Efficacy And Cost-Effectiveness Of A Web-Based Stress-Management Training In Employees – Results Of A Randomized Controlled Trial
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Abstract
Background: Work-related stress is associated with a variety of mental and emotional problems. Furthermore, it can lead to substantial economic costs due to lost productivity, absenteeism or the inability to work. Traditional face-to-face stress management interventions (SMIs) for employees have been proven to be effective; however, they are often costly, time-consuming, and characterized by a high access threshold. Web-based interventions may overcome some of these problems; yet the evidence in this field is not comprehensive.
Objective: The current study examines the efficacy and cost-effectiveness of a web-based guided stress-management training aimed at reducing stress in adult employees.
Methods: The study targets stressed adult employees. A randomized controlled trial (RCT) design is applied. Based on the power calculation d=.35 (1-β of 80 %, α = .05), 264 participants have been recruited and randomly assigned to either the intervention group or a six-month waitlist control group. Inclusion criteria include an elevated stress level (Cohen’s Perceived Stress Scale-10 ≥ 22) and current employment. Exclusion criteria include risk of suicide or previously diagnosed psychosis or dissociative symptoms. Perceived stress is assessed as the primary outcome. Secondary outcomes include depression, anxiety and emotional exhaustion. Data are collected at baseline and seven weeks and six months after randomization. An extended follow-up at 12 months is carried out for the intervention group. Moreover, a cost-effectiveness analysis will be conducted from a societal perspective and will include both direct and indirect health care costs. Data will be analyzed on an intention-to-treat basis and per protocol.
Results: Based on 80% of the participants, a distinct improvement of perceived stress could be found at post-test (Cohen’s d=0.85) and this effect appears to be maintained at 6 month follow-up. For a clinical relevant change in perceived stress, the number needed to treat according to reliable change is NNT=3.
Conclusions: Substantial negative consequences of work-related stress emphasize the necessity of effective stress management programs. If the current web-based intervention proves to be effective, an application as a preventative, economical stress management tool in the workplace health promotion is conceivable.
Objective: The current study examines the efficacy and cost-effectiveness of a web-based guided stress-management training aimed at reducing stress in adult employees.
Methods: The study targets stressed adult employees. A randomized controlled trial (RCT) design is applied. Based on the power calculation d=.35 (1-β of 80 %, α = .05), 264 participants have been recruited and randomly assigned to either the intervention group or a six-month waitlist control group. Inclusion criteria include an elevated stress level (Cohen’s Perceived Stress Scale-10 ≥ 22) and current employment. Exclusion criteria include risk of suicide or previously diagnosed psychosis or dissociative symptoms. Perceived stress is assessed as the primary outcome. Secondary outcomes include depression, anxiety and emotional exhaustion. Data are collected at baseline and seven weeks and six months after randomization. An extended follow-up at 12 months is carried out for the intervention group. Moreover, a cost-effectiveness analysis will be conducted from a societal perspective and will include both direct and indirect health care costs. Data will be analyzed on an intention-to-treat basis and per protocol.
Results: Based on 80% of the participants, a distinct improvement of perceived stress could be found at post-test (Cohen’s d=0.85) and this effect appears to be maintained at 6 month follow-up. For a clinical relevant change in perceived stress, the number needed to treat according to reliable change is NNT=3.
Conclusions: Substantial negative consequences of work-related stress emphasize the necessity of effective stress management programs. If the current web-based intervention proves to be effective, an application as a preventative, economical stress management tool in the workplace health promotion is conceivable.
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