Treating depression with a smartphone-delivered self-help cognitive behavioral therapy for insomnia: study protocol for a parallel group randomized controlled trial
Abstract Background Depression is a major public health concern. Emerging research has shown that cognitive behavioral therapy for insomnia (CBT-I) is effective in treating individuals with comorbid insomnia and depression. Traditional face-to-face CBT-I encounters many obstacles related to feasibil...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-10-01
|
| Series: | Trials |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13063-020-04778-1 |
| _version_ | 1818154334138925056 |
|---|---|
| author | Victoria Ka-Ying Hui Christy Yim-Fan Wong Eric Ka-Yiu Ma Fiona Yan-Yee Ho Christian S. Chan |
| author_facet | Victoria Ka-Ying Hui Christy Yim-Fan Wong Eric Ka-Yiu Ma Fiona Yan-Yee Ho Christian S. Chan |
| author_sort | Victoria Ka-Ying Hui |
| collection | DOAJ |
| description | Abstract Background Depression is a major public health concern. Emerging research has shown that cognitive behavioral therapy for insomnia (CBT-I) is effective in treating individuals with comorbid insomnia and depression. Traditional face-to-face CBT-I encounters many obstacles related to feasibility, accessibility, and help-seeking stigma. CBT-I delivered via smartphone application could be a potential solution. This paper reports a protocol designed to evaluate the efficacy of a self-help smartphone-based CBT-I, using a waitlist group as control, for people with major depression and insomnia. Methods A two-arm parallel randomized controlled trial is conducted in a target sample of 285 non-suicidal Hong Kong Chinese older than 17 years of age with major depression and insomnia. Participants complete an online rapid screening, followed by a telephone diagnostic interview. Those who meet the eligibility criteria are randomized in a ratio of 1:1 to receive either CBT-I immediately or to a waitlist control condition. The CBT-I consists of six weekly modules and is delivered through a smartphone application proACT-S. This smartphone app has been pilot tested and revamped to improve user experience. An online randomized algorithm is used to perform randomization to ensure allocation concealment. The primary outcomes are changes over the measurement points in sleep quality, insomnia severity, and depression severity. The secondary outcomes include changes over the measurement points in anxiety, subjective health, treatment expectancy, and acceptability of treatment. Assessments are administered at baseline, post-intervention, and 6-week follow-up. The recruitment is completed. Important adverse events, if any, are documented. Multilevel linear mixed model based on intention-to-treat principle will be conducted to examine the efficacy of the CBT-I intervention. Discussion It is expected that proACT-S is an efficacious brief sleep-focused self-help treatment for people with major depression and insomnia. If proven efficacious, due to its self-help nature, proACT-S may be applicable as a community-based early intervention, thereby reducing the burden of the public healthcare system in Hong Kong. Trial registration ClinicalTrials.gov NCT04228146 . Retrospectively registered on 14 January 2020. |
| first_indexed | 2024-12-11T14:24:51Z |
| format | Article |
| id | doaj.art-2639c272d8964d2497f0a3b7b3e15390 |
| institution | Directory Open Access Journal |
| issn | 1745-6215 |
| language | English |
| last_indexed | 2024-12-11T14:24:51Z |
| publishDate | 2020-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Trials |
| spelling | doaj.art-2639c272d8964d2497f0a3b7b3e153902022-12-22T01:02:43ZengBMCTrials1745-62152020-10-0121111210.1186/s13063-020-04778-1Treating depression with a smartphone-delivered self-help cognitive behavioral therapy for insomnia: study protocol for a parallel group randomized controlled trialVictoria Ka-Ying Hui0Christy Yim-Fan Wong1Eric Ka-Yiu Ma2Fiona Yan-Yee Ho3Christian S. Chan4Department of Psychology, The University of Hong KongDepartment of Psychology, The University of Hong KongDepartment of Psychology, The University of Hong KongDepartment of Psychology, The Chinese University of Hong KongDepartment of Psychology, The University of Hong KongAbstract Background Depression is a major public health concern. Emerging research has shown that cognitive behavioral therapy for insomnia (CBT-I) is effective in treating individuals with comorbid insomnia and depression. Traditional face-to-face CBT-I encounters many obstacles related to feasibility, accessibility, and help-seeking stigma. CBT-I delivered via smartphone application could be a potential solution. This paper reports a protocol designed to evaluate the efficacy of a self-help smartphone-based CBT-I, using a waitlist group as control, for people with major depression and insomnia. Methods A two-arm parallel randomized controlled trial is conducted in a target sample of 285 non-suicidal Hong Kong Chinese older than 17 years of age with major depression and insomnia. Participants complete an online rapid screening, followed by a telephone diagnostic interview. Those who meet the eligibility criteria are randomized in a ratio of 1:1 to receive either CBT-I immediately or to a waitlist control condition. The CBT-I consists of six weekly modules and is delivered through a smartphone application proACT-S. This smartphone app has been pilot tested and revamped to improve user experience. An online randomized algorithm is used to perform randomization to ensure allocation concealment. The primary outcomes are changes over the measurement points in sleep quality, insomnia severity, and depression severity. The secondary outcomes include changes over the measurement points in anxiety, subjective health, treatment expectancy, and acceptability of treatment. Assessments are administered at baseline, post-intervention, and 6-week follow-up. The recruitment is completed. Important adverse events, if any, are documented. Multilevel linear mixed model based on intention-to-treat principle will be conducted to examine the efficacy of the CBT-I intervention. Discussion It is expected that proACT-S is an efficacious brief sleep-focused self-help treatment for people with major depression and insomnia. If proven efficacious, due to its self-help nature, proACT-S may be applicable as a community-based early intervention, thereby reducing the burden of the public healthcare system in Hong Kong. Trial registration ClinicalTrials.gov NCT04228146 . Retrospectively registered on 14 January 2020.http://link.springer.com/article/10.1186/s13063-020-04778-1Major depressionInsomniaCognitive behavioral therapy for insomniaSleep disturbanceSmartphoneInternet intervention |
| spellingShingle | Victoria Ka-Ying Hui Christy Yim-Fan Wong Eric Ka-Yiu Ma Fiona Yan-Yee Ho Christian S. Chan Treating depression with a smartphone-delivered self-help cognitive behavioral therapy for insomnia: study protocol for a parallel group randomized controlled trial Trials Major depression Insomnia Cognitive behavioral therapy for insomnia Sleep disturbance Smartphone Internet intervention |
| title | Treating depression with a smartphone-delivered self-help cognitive behavioral therapy for insomnia: study protocol for a parallel group randomized controlled trial |
| title_full | Treating depression with a smartphone-delivered self-help cognitive behavioral therapy for insomnia: study protocol for a parallel group randomized controlled trial |
| title_fullStr | Treating depression with a smartphone-delivered self-help cognitive behavioral therapy for insomnia: study protocol for a parallel group randomized controlled trial |
| title_full_unstemmed | Treating depression with a smartphone-delivered self-help cognitive behavioral therapy for insomnia: study protocol for a parallel group randomized controlled trial |
| title_short | Treating depression with a smartphone-delivered self-help cognitive behavioral therapy for insomnia: study protocol for a parallel group randomized controlled trial |
| title_sort | treating depression with a smartphone delivered self help cognitive behavioral therapy for insomnia study protocol for a parallel group randomized controlled trial |
| topic | Major depression Insomnia Cognitive behavioral therapy for insomnia Sleep disturbance Smartphone Internet intervention |
| url | http://link.springer.com/article/10.1186/s13063-020-04778-1 |
| work_keys_str_mv | AT victoriakayinghui treatingdepressionwithasmartphonedeliveredselfhelpcognitivebehavioraltherapyforinsomniastudyprotocolforaparallelgrouprandomizedcontrolledtrial AT christyyimfanwong treatingdepressionwithasmartphonedeliveredselfhelpcognitivebehavioraltherapyforinsomniastudyprotocolforaparallelgrouprandomizedcontrolledtrial AT erickayiuma treatingdepressionwithasmartphonedeliveredselfhelpcognitivebehavioraltherapyforinsomniastudyprotocolforaparallelgrouprandomizedcontrolledtrial AT fionayanyeeho treatingdepressionwithasmartphonedeliveredselfhelpcognitivebehavioraltherapyforinsomniastudyprotocolforaparallelgrouprandomizedcontrolledtrial AT christianschan treatingdepressionwithasmartphonedeliveredselfhelpcognitivebehavioraltherapyforinsomniastudyprotocolforaparallelgrouprandomizedcontrolledtrial |