both the CBT and MBT arms will report being satisfied with treatment.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
129
Inclusion Criteria
  • Cis and trans women of any sexual orientation.
  • Must be fluent in English (online materials delivered in English).
  • Must have consistent access to the internet, basic competency in using online platforms (self-report).
  • Must be in a committed, stable romantic relationship of at least 6 months (because aspects of the interventions require partner participation). Partners may be of any gender.
  • Must meet telephone screening diagnostic criteria for sexual interest/arousal disorder.
  • Must be sexually active with a partner over the preceding 4 weeks (due to the sexual function outcome measure), and willing to engage in sexual activity with their partner during the study.
  • Must be able to participate in an 8-12-week online treatment.
Exclusion Criteria
  • Have sexual dysfunction that is, in their estimation, fully attributable to another psychiatric diagnosis, the effect of a substance, a general medical condition (e.g., Multiple Sclerosis), or non-sexual conflict in the relationship, none of which are meant to be addressed by the proposed interventions.
  • Poorly managed Anxiety or Mood Disorder (as per degree of life interference assessed at screening).
  • Report visual impairments that would make it difficult to read online materials.
  • Are regularly using prescription narcotics illegal recreational drug (not including cannabis).
  • Plan to change their medications known to impact sexual function over the course of the study.
  • On assessment report plans to end their romantic relationship in the next 6 months.
  • Engage in any other treatment for their sexual difficulties during the study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
MBT-OMindfulness-Based Therapy - Online (MBT-O)Women randomized to this arm will receive access to the eight modules of Mindfulness-Based Therapy-Online (MBT-O). Participants will meet weekly via Zoom with treatment navigators during the 8-12 weeks that it takes to complete the program.
CBT-OCognitive-Behavioural Therapy - Online (CBT-O)Women randomized to this arm will receive access to the eight modules of Cognitive-Behavioural Therapy-Online (CBT-O). Participants will meet weekly via Zoom with treatment navigators during the 8-12 weeks that it takes to complete the program.
Primary Outcome Measures
NameTimeMethod
Change in sexual distressbaseline; mid-treatment (an average of 5 weeks after starting the 8-module program); post-treatment (within 2 weeks of completing the 8-module program); and 6-month follow-up

Revised version of the Female Sexual Distress Scale-R (Derogatis et al., 2008). Scores on the scale range from 0-52, where higher scores represent higher levels of distress.

Change in sexual desirebaseline; mid-treatment (an average of 5 weeks after starting the 8-module program); post-treatment (within 2 weeks of completing the 8-module program); and 6-month follow-up

The Sexual Interest and Desire Inventory (SIDI; Clayton et al. 2006) total score will be used to measure sexual desire. Possible total scores range from 0-51, with higher scores indicating higher levels of sexual functioning.

Secondary Outcome Measures
NameTimeMethod
Change in relationship satisfactionbaseline; post-treatment (within 2 weeks of completing the 8-module program); and 6-month follow-up

Couples satisfaction index (CSI-16; Funk \& Rogge, 2007). CSI-16 scores can range from 0 to 81. Higher scores indicate higher levels of relationship satisfaction.

Change in relational sexual concernbaseline; post-treatment (within 2 weeks of completing the 8-module program); and 6-month follow-up

Relational concern subscale of the Sexual Satisfaction Scale-Women (SSS-W; Meston \& Trapnell, 2005). Scores range from 6-30, with higher scores reflecting lower levels of sexual relational concern.

Treatment satisfaction for module 2An average of 2 weeks after starting the 8-module program

Face-valid single item measures, asking participants to rate helpfulness of content covered each week, and ease of reading the content (0-10 scale). Research suggests a cut-off of 6.5/10 on these measures to indicate acceptable utility and clarity of content. Asked after completing module 2.

Treatment satisfaction for module 3An average of 3 weeks after starting the 8-module program

Face-valid single item measures, asking participants to rate helpfulness of content covered each week, and ease of reading the content (0-10 scale). Research suggests a cut-off of 6.5/10 on these measures to indicate acceptable utility and clarity of content. Asked after completing module 3.

Treatment satisfaction for module 4An average of 5 weeks after starting the 8-module program

Face-valid single item measures, asking participants to rate helpfulness of content covered each week, and ease of reading the content (0-10 scale). Research suggests a cut-off of 6.5/10 on these measures to indicate acceptable utility and clarity of content. Asked after completing module 4.

Treatment satisfaction for module 6An average of 7 weeks after starting the 8-module program

Face-valid single item measures, asking participants to rate helpfulness of content covered each week, and ease of reading the content (0-10 scale). Research suggests a cut-off of 6.5/10 on these measures to indicate acceptable utility and clarity of content. Asked after completing module 6.

Change in sexual satisfactionbaseline; post-treatment (within 2 weeks of completing the 8-module program); and 6-month follow-up

Quality of Sex Inventory (QSI; Shaw \& Rogge, 2016). For all items, responses are given values on a 0 to 5 point scale with 0 = Not at all TRUE and 5 = Completely TRUE. The items of the sexual satisfaction subscale are summed to create a total where higher scores indicate higher levels of sexual satisfaction (0-60). The items of the sexual dissatisfaction subscale are summed separately to create a total where higher scores reflect higher levels of sexual dissatisfaction (0-60).

Treatment satisfaction for module 7An average of 9 weeks after starting the 8-module program

Face-valid single item measures, asking participants to rate helpfulness of content covered each week, and ease of reading the content (0-10 scale). Research suggests a cut-off of 6.5/10 on these measures to indicate acceptable utility and clarity of content. Asked after completing module 7.

Treatment satisfaction for module 8An average of 10 weeks after starting the 8-module program

Face-valid single item measures, asking participants to rate helpfulness of content covered each week, and ease of reading the content (0-10 scale). Research suggests a cut-off of 6.5/10 on these measures to indicate acceptable utility and clarity of content. Asked after completing module 8.

Treatment satisfaction for module 1An average of 1 week after starting the 8-module program

Face-valid single item measures, asking participants to rate helpfulness of content covered each week, and ease of reading the content (0-10 scale). Research suggests a cut-off of 6.5/10 on these measures to indicate acceptable utility and clarity of content. Asked after completing module 1.

Treatment satisfaction for module 5An average of 6 weeks after starting the 8-module program

Face-valid single item measures, asking participants to rate helpfulness of content covered each week, and ease of reading the content (0-10 scale). Research suggests a cut-off of 6.5/10 on these measures to indicate acceptable utility and clarity of content. Asked after completing module 5.

Change in sexual functionbaseline; mid-treatment (an average of 5 weeks after starting the 8-module program); post-treatment (within 2 weeks of completing the 8-module program); and 6-month follow-up

Female Sexual Function Index total score (FSFI; Rosen et al., 2000). Scores range from 2 - 36 where increase in sexual dysfunction is represented by lower scores.

Quantitative program treatment satisfaction as assessed by the adapted Erectile Dysfunction Inventory of Treatment Satisfactionpost-treatment (within 2 weeks of completing the 8-module program)

Adapted Erectile Dysfunction Inventory of Treatment Satisfaction (Althof et al., 1999; items 1-10). Scores range from 0-40, with higher scores reflecting higher treatment satisfaction.

Qualitative program treatment satisfactionthrough completion of the 8-module program, an average of 10 weeks

Qualitative feedback about eSense and between-module activities collected by treatment navigators.

Change in satisfaction with lifebaseline; post-treatment (within 2 weeks of completing the 8-module program); and 6-month follow-up

Satisfaction with Life Scale (Diener et al., 1985). Scores range from 5-35, with higher scores reflecting higher levels of life satisfaction.

Trial Locations

Locations (1)

UBC Sexual Health Research Lab; Gordon & Leslie Diamond Health Care Centre

🇨🇦

Vancouver, British Columbia, Canada

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