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Completed

NCT Number: NCT04573465

Pilot Evaluation of Peer-support Coaching to Increase Adherence to Online Self-help for College Mental Health

This study aims to test if coaching can improve program adherence to an online mental health program in college students if delivered by undergraduate peers. Participants will be randomly assigned to either receive phone coaching, text message coaching, or no coaching. It is hypothesized that participants who receive phone coaching will exhibit greater adherence to the provided online mental health program than participants who receive text message coaching or no coaching.

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Key information

Conditions

Treatment Adherence Behavior Health Behavior Treatment Adherence and Compliance

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Utah State University

Logan, Utah, 84322, United States

About this study

The purpose of this study is to test the feasibility and effectiveness of an innovative peer support coaching model for college students. The primary aim of the coaching model is to increase participants' adherence to ACT Guide, an online mental health program. To test the effects of peer-support coaching on ACT Guide adherence rates and outcomes, the investigators will conduct a randomized controlled trial with three conditions (peer-support phone coaching, peer-support text message coaching, and a no support control group) using a sample of 300 Utah State University undergraduate students. Individuals who indicate interest in participating will complete an automated online workflow through Qualtrics which will include informed consent, baseline assessment, ACT Guide registration, and randomization into one of the three conditions. Participants will then gain access to a research version of ACT Guide, either with no additional support, with concurrent peer-support coaching, or with concurrent peer-support text messaging based on their randomly assigned condition. Coaching will take place over 10 weeks, with the post assessment being administered 10 weeks after baseline assessment. The investigators hypothesize that participants will adhere to coaching (80% completing ≥ 6 coaching calls; 80% responding to texts > 6 weeks), be satisfied with coaching (M = 5 "agree" on a 6-point self-reported coaching satisfaction scale), and that coaching fidelity will be maintained (80% of audited coaching calls/texts meeting criteria for fidelity). The investigators also hypothesize that participants who receive peer-support phone coaching will complete more ACT Guide modules and will report greater improvements in mental health relative to both the text messaging and no support conditions, and that the text messaging condition will perform greater in this regard than the no support condition.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • USU undergraduate student
  • Fluent in English

Exclusion criteria

  • Must have not used ACT Guide in the past

Treatment and study plan

Phone Coaching

Behavioral

Participants receiving phone coaching receive one 10-15 minute phone call each week from their randomly assigned peer-support coach. During coaching calls, the peer-support coach will discuss ACT Guide usage with the participant (e.g., asking how many modules the participant completed, asking what the participant liked/disliked about the modules, etc.).

Text Message Coaching

Behavioral

Participants receiving text message coaching receive text messages on a weekly basis from their randomly assigned peer-support coach. Text messages from the peer-support coach will discuss ACT Guide usage with the participant (e.g., asking how many modules the participant completed).

ACT Guide

Behavioral

ACT Guide is an online self-help program based on acceptance and commitment therapy (ACT), targeting acceptance, mindfulness, and values-based processes. It is intended to be used for 20 to 40 minutes at time, a few times a week. While using ACT Guide, participants will read about concepts relevant to ACT and engage in guided experiential exercises, with additional exercises being assigned to be completed in between sessions as homework.

Primary outcomes

  1. ACT Guide Module Completion

    Time frame: Post-treatment (10 weeks after baseline)

    Number of modules completed within ACT Guide, out of a total of 12 modules. This is automatically recorded within the ACT Guide program, and is not self-reported.

  2. Depression, Anxiety, and Stress Scale (DASS-21; Osman et al., 2012)

    Time frame: Post-treatment (10 weeks after baseline)

    A self-report measure for depression, anxiety, and stress . Items are rated on a 4-point Likert scale from 0 (did not apply to me at all) to 3 (applied to me most of the time), with a higher score indicating a worse outcome. Minimum total of 0 and maximum total of 63.

Secondary outcomes

  1. Short Form of the Revised Vanderbilt Therapeutic Alliance Scale adapted for coaching (VTAS-R; Shelef & Diamond, 2008)

    Time frame: After completion of first contact with coach and post-treatment (10 weeks after baseline)

    A self-report measure for therapeutic alliance, with modified wording in order to adapt to a coaching context. Only administered to participants in either coaching condition. Items are rates on a 6-point Likert scale from 0 (not at all) to 5 (a great deal), with a higher score indicating a better outcome. Minimum total of 0 and maximum total of 25.

  2. Mental Health Continuum Short Form (MHC-SF; Keyes, 2005)

    Time frame: Post-treatment (10 weeks after baseline)

    A self-report measure for positive mental health. Items are rated on a 6-point Likert scale from 1 (never) to 6 (every day), with a higher score indicating a better outcome. Minimum total of 14 and maximum total of 84.

  3. The Acceptance and Action Questionnaire (AAQ-II; Bond et al., 2011)

    Time frame: Post-treatment (10 weeks after baseline)

    A self-report measure for psychological flexibility. Items are rated on a 7-point Likert scale from 1 (never true) to 7 (always true), with a higher score indicating a worse outcome. Minimum total of 7 and maximum total of 49.

  4. Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT; Francis, Dawson, & Golijani-Moghaddam, 2016)

    Time frame: Post-treatment (10 weeks after baseline)

    A self-report measure for psychological flexibility. Items are rated on a 7-point Likert scale from 0 (strongly disagree) to 6 (strongly agree), with a higher score indicating a better outcome. Minimum total of 0 and maximum total of 138.

  5. Client Satisfaction Questionnaire adapted to Internet-based interventions (CSQ-I; Boß et al., 2016)

    Time frame: Post-treatment (10 weeks after baseline)

    A self-report measure for program satisfaction. Items are rated on a 4-point Likert scale from 1 (does not apply to me) to 4 (does totally apply to me), with a higher score indicating a better outcome. Minimum total of 8 and a maximum total of 32.

  6. Novel user experience item 1

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked to rate agreement from 1 (Strongly disagree) to 6 (Strongly agree) with the statement "Overall, I was motivated to use ACT Guide" This is a user experience item specific to this study.

  7. Novel user experience item 2

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked to rate agreement from 1 (Strongly disagree) to 6 (Strongly agree) with the statement "I had the support I needed to use ACT Guide." This is a novel user experience item specific to this study.

  8. Novel user experience item 3

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked to rate agreement from 1 (Strongly disagree) to 6 (Strongly agree) with the statement "I understood the concepts and skills presented in ACT Guide." This is a novel user experience item specific to this study.

  9. Novel user experience item 4

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked to rate agreement from 1 (Strongly disagree) to 6 (Strongly agree) with the statement "I was able to apply skills I learned in ACT Guide to my personal struggles and daily life." This is a novel user experience item specific to this study.

  10. Novel user experience item 5

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked to rate agreement from 1 (Strongly disagree) to 6 (Strongly agree) with the statement "I was able to identify and problem solve barriers to using ACT Guide." This is a novel user experience item specific to this study.

  11. Novel user experience item 6

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked to rate agreement from 1 (Strongly disagree) to 6 (Strongly agree) with the statement "Many college students who struggle with mental health issues use self-help resources like ACT Guide for support." This is a novel user experience item specific to this study.

  12. Novel user experience item 7

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked to rate agreement from 1 (Strongly disagree) to 6 (Strongly agree) with the statement "People would judge me negatively if they found out I was using ACT Guide." This is a novel user experience item specific to this study.

  13. Novel user experience item 8

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked to rate agreement from 1 (Strongly disagree) to 6 (Strongly agree) with the statement "College students approve of the use of self-help resources like ACT Guide for addressing mental health issues." This is a novel user experience item specific to this study.

  14. Novel coaching experience item 1

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked to rate agreement from 1 (Strongly disagree) to 6 (Strongly agree) with the statement "I would have preferred using ACT Guide without a coach." This is a novel coaching experience item specific to this study. Only administered to participants in either coaching condition.

  15. Novel coaching experience item 2

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked to rate agreement from 1 (Strongly disagree) to 6 (Strongly agree) with the statement "ACT Guide would have been just as helpful to me without a coach." This is a novel user experience item specific to this study. Only administered to participants in either coaching condition.

  16. Novel coaching experience item 3

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked to rate agreement from 1 (Strongly disagree) to 6 (Strongly agree) with the statement "I would have preferred to receive coaching from a mental health professional." This is a novel user experience item specific to this study. Only administered to participants in either coaching condition.

  17. Novel coaching acceptability item 1

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked to rate "Coaching through phone calls" on a scale from 1 (Unacceptable) to 5 (Strongly preferred). This is a novel coaching acceptability item specific to this study. Only administered to participants in either coaching condition.

  18. Novel coaching acceptability item 2

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked to rate "Coaching through text messaging" on a scale from 1 (Unacceptable) to 5 (Strongly preferred). This is a novel coaching acceptability item specific to this study. Only administered to participants in either coaching condition.

  19. Novel coaching acceptability item 3

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked to rate "Coaching through email" on a scale from 1 (Unacceptable) to 5 (Strongly preferred). This is a novel coaching acceptability item specific to this study. Only administered to participants in either coaching condition.

  20. Novel coaching acceptability item 4

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked to rate "Coaching through videoconferencing software" on a scale from 1 (Unacceptable) to 5 (Strongly preferred). This is a novel coaching acceptability item specific to this study. Only administered to participants in either coaching condition.

  21. Novel coaching satisfaction item 1

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked "What was helpful about the coaching process?" to gather qualitative feedback on their respective coaching intervention. Only administered to participants in either coaching condition.

  22. Novel coaching satisfaction item 2

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked "What was unhelpful about the coaching process?" to gather qualitative feedback on their respective coaching intervention. Only administered to participants in either coaching condition.

  23. Novel coaching satisfaction item 3

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked "How did having another USU undergraduate be your coach affect the coaching process?" to gather qualitative feedback on their respective coaching intervention. Only administered to participants in either coaching condition.

  24. Novel coaching satisfaction item 4

    Time frame: Post-treatment (10 weeks after baseline)

    Participants will be asked "How can the coaching process be improved in the future?" to gather qualitative feedback on their respective coaching intervention. Only administered to participants in either coaching condition.

  25. Phone coaching adherence

    Time frame: Post-treatment (10 weeks after baseline)

    Number of coaching calls answered, out of a total of 10 calls. This is based on coaches call logs, and is not self-reported. Only applicable to participants in the phone coaching condition.

  26. Text coaching adherence

    Time frame: Post-treatment (10 weeks after baseline)

    Number of initial coaching text messages responded to, out of a total of 10 initial text messages (one sent per week, not including text messages continuing a conversation stemming from an initial text message). This is based on coaches text message logs, and is not self-reported. Only applicable to participants in the text message coaching condition.

Sponsors and collaborators

Lead sponsor

Utah State University

Other

Registry information

Important dates

Study start
2020
Primary completion
2021
Study completion
2021
First posted
Oct 5, 2020
Registry last updated
Sep 29, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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