Treating depressed Australian workers using an app-based intervention: A randomised controlled trial (Anchored)

INTERVENTION: 'Anchored' is a smartphone application‐based intervention that includes therapeutic content centred on behavioural activation (BA), mindfulness, and cognitive behavioural tasks. It was adapted from HeadGear, an existing smartphone application designed for individuals working in male‐dominated industries. Anchored is more broadly aimed at all working adults, and has a more gender‐neutral look and feel, achieved through use of colour scheme, imagery, font/typography, inclusion of male and female ‘characters’, and delivery of in‐app content by both male and female presenters. The Anchored app is designed for self‐directed use by an individual on a smartphone device. It features interactive content, delivered by on‐screen text, audio, static and interactive image displays and videos. The app can be accessed by the participant on their smartphone at a time and location of their choosing. This app/intervention has been used previously in a pilot study: Pilot‐testing of a mobile phone application to support the mental health of Australian workers (ACTRN12619000761167). The main therapeutic component of the Anchored app takes the form of a 30 day intervention in which users complete one ‘challenge’ daily (5‐ 10 minutes per day). These 'challenges' feature a variety of evidence‐based therapeutic techniques delivered using a range of formats including: psychoeducational videos (on coping skills and resilience, mindfulness, and behavioural activation); mindfulness exercises; value‐driven activity planning, goal‐setting and review; and coping skill development (problem solving, sleep, grounding, alcohol use, assertiveness, and training in adaptive forms of coping). Users can also complete an optional risk calculator that assesses risk for future common mental disorders a CONDITION: Depression;Anxiety;Emotional wellbeing;Stress; ; Depression ; Anxiety ; Emotional wellbeing ; Stress Mental Health ‐ Anxiety Mental Health ‐ Depression Public Health ‐ Health promotion/education Public Health ‐ Other public health PRIMARY OUTCOME: Depressive symptom change as measured by the Patient Health Questionnaire‐9 (PHQ‐9). [Data will be collected at baseline, and 30 days, 3 months and 6 months after baseline. ] INCLUSION CRITERIA: To be included in the study participants must: ‐ Be over 18 years of age ‐ Be currently employed either on a casual basis, part time, or full time ‐ Have satisfactory English comprehension ‐ Be a current Australian resident ‐ Respond >=3 ("to some extent") to Single‐Item Stress Question (SISQ) at screening ‐ Meet diagnosis of major depressive disorder (MDD) using the PHQ‐9 algorithm SECONDARY OUTCOME: Alcohol use measured by the AUDIT‐C[Data will be collected at baseline, and 30 days, 3 months and 6 months after baseline.] Anxiety symptom change as measured by the Generalized Anxiety Disorder (GAD) 7‐item scale. [Data will be collected at baseline, and 30 days, 3 months and 6 months after baseline.] Application engagement/feedback as measured using questions adapted from the Mobile Application Rating Scale; including questions measuring likelihood to recommend the app to others, overall rating, appropriateness to the target audience, as well as questions assessing how easy and interesting the app was to use.[Data will be collected 30 days after baseline.] Change in depression caseness as measured by the Patient Health Questionnaire‐9 (PHQ‐9) diagnostic algorithm.[Data will be collected at baseline, and 30 days, 3 months and 6 months after baseline.] Change in resilience as measured using six items from the Brief Resilience Scale (BRS). [Data will be collected at baseline, and 30 days, 3 months and 6 months after baseline.] Change in wellbeing as measured by the World Health Organisation (Five) Well‐being Index (WHO‐5).[Data will be collected at baseline, and 30 days, 3 months and 6 months after baseline.] Change in work performance as measured by three items: (1) an item from the Health and Work Performance Questionnaire (HPQ), asking about job performance during the past 4 weeks; (2) an item pertaining to past month sickness absence (days absent, days absent for mental health reasons); and, (3) an item regarding past 6‐month weeklong sickness absence (weeks absent, weeks absent for mental health reasons).[Data will be collected at baseline, and 30 days, 3 months and 6 months after baseline.] Change in Workplace burnout as measured by the Copenhagen Burnout Inventory (7 items).[Data will be collected at baseline, and 30 days, 3 months and 6 months after baseline.] Exercise as measured by single item (how often do you participate in moderate or intensive physical activity for at least 30 minutes? )[Data will be collected at baseline, and 30 days, 3 months and 6 months after baseline.] General health outcomes (functioning, quality of life) as measured by the Assessment of Quality of Life (AQoL‐4D).[Data will be collected at baseline, and 30 days, 3 months and 6 months after baseline. ] Objective application engagement as measured through in‐app data collection, including: (1) number of times App opened; (2) number of "challenges" completed; (3) number of “toolboxâ€? items accessed; and, (4) total time spent in App.[Data will be collected 30 days after baseline.] Work‐related stress symptom change as measured using the Perceived Stress Scale (PSS). [Data will be collected at baseline, and 30 days, 3 months and 6 months after baseline.]