MedPath

Online Personalized Intervention for the Prevention of Anxiety.

Not Applicable
Recruiting
Conditions
Anxiety Disorders
Interventions
Behavioral: prevANS intervention
Registration Number
NCT05682365
Lead Sponsor
University of Malaga
Brief Summary

Objective: To design, develop and evaluate an online personalized intervention based on a risk algorithm for the universal prevention of anxiety disorders in the general population.

Methods: Randomized controlled trial, with two parallel arms and 12 months follow-up. The entire process of recruitment, randomization, intervention and follow-up will be carried out from a web platform designed for the study (web prevANS). Through a communication campaign, where announcements and informative videos will be produced, and through the dissemination on prevANS website, 2,000 Spanish and Portuguese adult participants without anxiety in the baseline of the study will be recruited. The participants will be randomly assigned to the prevANS intervention, which will be self-guided and can be implemented from the prevANS web or from the participants' Smartphone (through an APP), or to a control group. The prevANS intervention will have different intensities depending on the risk level of the population, evaluated from the already validated risk algorithm for anxiety: predictA. Participants with a low risk of anxiety will receive information on their level and profile (risk factors) of anxiety and psychoeducational information periodically. Participants with moderate and high risk of anxiety will also receive information on their risk level and profile, but will also include a cognitive-behavioral training (problem solving, decision-making, handling thoughts / concerns and emotions and communicational skills). Both groups of risk will work towards manage stressors and enhance protective factors. The control group will not receive any intervention, but they will fill out the same questionnaires as in the intervention group. The main result will be the incidence of new cases of anxiety disorders measured by CIDI, and the secondary results will be the reduction of anxiety (GAD-7) and depression (PHQ-9) symptoms, of the risk probability of anxiety and depression (predictA and predictD algorithms) and improvement of quality of life measured by SF-12 and EuroQol, and cost-effectiveness and cost-utility.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
2000
Inclusion Criteria
  • GAD-7 <10 at baseline
  • GAD-7 ≥10 at baseline and a negative diagnosis of anxiety disorders by CIDI
Exclusion Criteria
  • Not have a smartphone and internet for personal use
  • Unable to speak Spanish
  • Documented terminal illness
  • Documented cognitive impairment
  • Documented serious mental illness (psychosis, bipolar, addictions, etc.)
  • Being involved in any psychological intervention or treatment

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
prevANS interventionprevANS interventionIn this arm, participants will receive an online personalized intervention to prevent anxiety disorders based on a risk predictive algorithm (predictA).
Primary Outcome Measures
NameTimeMethod
Primary Outcome Measure12 months

Rate of anxiety disorders measured by the Composite International Diagnostic Interview (CIDI). CIDI is a structured diagnostic interview that provides current diagnoses of anxiety disorders according to DSM.

Secondary Outcome Measures
NameTimeMethod
Mediator of the intervention: cognitive change12 months

The cognitive change will be evaluated through the number of negative thoughts worked and modified in the app

Subgroup analysis according to depressive symptoms at baseline (through the PHQ-9 questionnaire)12 months

The Patient Health Questionnaire-9 (PHQ-9) measures symptoms of depression through 9 items, each of which is scored 0 ('not at all') to 3 ('nearly every day'). Low scores are equivalent to less symptoms of depression, the scalen range is 0 to 27 (9 items). The subgroups will be: 1) from 0 to 5 points; 2) from 6 to 10 points; and 3) \> 10 points

Probability of anxiety measured by the Spanish predictA risk algorithm12 months

The Spanish predictA risk algorithm measures 12 risk factors for anxiety disorders

Cost-utility12 months

It will be conducted from two perspectives: (1) a societal perspective and (2) a National Health System perspective. We will calculate incremental cost-effectiveness ratio (ICER) using the incremental cost (difference in costs between arms) divided by incremental QALYs (difference in QALYs between arms). Quality-adjusted life years (QALYs) will be measured using the EuroQol five questionnaire (EuroQol-5D).

Acceptability and satisfaction with the intervention (prevANS intervention) measured by u-MARS scale12 months

The User Version of the Mobile Application Rating Scale (u-MARS) consists of 23 items assessing app quality, each of which is scored 1 ('poor') to 5('excellent'), except items 14-17 and item 19, which also include the "not applicable" option. Higher scores are equivalent to higher app quality.

Subgroup analysis according to age12 months

A subgroup analysis will be conducted according to age of the participants (from 18 to 30 years; from 31 to 50 years; and \> 50 years)

Subgroup analysis according to anxiety symptoms at baseline (through the GAD-7 questionnaire)12 months

The General Anxiety Questionnaire (GAD-7) measures generalized anxiety disorder through 7 items, each of which is scored 0 ('not at all') to 3 ('nearly every day'). Low scores are equivalent to less symptoms of anxiety, the scale range is 0 to 21 (7 items). The subgroups will be: 1) from 0 to 5 points; and 2) \> 5 points

Subgroup analysis according to risk level of anxiety (through the predictA risk algorithm)12 months

The Spanish predictA risk algorithm measures 12 risk factors for anxiety disorders. The subgroups will be: 1) probability of risk from 0 to 6%; and 2) probability of risk \>6%

Anxious symptoms measured by the General Anxiety Questionnaire (GAD-7)12 months

The General Anxiety Questionnaire (GAD-7) measures generalized anxiety disorder through 7 items, each of which is scored 0 ('not at all') to 3 ('nearly every day'). Low scores are equivalent to less symptoms of anxiety, the scale range is 0 to 21 (7 items).

Depressive symptoms measured by the Patient Health Questionnaire-9 (PHQ-9)12 months

The Patient Health Questionnaire-9 (PHQ-9) measures symptoms of depression through 9 items, each of which is scored 0 ('not at all') to 3 ('nearly every day'). Low scores are equivalent to less symptoms of depression, the scalen range is 0 to 27 (9 items).

Probability of depression measured by the Spanish predictD risk algorithm12 months

The Spanish predictD risk algorithm measures 13 risk factors for depression

Quality of life measured by SF-1212 months

The 12-item Short Form (SF-12) measures quality of life related to physical health and quality of life related to mental health. Scores on the scales range from 0 to 100. Higher scores are equivalent to better health-related quality of life.

Cost-effectiveness12 months

It will be conducted from two perspectives: (1) a societal perspective and (2) a National Health System perspective. We will calculate incremental cost-effectiveness ratio (ICER) using the incremental cost (difference in costs between arms) divided by incremental effectiveness (difference in the number of diagnoses of anxiety disorders between arms).

Subgroup analysis according to sex12 months

A subgroup analysis will be conducted according to sex of the participants (women or men)

Subgroup analysis according to education level12 months

A subgroup analysis will be conducted according to education level of the participants (without primary education; primary education; secondary education; or higher education)

Subgroup analysis according to risk level of depression (through the predictD risk algorithm)12 months

The Spanish predictD risk algorithm measures 13 risk factors for depression. The subgroups will be: 1) probability of risk from 0 to 9%; and 2) probability of risk \>9%

Trial Locations

Locations (1)

Facultad de Psicología y Logopedia

🇪🇸

Málaga, Spain

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