Mental Health Response to the COVID-19 Pandemic: Effectiveness of a Daily Supportive Text Message (Text4Hope) Program at Six Weeks in Reducing Stress, Anxiety, and Depression, and Impact of Demographic Factors and Self-isolation Status (Preprint) [post]

Vincent Israel Ouoku Agyapong, Marianne Hrabok, Wesley Vuong, Reham Shalaby, Jasmine Brown, April Gusnowski, Kelly Mrklas, Daniel Li, Liana Urichuk, Mark Snaterse, Shireen Surood, Bo Cao (+3 others)
2020 unpublished
BACKGROUND Background: In addition to the obvious medical (physical) impact of COVID-19, threats to mental health, psychological safety, and well-being are evident. Provision of support for these challenges is complicated by the high number of people requiring support and the need to maintain physical distancing. Text4Hope, a daily supportive texting messaging program was launched in Canada to mitigate the negative mental health impacts of the pandemic amongst Canadians. OBJECTIVE Objective:
more » ... CTIVE Objective: This paper aimed to describe the changes in stress, anxiety, and depression levels after 6-weeks of exposure to daily supportive text messages. Additionally, we aimed to identify associations between some demographic variables as well as self-isolation/self-quarantine status and the changes in stress, anxiety and depression levels. METHODS Methods: Self-administered, online, empirically-supported questionnaires were used to assess demographic and clinical characteristics of subscribers. Perceived stress, anxiety, and depression were measured with the Perceived Stress Scale (PSS), the Generalized Anxiety Disorder-7 (GAD-7) scale and the Patient Health Questionnaire-9 (PHQ-9) at baseline and 6-week time points. Moderate/high perceived stress, suspected GAD and MDD were assessed using cut-off scores of PSS ≥ 14, GAD-7 ≥ 10, and PHQ-9 ≥ 10, respectively. By the six-weeks into the program, 688 participants completed the questionnaires at both time points. RESULTS Results: At the 6-week time point, there were statistically significant reductions in mean scores on the PSS and GAD-7 scale but not the PHQ-9 scale. Effect sizes were small overall. There were statistically significant reductions in the prevalence rates for moderate/high stress, likely GAD, and likely MDD for the group that completed both the baseline and 6-week assessments and also for all subscribers. The biggest reduction in prevalence rates was for anxiety; 12.4% for those who completed both the baseline and 6-week surveys and 14.8% for all subscribers. CONCLUSIONS Conclusion: Text4Hope is a convenient, cost-effective, and accessible means for implementing a population-level psychological intervention, overall demonstrating comparable to superior outcomes compared to other remote interventions. This program demonstrated significant reduction in anxiety and stress during the COVD-19 pandemic and could be used as a population level mental health intervention during natural disasters and other emergencies. CLINICALTRIAL The study protocol was approved by the Research and Ethics Board of the University of Alberta (Pro00086163). INTERNATIONAL REGISTERED REPORT RR2-10.2196/19292
doi:10.2196/preprints.22423 fatcat:j63h3ae4orgevjxroi5lpslbbe