Plain English Summary
Background and study aims
Depression affects people in different ways including feeling hopeless and losing interest in activities. It is one of the most common mental health conditions but available treatments meet just 15% of the need. Many people are on treatment waiting lists, have dropped out of treatment, or do not meet the threshold to access services. This is a problem because without help symptoms of depression can get worse. There is a need for basic treatments that people with symptoms of depression can easily access. This study aims to find out how acceptable and feasible a basic online support tool for people with depression is. The website uses ideas from positive psychology, which suggests that depression can be improved by promoting positive emotions, use of personal strengths and a sense of meaning and connection with others.
Who can participate?
People experiencing depression who are over 18, who can regularly access the internet, who can understand English and who have capacity to consent can take part.
What does the study involve?
This intervention comprises a self-help website, containing activities to promote strengths, positive emotions and social connections for people with depression. The activities in the website are adapted from those used in positive psychotherapy. The website is intended to be accessed independently by people with depression, to support them as and when they need it. It has been designed to complement, not replace, existing provision for common mental health conditions. As such people using the website may also be receiving treatment from their GP or psychiatrist, which may include taking medication or accessing counselling or psychological services. Participants are given access to the website for 6 weeks. When they first access the website participants see the four sections of the website, which contain a total of six discrete interventions; finding strengths, others finding strengths and a strengths plan; good things log; savouring activity; practicing positive communication; saying thanks; and sharing strengths. After being introduced to these exercises, participants are encouraged to select interventions which they feel they want to try. They are encouraged to use the website flexibly, although there is a recommendation that it may be helpful to pick a minimum of one activity to practice per week (on average this will be one hour in total).
What are the possible benefits and risks of participating?
We expect that the Uplift website will be beneficial to patients as it uses principles of positive psychology, which evidence suggests reduces depression and improves wellbeing. Study participants will continue to receive treatment as usual and at no point will treatment be compromised. Consequently, no harms or risks are expected from this low-intensity intervention. In order to reimburse participants for their time spent completing questionnaires they will receive a £10 Amazon voucher per questionnaire. Previous research has suggested this level of compensation can increase follow up rates in online studies. A subsample of participants will be invited to an in-person interview to provide more in-depth feedback on the intervention. As this requires a greater burden in terms of travel and participant time participants will be reimbursed £20.
Where is the study run from?
East London NHS Foundation Trust (UK)
When is the study starting and how long is it expected to run for?
March 2016 to January 2017
Who is funding the study?
East London NHS Foundation Trust (UK)
Who is the main contact?
Sophie Walsh
sophie.walsh@elft.nhs.uk
Trial website
Contact information
Type
Public
Primary contact
Miss Sophie Walsh
ORCID ID
http://orcid.org/0000-0002-7759-4674
Contact details
Unit for Social and Community Psychiatry
WHO Collaborating Centre for Mental Health Service Development
Queen Mary University of London
Newham Centre for Mental Health
London
E13 8SP
United Kingdom
+44 (0)207 540 4380 (extension 2309)
sophie.walsh@elft.nhs.uk
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
2016_05_18 v1.0
Study information
Scientific title
Self-help ‘Uplift’ website for depression: a feasibility study of a website using principles of positive psychology for people with symptoms of depression
Acronym
Study hypothesis
The overall aim of this study is to assess the feasibility and acceptability of a flexible self-help website using exercises from positive psychotherapy for people with symptoms of depression. The research will use a pre-post study design and collect a mixture of quantitative and qualitative data. The study objectives are to:
1. Establish the patterns of use of the website
2. Understand participants’ views on the ease of use and helpfulness of the website
3. Establish if and how personal characteristics of participants are associated with website use
4. Estimate the variability in possible outcome measures (e.g. symptoms of depression, satisfaction with life)
5. Explore potential for change in outcomes
Ethics approval
North West - Greater Manchester West Research Ethics Committee, 09/06/2016, ref: 16/NW/0447
Study design
Single-centre pre-post study
Primary study design
Interventional
Secondary study design
Feasibility study
Trial setting
Internet
Trial type
Treatment
Patient information sheet
Condition
Depression
Intervention
This intervention comprises a self-help website, containing six activities to promote strengths, positive emotion and social connections for people with depression. The activities in the website are adapted from those used in positive psychotherapy.
Participants will have access for six weeks and be advised to practice one activity per week, although they are able to use the site flexibly.
Intervention type
Other
Phase
Drug names
Primary outcome measure
The feasibility and acceptability of the intervention will be measured by assessing:
1. Number of website log ins (during six weeks of intervention)
2. Number of times data submitted to the website (during six weeks of intervention)
3. Intervention satisfaction, benefits (after six weeks of intervention)
Secondary outcome measures
The following outcomes will be measured before the intervention and after 6 weeks of using it in order to assess variability in outcomes and potential for change:
1. Depressive symptoms (PHQ-9) (Kroenke et al., 2001)
2. Life satisfaction (DIALOG) (Priebe et al., 2007)
Overall trial start date
14/03/2016
Overall trial end date
31/01/2017
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
1. Aged over 18 years
2. Have regular access to the internet
3. Have sufficient command of English to complete the measures
4. Endorse one of the Whooley screening items for depression
5. Have capacity to consent
Participant type
Patient
Age group
Adult
Gender
Both
Target number of participants
100
Participant exclusion criteria
This study has no exclusion criteria as the aim is to be as inclusive as possible. A recent review into how exclusion criteria are used in depression treatment research found that studies excluded between 75-85% of people with depression (Halvorson & Humphreys, 2015). This makes it difficult to generalise from research to the typical clinical population and is something the present study wishes to avoid by having an inclusive sample.
Recruitment start date
01/08/2016
Recruitment end date
01/12/2016
Locations
Countries of recruitment
United Kingdom
Trial participating centre
East London NHS Foundation Trust
Trust Headquarters
9 Alie Street
London
E1 8DE
United Kingdom
Funders
Funder type
Hospital/treatment centre
Funder name
East London NHS Foundation Trust (UK)
Alternative name(s)
Funding Body Type
Funding Body Subtype
Location
Results and Publications
Publication and dissemination plan
The results of this research study will be used in a doctoral thesis submitted to the Queen Mary University of London. It is hoped the results will be published in scientific journals and this will be shared widely via open access publications and using the department's Twitter account. Participants in the study will receive a summary of findings if they wish. Findings will also be shared with SUGAR, the service user and carer advisory group within City University and East London NHS Foundation Trust and disseminated via their newsletters and social media accounts.
IPD sharing statement:
Anonymised study data will be made available on request, subject to data sharing agreement from the lead researcher Sophie Walsh (sophie.walsh@qmul.ac.uk)
Intention to publish date
01/09/2017
Participant level data
Available on request
Basic results (scientific)
Publication list
2018 results in: https://www.sciencedirect.com/science/article/pii/S2214782918300083