Skip navigation
Skip navigation

Effectiveness and Cost-Effectiveness of a Self-Guided Internet Intervention for Social Anxiety Symptoms in a General Population Sample: Randomized Controlled Trial

Powell, John; Williams, Veronika; Atherton, Helen; Bennett, Kylie; Yang, Yaling; Davoudianfar, Mina; Hellsing, Annika; Martin, Angela; Mollison, Jill; Shanyinde, Milensu; Yu, Ly-Mee; Griffiths, Kathleen

Description

Background: Many people are accessing digital self-help for mental health problems, often with little evidence of effectiveness. Social anxiety is one of the most common sources of mental distress in the population, and many people with symptoms do not seek help for what represents a significant public health problem. Objective: This study aimed to evaluate the effectiveness of a self-guided cognitive behavioral internet intervention for people with social anxiety symptoms in the general...[Show more]

dc.contributor.authorPowell, John
dc.contributor.authorWilliams, Veronika
dc.contributor.authorAtherton, Helen
dc.contributor.authorBennett, Kylie
dc.contributor.authorYang, Yaling
dc.contributor.authorDavoudianfar, Mina
dc.contributor.authorHellsing, Annika
dc.contributor.authorMartin, Angela
dc.contributor.authorMollison, Jill
dc.contributor.authorShanyinde, Milensu
dc.contributor.authorYu, Ly-Mee
dc.contributor.authorGriffiths, Kathleen
dc.date.accessioned2021-02-05T04:54:14Z
dc.date.available2021-02-05T04:54:14Z
dc.identifier.citationPowell J, Williams V, Atherton H, Bennett K, Yang Y, Davoudianfar M, Hellsing A, Martin A, Mollison J, Shanyinde M, Yu LM, Griffiths KM Effectiveness and Cost-Effectiveness of a Self-Guided Internet Intervention for Social Anxiety Symptoms in a General Population Sample: Randomized Controlled Trial J Med Internet Res 2020;22(1):e16804 URL: http://www.jmir.org/2020/1/e16804/ doi: 10.2196/16804
dc.identifier.issn1438-8871
dc.identifier.urihttp://hdl.handle.net/1885/222104
dc.description.abstractBackground: Many people are accessing digital self-help for mental health problems, often with little evidence of effectiveness. Social anxiety is one of the most common sources of mental distress in the population, and many people with symptoms do not seek help for what represents a significant public health problem. Objective: This study aimed to evaluate the effectiveness of a self-guided cognitive behavioral internet intervention for people with social anxiety symptoms in the general population. Methods: We conducted a two-group randomized controlled trial in England between May 11, 2016, and June 27, 2018. Adults with social anxiety symptoms who were not receiving treatment for social anxiety were recruited using online advertisements. All participants had unrestricted access to usual care and were randomized in a 1:1 ratio to either a Web-based unguided self-help intervention based on cognitive behavioral principles or a waiting list control group. All outcomes were collected through self-report online questionnaires. The primary outcome was the change in 17-item Social Phobia Inventory (SPIN-17) score from baseline to 6 weeks using a linear mixed-effect model that used data from all time points (6 weeks, 3 months, 6 months, and 12 months). Results: A total of 2122 participants were randomized, and 6 were excluded from analyses because they were ineligible. Of the 2116 eligible randomized participants (mean age 37 years; 80.24%, 1698/2116 women), 70.13% (1484/2116) had follow-up data available for analysis, and 56.95% (1205/2116) had data on the primary outcome, although attrition was higher in the intervention arm. At 6 weeks, the mean (95% CI) adjusted difference in change in SPIN-17 score in the intervention group compared with control was −1.94 (−3.13 to −0.75; P=.001), a standardized mean difference effect size of 0.2. The improvement was maintained at 12 months. Given the high dropout rate, sensitivity analyses explored missing data assumptions, with results that were consistent with those of the primary analysis. The economic evaluation demonstrated cost-effectiveness with a small health status benefit and a reduction in health service utilization. Conclusions: For people with social anxiety symptoms who are not receiving other forms of help, this study suggests that the use of an online self-help tool based on cognitive behavioral principles can provide a small improvement in social anxiety symptoms compared with no intervention, although dropout rates were high.
dc.description.sponsorshipThis work was funded by the MQ: Transforming Mental Health charity under its PsyIMPACT funding call (MQ14PE_25). JP is also funded by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Oxford at Oxford Health NHS Foundation Trust. YY is supported by the National Institute for Health Research Oxford Biomedical Research Centre. KG was supported by a National Health & Medical Research Council Senior Research Fellowship.
dc.format.mimetypeapplication/pdf
dc.language.isoen_AU
dc.publisherJournal of medical Internet Research
dc.rights© 2020 John Powell, Veronika Williams, Helen Atherton, Kylie Bennett, Yaling Yang, Mina Davoudianfar, Annika Hellsing, Angela Martin, Jill Mollison, Milensu Shanyinde, Ly-Mee Yu, Kathleen M Griffiths
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.sourceJournal of Medical Internet Research
dc.subjectrandomized controlled trial
dc.subjectinternet
dc.subjectself-care
dc.subjectsocial anxiety
dc.titleEffectiveness and Cost-Effectiveness of a Self-Guided Internet Intervention for Social Anxiety Symptoms in a General Population Sample: Randomized Controlled Trial
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolume22
dcterms.dateAccepted2019-12-10
dc.date.issued2020-01-10
local.identifier.absfor170202 - Decision Making
local.identifier.ariespublicationu6269649xPUB674
local.type.statusPublished Version
local.contributor.affiliationPowell, John, University of Oxford
local.contributor.affiliationWilliams, Veronika, Nipissing University
local.contributor.affiliationAtherton, Helen, University of Warwick
local.contributor.affiliationBennett, Kylie, eHub Health Pty Ltd
local.contributor.affiliationYang, Yaling, University of Oxford
local.contributor.affiliationDavoudianfar, Mina, University of Oxford
local.contributor.affiliationHellsing, Annika, College of Health and Medicine, ANU
local.contributor.affiliationMartin, Angela, University of Oxford
local.contributor.affiliationMollison, Jill, University of Oxford
local.contributor.affiliationShanyinde, Milensu, University of Oxford
local.contributor.affiliationYu, Ly-Mee, University of Oxford
local.contributor.affiliationGriffiths, Kathleen, College of Health and Medicine, ANU
local.bibliographicCitation.issue1
local.bibliographicCitation.startpage1
local.bibliographicCitation.lastpage12
local.identifier.doi10.2196/16804
local.identifier.absseo920203 - Diagnostic Methods
dc.date.updated2020-11-02T04:27:44Z
local.identifier.scopusID2-s2.0-85077762234
dcterms.accessRightsOpen Access
dc.provenanceThis is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited.
dc.rights.licenseCreative Commons Attribution License
CollectionsANU Research Publications

Download

File Description SizeFormat Image
01_Powell_Effectiveness_and_2020.pdf310.81 kBAdobe PDFThumbnail


This item is licensed under a Creative Commons License Creative Commons

Updated:  19 May 2020/ Responsible Officer:  University Librarian/ Page Contact:  Library Systems & Web Coordinator