Reducing stress in the workplace using a digital intervention designed to improve employee wellbeing and help them stay engaged and productive in work

Plain English Summary

Background and study aims
Mental health problems affect one in six workers each year and are the leading cause of sickness absence, where stress, anxiety and depression are responsible for approximately half of the working days lost. The estimated annual cost of poor mental health has increased 16% since 2017, and is now up to £45 billion. It is estimated that approximately 41.8% of the UK population are at high risk of mental health problems due to their economic vulnerability and exposure to a negative economic shock as a result of the COVID-19 outbreak.
This project, funded by the Midlands Engine, comprises the initial pilot study of an intervention to improve workforce mental health and productivity as part of the Mental Health and Productivity Pilot program (https://mhpp.me/). REST is a digital intervention informed by cognitive behavioural therapy that aims to improve stress, depression and anxiety symptoms and productivity across the Midlands.

The aim of this study is to investigate how practical and feasible a multisite waitlist randomised trial would be in the Midlands to examines whether an iCBT treatment for mild to clinical levels of depression and anxiety reduces symptom severity for employees in the workplace. The study also aims to explore the feasibility of the methodological approach, focusing particularly upon:
1. The willingness of organisations to participate in a trial
2. The willingness of employees to participate in a trial
3. The adherence of participants to the treatment as measured through platform user data
4. Appropriateness of the analytical approach
5. Acceptability of the intervention based on participants experiences

The results of this study will be used to inform a future, fully powered RCT which will be undertaken to understand whether an iCBT treatment can help to reduce symptom severity and improve mental health for employees in the workplace. This trial therefore has a twofold contribution to the literature: it serves as an early indication of the potential benefits of iCBT in the workplace, and it provides evidence of the feasibility of this type of in-business trial in the Midlands and nationally for mental health and productivity. Such trials can inform improvements in employer mental health policies and practices, benefitting both the organisations and their employees.

Who can participate?
Adults over 18 years, currently in employment, who suffer from insomnia and anxiety but are not currently receiving treatment.

What does the study involve?
REST will last for 8 weeks using a randomised waitlist-controlled trial design, where the control group will receive the intervention after eight weeks.
Those in the REST intervention will be offered an 8-week self-guided, digital intervention. The intervention will consist of an hour weekly commitment. Those in the waitlist control group will be asked to continue life as usual for 8-week (i.e. they will not receive the 8-week digital intervention or provided with any other treatment). Subsequently, participants will be offered the 8-week digital intervention. Participants will then be contacted after two months to complete the follow-up questionnaires.
Overall, the REST trial will last for 4 months, if participants are initially placed in the intervention group (8 weeks in intervention arm + follow up after 2 months). If a participant is initially placed in the waitlist control group, they will be offered the intervention after an 8-week delay, and be in the study for 6 months (8 weeks in waitlist control arm + 8 weeks in intervention arm + follow up after 2 months)
Upon completion of the 8-week study period, a qualitative evaluation will be conducted of the 8-week intervention programme using semi-structured interviews, aiming to explore effectiveness, acceptability, barriers, and facilitators of the intervention. This will be completed with a randomly selected 25 participants, who have completed the intervention, and consented to be contacted again for the qualitative part of the study.

What are the possible benefits and risks of participating?
We do not anticipate any major disadvantages, side effects or risks in taking part in this study. The PHQ-9 questionnaire of the study asks about self-harming and suicidal behaviour (item 9), which would require participants to disclose sensitive information. In addition, scores between 15-28 on the ISI, and scores between 15-27 on the PHQ-9 and GAD-7 questionnaires may indicate clinically significant conditions. This could highlight an undiagnosed severe mental-health condition for which the participant is not receiving care.

Where is the study run from?
University of Warwick (UK)

When is the study starting and how long is it expected to run for?
January 2021 to April 2022

Who is funding the study?
Midlands Engine (UK)

Who is the main contact?
Charlotte Kershaw, Charlotte.Kershaw@warwick.ac.uk
Dr Carla Toro, Carla.Toro@warwick.ac.uk

Study website

Contact information

Study information

Eligibility

Locations

Countries of recruitment

• England
• United Kingdom

Study participating centres

Sponsor information

University of Warwick
University/education

University House
Coventry
C4 7AL
United Kingdom

Phone	+44 (0)2476 575386
Email	Sponsorship@warwick.ac.uk
Website	https://warwick.ac.uk/services/ris/research_integrity/sponsorship
"ROR"	https://ror.org/01a77tt86

Funders

Funder type

Government

Results and Publications

Study outputs

Additional files

ISRCTN31161020 BasicResults.pdf

Editorial Notes

26/05/2023: The basic results have been uploaded as an additional file.
18/05/2023: The intention to publish date was changed from 01/04/2023 to 30/06/2023.
06/01/2023: Publication reference added.
03/11/2022: Protocol (not peer reviewed), total final enrolment and IPD sharing statement added.
29/10/2021: The study hypothesis has been updated.
28/10/2021: The following changes have been made:
1. The recruitment end date has been changed from 30/10/2021 to 31/12/2021.
2. The study design has been changed from "Multicentre interventional waitlist randomized-controlled trial" to "Multicentre interventional waitlist randomized-controlled feasibility trial".
3. The primary outcome measure has been updated.
4. The secondary outcome measures have been updated.
5. The plain English summary has been updated.
15/09/2021: The recruitment end date was changed from 17/09/2021 to 30/10/2021.
17/05/2021: Trial's existence confirmed by University of Warwick.