A Web-Based Approach to Managing Stress and Mood Disorders in the Workforce
Open accessAbstract
OBJECTIVE: To evaluate the effectiveness of a web-based multimedia health promotion program for the workplace, designed to help reduce stress and to prevent depression, anxiety, and substance abuse. METHODS: Using a randomized controlled trial design, 309 working adults were randomly assigned to the web-based condition or to a wait-list control condition. All participants were assessed on multiple self-reported outcomes at pretest and posttest. RESULTS: Relative to controls, the web-based group reduced their stress, increased their knowledge of depression and anxiety, developed more positive attitudes toward treatment, and adopted a more healthy approach to alcohol consumption. CONCLUSIONS: We found that a brief and easily adaptable web-based stress management program can simultaneously reduce worker stress and address stigmatized behavioral health problems by embedding this prevention material into a more positive stress management framework.
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- Method
The intervention begins with stress management because stress is common, relatively nonstigmatized, and linked to depression, anxiety, and substance use.
“Because stress is a highly prevalent, yet relatively nonstigmatized problem with clear connections to depression, anxiety, and substance use,15 the program begins with the stress management module, and it serves as a gateway to the other more stigmatized content learning areas.”
Quote in the paperNot yet classified0 of 1 sources checked- cites [15] source
Checked before — its earlier verdict is held back until a new check runs.
- Finding
At baseline, participants reported very little mood disturbance.
“As expected, participants were functioning quite well, reporting very little mood disturbance.”
Quote in the paperNot yet classified - Finding
The study's principal limitation was the modest effect sizes.
“The principal limitation of the study was the modest effect sizes.”
Quote in the paperNot yet classified - Finding
The discussion states that the web-based program reduced stress and binge drinking and increased understanding of anxiety and depression.
“Compared to controls, participants who used the web-based program showed reductions on measures of stress and binge drinking. In addition, experimental participants increased their understanding of the signs and symptoms of anxiety and depression.”
Quote in the paperNot yet classified - Finding
Web participants showed a more healthy approach to drinking, with positive movement on the binge drinking stage of change measure.
“As predicted, web participants adopted a more healthy approach to drinking as compared to control, showing positive movement on the binge drinking stage of change measure (F = 7.57, P < 0.01).”
Quote in the paperNot yet classified
- Finding
Randomization produced groups with no significant baseline differences on demographics or pretest dependent measures.
“No significant differences were found (all Ps >0.05).”
Quote in the paperNot yet classified - Finding
Participants who used the web-based program improved their knowledge about the early warning signs, prevention, and treatment of stress, anxiety, and depression compared to controls.
“As predicted, participants who used the web-based program improved their knowledge about the early warning signs, prevention, and treatment of stress, anxiety, and depression compared to controls (F = 4.24, P < 0.05; see Table 2).”
Quote in the paperNot yet classified - Finding
The web-based program led to a significant reduction in stress compared with controls.
“Despite reporting very low levels of stress at baseline, participants using the web-based program experienced a significant reduction in stress compared to controls (F = 5.23, P < 0.05; see Table 3).”
Quote in the paperNot yet classified - Finding
The authors argue that embedding depression and anxiety content within a web-based stress management program can reduce stress and substance use while improving knowledge and skills for handling mood problems.
“these findings indicate that imbedding segments on depression and anxiety within a web-based stress management program will not only lead to a reduction in stress and substance use, but also improve skills and knowledge about how to handle problems of depression and anxiety.”
Quote in the paperNot yet classified - Finding
The sample was predominantly young, female, highly educated, and half reported annual income above $100,000.
“The sample was predominantly young, female, highly educated, and half reported an annual income of over $100,000 (see Table 1).”
Quote in the paperNot yet classified - Finding
The experimental group developed a more positive attitude toward seeking psychological help than the control group.
“Similarly, the experimental group gained a more positive attitude toward seeking psychological help as compared to the control group (F = 5.28, P < 0.05).”
Quote in the paperNot yet classified - Finding
The program did not produce significant differences in depression, anxiety, or mood.
“There were no other significant group differences in depression, anxiety, or mood (all ps >0.05).”
Quote in the paperNot yet classified - Finding
Although 21% of pretest completers did not complete the posttest, baseline knowledge about managing stress and mood was associated with study completion.
“There was a moderate amount of attrition from pretest to posttest, as 64 subjects (21%) who completed the pretest did not complete the post-test.”
Quote in the paperNot yet classified - Finding
The web-based group reduced stress, increased knowledge about depression and anxiety, developed more positive attitudes toward treatment, and adopted a healthier approach to alcohol consumption relative to controls.
“Relative to controls, the web-based group reduced their stress, increased their knowledge of depression and anxiety, developed more positive attitudes toward treatment, and adopted a more healthy approach to alcohol consumption.”
Quote in the paperNot yet classified - Finding
Participants who viewed the program appeared to improve their ability to handle time and scheduling demands at work, though the effect was only marginal.
“Specifically, participants who viewed the program appeared to improve their ability to handle the time and scheduling demands of their job as compared to controls, (F = 3.85, P < 0.10; see Table 5).”
Quote in the paperNot yet classified - Finding
The authors conclude that a brief, easily adaptable web-based stress management program can reduce worker stress while also addressing stigmatized behavioral health problems by embedding prevention content within a positive stress management framework.
“We found that a brief and easily adaptable web-based stress management program can simultaneously reduce worker stress and address stigmatized behavioral health problems by embedding this prevention material into a more positive stress management framework.”
Quote in the paperNot yet classified - Finding
The authors conclude that Internet delivery increased privacy and flexibility while potentially lowering costs and making workplace adoption easier.
“By delivering the program over the Internet, user privacy was further increased while allowing for greater flexibility, potentially lower costs, and ease of adoption for the workplace.”
Quote in the paperNot yet classified - Background
Stress management programs are described as a promising vehicle for disseminating information about stigmatized behavioral health issues such as substance abuse, depression, and anxiety.
“Stress management programs, in particular, seem to be a promising vehicle for disseminating information about such behavioral health issues.”
Quote in the paperNot yet classified0 of 1 sources checked- cites [14]
Not checked in the free run.
- Method
The study aimed to evaluate whether a web-based multimedia workplace health promotion program could reduce stress and prevent depression, anxiety, and substance abuse.
“To evaluate the effectiveness of a web-based multimedia health promotion program for the workplace, designed to help reduce stress and to prevent depression, anxiety, and substance abuse.”
Quote in the paperNot yet classified - Method
Stress and Mood Management is a web-based, multimedia health promotion program designed to help working adults manage stress, prevent mood problems, and seek early identification and treatment of depression and anxiety when appropriate.
“Stress and Mood Management is a web-based, multimedia health promotion program designed to help working adults manage their stress, prevent mood problems, and seek early identification and treatment of depression and anxiety when appropriate.”
Quote in the paperNot yet classified - Method
The study constructed a 22-item scale to measure knowledge about the early identification, prevention, and treatment of stress, anxiety, and mood disorders.
“A 22-item scale measuring knowledge about the early identification, prevention, and treatment of stress, anxiety, and mood disorders was constructed for this study.”
Quote in the paperNot yet classified - Method
The program uses cognitive-behavioral techniques including goal setting, problem solving, identifying and testing negative thoughts, relaxation, and time management.
“The program utilizes an array of cognitive-behavioral techniques such as goal setting, problem solving, identifying and testing negative thoughts, relaxation, and time management.”
Quote in the paperNot yet classified - Method
The trial used a randomized controlled design in which 309 working adults were assigned to either the web-based intervention or a wait-list control condition.
“Using a randomized controlled trial design, 309 working adults were randomly assigned to the web-based condition or to a wait-list control condition.”
Quote in the paperNot yet classified - Method
Participants were recruited from a major technology company in the Mid-Atlantic region through a company listserv email and a health fair at the worksite.
“Participants were recruited from a major technology company in the Mid-Atlantic region via two mechanisms. First, all employees on a company list serve focusing on corporate health and activity promotion were sent an e-mail describing the current study. Second, employees attending a health fair were recruited at the worksite.”
Quote in the paperNot yet classified - Method
Participants in the web condition received access to the program for 3 months and were instructed to review the sections most relevant to their health needs and interests.
“Participants in the web condition were given access to the program for 3 months, and were encouraged to review the sections of Stress and Mood Management most relevant to their health needs and interests.”
Quote in the paperNot yet classified
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Most interventions (18/28, 64%) focused on reducing stress and depressive symptoms in employees.
“Most interventions (18/28, 64%) were focused on reducing stress [21-35] and depressive symptoms [23,31,36-39] in employees.”
From Acceptability of Web-Based Mental Health Interventions in the Workplace: Systematic Review (2022) · cites this paper as [22]
Convening groups at scheduled times can impede the implementation of interventions for any occupational group, and this is especially problematic for nurses due to their mobility and need for immediate responsiveness to patient needs.
“Convening groups at scheduled times can be an impediment to implementing interventions with any occupational group (Cook & Schlenger, 2002; Snow et al., 2003; Billings et al., 2008), but it is especially problematic for nurses whose duties require an unusual amount of mobility and immediate responsiveness to patient needs (Chesak et al, 2015; Hersch et al., 2009).”
From Reducing nurses' stress: A randomized controlled trial of a web-based stress management program for nurses (2016) · cites this paper as Billings et al., 2008
There were only marginal changes in work productivity and no change in mood, anxiety, and depression compared with the control group for the brief self-paced multimedia intervention.
“although there were only marginal changes in work productivity and no change in mood, anxiety, and depression compared with the control group”
From Web-based interventions for the management of stress in the workplace: Focus, form, and efficacy (2017) · cites this paper as [44]
In the Stress Free Now trial, improvements ranged from medium to large in size (d = 0.5-0.8) compared with controls and were maintained at 16-week follow-up, except for mindfulness in WSM2 group and professional efficacy and emotional role functioning in the WSM and WSM2 groups.
“Improvements ranged from medium to large in size (d = 0.5-0.8) compared with controls and were maintained 16-week follow-up, except for mindfulness in WSM2 group and professional efficacy and emotional role functioning in the WSM and WSM2 groups.”
From Web-based interventions for the management of stress in the workplace: Focus, form, and efficacy (2017) · cites this paper as [44]
In the Stress Free Now trial, there was no change in productivity or professional efficacy.
“There was no change in productivity or professional efficacy.”
From Web-based interventions for the management of stress in the workplace: Focus, form, and efficacy (2017) · cites this paper as [44]
In the Stress Free Now trial, effect sizes were larger for participants who received group support than did not on all outcome measures except for productivity (d = 0.8 versus d = 0.4 at 8 weeks and d = 0.7 versus d = 0.4 at 16 weeks).
“Effect sizes were larger for participants who received group support than did not on all outcome measures except for productivity (d = 0.8 versus d = 0.4 at 8 weeks and d = 0.7 versus d = 0.4 at 16 weeks).”
From Web-based interventions for the management of stress in the workplace: Focus, form, and efficacy (2017) · cites this paper as [44]
In the Stress Free Now trial, perceived stress was the only outcome to improve for the control group.
“Perceived stress was the only outcome to improve for the control group.”
From Web-based interventions for the management of stress in the workplace: Focus, form, and efficacy (2017) · cites this paper as [44]
In the Stress Free Now trial, significant improvement on all outcome measures of stress, burnout, and mindfulness were found postintervention for all intervention groups.
“Significant improvement on all outcome measures of stress, burnout, and mindfulness were found postintervention for all intervention groups.”
From Web-based interventions for the management of stress in the workplace: Focus, form, and efficacy (2017) · cites this paper as [44]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Negative coping scale described as 5-point but ranged 1 to 4
MinorThe negative coping measure is said to use a 5-point Likert scale, but the stated response options run from 1 to 4. The numeric range corresponds to four points, not five.
Reported 5 · recomputed 3
“Participants responded on a 5-point Likert scale ranging from 1 (never) to 4 (always) as to how often they used each coping strategy during the past 30 days (baseline internal consistency reliability = 0.74).”
Likert scale range is internally inconsistent for mood measure
MinorThe mood measure is described as a 5-point Likert scale, but the endpoints given span only 1 to 4. That makes the stated scale length inconsistent with the numeric range.
Reported 5 · recomputed 3
“Participants responded on a 5-point Likert scale ranging from 1 (very slightly or not at all) to 4 (extremely) as to how often they felt each mood item during the past 30 days.”
Mood response scale has conflicting point count and endpoints
MinorThe mood measure is described as a five-point Likert scale, but its stated endpoints run from 1 to 4, which provide only four integer response values.
“Participants responded on a 5-point Likert scale”
“ranging from 1 (very slightly or not at all) to 4 (extremely)”
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“prevention to be delivered by interweaving this material into stress management techniques, a finding that parallels the results of previous studies of nonweb-based interventions.(28,35) In addition, depression and anxiety items were embedded within the stress assessment segment to identify users who could benefit fro…”
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ResultSelf-citationA workplace coping-skills intervention to prevent alcohol abuse.
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“Seventeen (81%) of the interventions included in the studies used a website as their primary means of delivering the intervention [42-54,56-59], 2 (10%) delivered the intervention via a computer application [41,60], 1 (5%) via email [39], and one (5%) through a standalone computer [55].”
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Mass media interventions for reducing mental health-related stigma
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“Of these studies, there were 268 unique RCTs that were self-help Internet-based interventions; and of the 268 studies, there were 57 trials demonstrating a health benefit with a functional website [77-138].”
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Heber, E., Lehr, D., Ebert, D. D., Berking, M., & Riper, H. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5112 · Cited by 213 · see citing works
“Guided iSMIs [16-18] appear to be more effective than unguided interventions [21,22,57,58], a result that is known from Web-based interventions for other mental health problems [59].”
Tan, L., Wang, M.-J., Modini, M., Joyce, S., Mykletun, A., Christensen, H., & Harvey, S. B. (2014) · BMC Medicine · doi:10.1186/1741-7015-12-74 · Cited by 208 · see citing works
“A further independent appraisal (by LT and SH) of the full text version of these articles resulted in 17 studies meeting the criteria for quality assessment [35-50].”
BackgroundMethodEbert, D. D., Heber, E., Berking, M., Riper, H., Cuijpers, P., Funk, B., & Lehr, D. (2016) · Occupational and Environmental Medicine · doi:10.1136/oemed-2015-103269 · Cited by 176 · see citing works
Phillips, E. A., Gordeev, V. S., & Schreyögg, J. (2019) · Scandinavian Journal of Work, Environment & Health · doi:10.5271/sjweh.3839 · Cited by 148 · see citing works
Ebert, D. D., Berking, M., Thiart, H., Riper, H., Laferton, J. A. C., Cuijpers, P., Sieland, B., & Lehr, D. (2015) · Health Psychology · doi:10.1037/hea0000277 · Cited by 161 · see citing works
Hersch, R. K., Cook, R. F., Deitz, D. K., Kaplan, S., Hughes, D., Friesen, M. A., & Vezina, M. (2016) · Applied Nursing Research · doi:10.1016/j.apnr.2016.04.003 · Cited by 159 · see citing works
“…groups at scheduled times can be an impediment to implementing interventions with any occupational group (Cook & Schlenger, 2002; Snow et al., 2003; Billings et al., 2008), but it is especially problematic for nurses whose duties require an unusual amount of mobility and immediate responsiveness…”
BackgroundSelf-citationStress management interventions for college students: A systematic review and meta-analysis.
Amanvermez, Y., Rahmadiana, M., Karyotaki, E., de Wit, L. D., Ebert, D., Kessler, R., & Cuijpers, P. (2020) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12342 · Cited by 163 · see citing works
Zarski, A.-C., Lehr, D., Berking, M., Riper, H., Cuijpers, P., & Ebert, D. D. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.4493 · Cited by 114 · see citing works
“Internet-based stress management interventions for employees show promising effects in reducing stress and related health problems such as depression [15-19].”
Does internet-based prevention reduce the risk of relapse for anorexia nervosa?
Fichter, M. M., Quadflieg, N., Nisslmüller, K., Lindner, S., Osen, B., Huber, T., & Wünsch‐Leiteritz, W. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.12.003 · Cited by 117 · see citing works
Mayo-Wilson, E., & Montgomery, P. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005330.pub4 · Cited by 112 · see citing works
Imamura, K., Kawakami, N., Furukawa, T. A., Matsuyama, Y., Shimazu, A., Umanodan, R., Kawakami, S., & Kasai, K. (2014) · PLoS ONE · doi:10.1371/journal.pone.0097167 · Cited by 104 · see citing works
“The effect sizes for knowledge were better than the one reported by a previous worksite-based study [40].”
ResultHeber, E., Ebert, D. D., Lehr, D., Nobis, S., Berking, M., & Riper, H. M. (2013) · BMC Public Health · doi:10.1186/1471-2458-13-655 · Cited by 89 · see citing works
“However, only few studies have investigated the potential of webbased stress-management interventions in employees [22-27].”
BackgroundInfluentialStress Level, Health Behaviors, and Quality of Life in Employees Joining a Wellness Center
Clark, M. M., Warren, B. A., Hagen, P. T., Johnson, B. D., Jenkins, S. M., Werneburg, B. L., & Olsen, K. D. (2011) · American Journal of Health Promotion · doi:10.4278/ajhp.090821-quan-272 · Cited by 100 · see citing works
Sin, J., Galeazzi, G. M., McGregor, E., Collom, J., Taylor, A. F., Barrett, B. M., Lawrence, V. C., & Henderson, C. (2020) · Journal of Medical Internet Research · doi:10.2196/20581 · Cited by 80 · see citing works
“Outcomes with validated measures Comparisons (n), gender distributionc (%F/M/other), and age Intervention approach (n)b, gender distri- butionc (%F/M/other), and age Targeted CMDaReference; country AHSQe, PHQ-9f, GHSQg, AQoL-4Dh No tailored feedback, just generic advice (n=1431, US) Web-based assessment with tailored…”
BackgroundInfluentialPrevention interventions of alcohol problems in the workplace.
Ames, G. M., & Bennett, J. B. (2011) · Europe PMC (PubMed Central) · Cited by 105 · see citing works
Sakuraya, A., Imamura, K., Watanabe, K., Asai, Y., Ando, E., Eguchi, H., Nishida, N., Kobayashi, Y., Arima, H., Iwanaga, M., et al. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.528656 · Cited by 75 · see citing works
“Int: 42 (11.4) Cont: 38 (12.1) Tailored online interventions based on CBT Period: 6 weeks−12 months Number and hours of session: 4–8 weekly sessions Instrument: web site and e-mail Provider: not listed Positive mental health (The Mental Health Continuum—Short Form): Eudemonic Positive mental health: + PSYCHOLOGY (CB B…”
BackgroundMethodInfluentialLehr, D., Geraedts, A. S., Asplund, R. P., Khadjesari, Z., Heber, E., de Bloom, J., Ebert, D. D., Angerer, P., & Funk, B. (2016) · Springer eBooks · doi:10.1007/978-3-319-32331-2_19 · Cited by 64 · see citing works
A Web-based health promotion program for older workers : Randomized controlled trial
Cook, R. F., Hersch, R. K., Schlossberg, D., & Leaf, S. L. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.3399 · Cited by 71 · see citing works
“Research on Web-based programs indicates that such approaches can be an effective means of contributing to positive changes in diet, physical activity, stress management, and substance misuse [14-19].”
InfluentialSelf-citationStratton, E., Lampit, A., Choi, I., Gavelin, H. M., Aji, M., Taylor, J., Calvo, R. A., Harvey, S. B., & Glozier, N. (2022) · Journal of Medical Internet Research · doi:10.2196/37776 · Cited by 57 · see citing works
Alcohol and Illicit Drug Use in the Workforce and Workplace
Frone, M. R. (2010) · American Psychological Association eBooks · doi:10.2307/j.ctv1chs29w.20 · Cited by 59 · see citing works
Stansfeld, S. A., Kerry, S., Chandola, T., Russell, J., Berney, L., Hounsome, N., Lanz, D., Costelloe, C., Smuk, M., & Bhui, K. (2015) · BMJ Open · doi:10.1136/bmjopen-2015-007981 · Cited by 53 · see citing works
“4) Intervention 224 72 (20) 71 (21) −1.”
Moe-Byrne, T., Shepherd, J., Merecz-Kot, D., Sinokki, M., Naumanen, P., Hakkaart-van Roijen, L., & Van Der Feltz-Cornelis, C. (2022) · PLOS Digital Health · doi:10.1371/journal.pdig.0000123 · Cited by 55 · see citing works
“Three studies (four publications as mentioned above) included in this review designed their digital interventions to increase wellbeing and act as preventative interventions for mental health problems such as anxiety and depression, rather than treating these conditions [43,46,48,49].”
BackgroundMethodInfluentialDigital mHealth Interventions for Employees
Stratton, E., Jones, N. M., Peters, S. E., Torous, J. B., & Glozier, N. (2021) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000002267 · Cited by 49 · see citing works
Brief Report: A Web-Based Mental Health Program: Reaching Parents at Work
Deitz, D., Cook, R. F., Billings, D. W., & Hendrickson, A. (2008) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsn108 · Cited by 49 · see citing works
“education ( Billings, Cook, Hendrickson, & Dove, 2008; Christensen, Griffiths, & Korten, 2002; Evers, 2006).”
Self-citationSvärdman, F., Sjöwall, D., & Lindsäter, E. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100553 · Cited by 47 · see citing works
“7 management training programs or employee health-promotion programs (e.g. Umanodan et al., 2014; Billings et al., 2008) to targeted samples with elevated stress, depression and anxiety.”
BackgroundTest of a Web-Based Program to Improve Adherence to HIV Medications
Hersch, R. K., Cook, R. F., Billings, D. W., Kaplan, S. A., Murray, D. M., Safren, S. A., Goforth, J., & Spencer, J. (2013) · AIDS and Behavior · doi:10.1007/s10461-013-0535-8 · Cited by 44 · see citing works
“The web-based program is based on ISA’s Stress and Mood Management program [21] and Safren’s in-person CBT-AD program, which contained the Life-Steps medication adherence program [9].”
Self-citationWeb-based interventions for the management of stress in the workplace: Focus, form, and efficacy
Ryan, C., Bergin, M., Chalder, T., & Wells, J. S. G. (2017) · Journal of Occupational Health · doi:10.1539/joh.16-0227-ra · Cited by 42 · see citing works
Hayes, J., Maughan, D. L., & Grant‐Peterkin, H. (2016) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.114.161067 · Cited by 40 · see citing works
Internet-based relapse prevention for anorexia nervosa: nine- month follow-up
Fichter, M. M., Quadflieg, N., & Lindner, S. (2013) · Journal of Eating Disorders · doi:10.1186/2050-2974-1-23 · Cited by 41 · see citing works
“There are a significant number of controlled internetbased studies for primary, secondary, and tertiary prevention for physical disorders, mostly delivering interventions for asthma [3], cardiological disorders [4], management of work-related stress [5], the promotion of physical activity to improve health in general…”
BackgroundDawkins, S., Martin, A. J., Kilpatrick, M., & Scott, J. L. (2018) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000001360 · Cited by 37 · see citing works
Imamura, K., Kawakami, N., Tsuno, K., Tsuchiya, M., Shimada, K., & Namba, K. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.05.045 · Cited by 31 · see citing works
Ketelaar, S. M., Nieuwenhuijsen, K., Gärtner, F. R., Bolier, L., Smeets, O., & Sluiter, J. K. (2013) · PLoS ONE · doi:10.1371/journal.pone.0072546 · Cited by 38 · see citing works
“[18]), although to our knowledge their effects on work functioning have not been studied in a specific working population such as nurses and allied health professionals.”
BackgroundMorshed, M. B., Hernandez, J., McDuff, D., Suh, J., Howe, E. S., Rowan, K., Abdin, M., Ramos, G., Tran, T., & Czerwinski, M. P. (2022) · International Conference on Affective Computing and Intelligent Interaction and workshops · doi:10.1109/acii55700.2022.9953824 · Cited by 35 · see citing works
“Prolonged high levels of stress have been shown to contribute to a wide variety of physical and psychological health issues such as high blood pressure [40], depression [30], mood disorders [2], and suicidal ideation [20].”
BackgroundDepression in the workplace: a systematic review of evidence-based prevention strategies
Dietrich, S., Deckert, S., Ceynowa, M., Hegerl, U., & Stengler, K. (2011) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-011-0634-7 · Cited by 38 · see citing works
“These studies did not include a diagnosis of depression with a validated screening instrument (Bender and Farvolden 2008; Billings et al. 2008; Caruso and Myette 2008; Charbonneau et al. 2005; Colombi 2005; Davies 2008; Dunnagan et al. 2001; Hauck and Chard 2009; Kitchener and Jorm 2004; Langlieb and Kahn 2005; (Mille…”
Chen, Q., Zhao, Z., Bao, J., Lin, J., Li, W., & Zang, Y. (2024) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2024.100489 · Cited by 49 · see citing works
“The remaining four trials used self-designed questionnaires (Billings et al., 2008; Deitz et al., 2008; Griffiths et al., 2017; Imamura et al., 2016).”
MethodCan we learn to manage stress? A randomized controlled trial carried out on university students
Saleh, D., Camart, N., Sbeira, F., & Romo, L. (2018) · PLoS ONE · doi:10.1371/journal.pone.0200997 · Cited by 36 · see citing works
Dunkl, A., & Jiménez, P. (2017) · Health Informatics Journal · doi:10.1177/1460458215623077 · Cited by 36 · see citing works
“The 12 items and can be categorized in four scales: (1) individual feedback, (2) analyses of results, (3) advice/suggestions, and (4) sharing results.”
BackgroundA Pilot Randomized Controlled Trial of an Internet-Based Alcohol Intervention in a Workplace Setting
Brendryen, H., Johansen, A. B., Duckert, F., & Nesvåg, S. M. (2017) · International Journal of Behavioral Medicine · doi:10.1007/s12529-017-9665-0 · Cited by 37 · see citing works
Airagnes, G., Lemogne, C., Goldberg, M., Hoertel, N., Roquelaure, Y., Limosin, F., & Zins, M. (2018) · PLoS ONE · doi:10.1371/journal.pone.0196330 · Cited by 34 · see citing works
“In addition, vulnerable individuals may be offered more specific interventions aiming at reducing the impact of interpersonal stressful relationships on their substance consumptions, with the advantage of addressing these issues into a non-stigmatizing stress management framework [56], or failing that, to reduce their…”
BackgroundMorse, A. K., Askovic, M., Sercombe, J., Dean, K., Fisher, A., Marel, C., Chatterton, M.-L., Kay-Lambkin, F., Barrett, E., Sunderland, M., et al. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.1051119 · Cited by 33 · see citing works
Evans-Lacko, S., Hahn, J. S., Peter, L.-J., & Schomerus, G. (2022) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000788 · Cited by 32 · see citing works
“Billings et al. (2008) Working adults (n¼309) Multimedia program with tailored content delivered via web to hep with stress management, mood problem prevention, and early identification of treatment for depression and anxiety The intervention group had better help-seeking attitude for seeking…”
BackgroundAcceptability of Web-Based Mental Health Interventions in the Workplace: Systematic Review
Scheutzow, J., Attoe, C., & Harwood, J. (2022) · JMIR Mental Health · doi:10.2196/34655 · Cited by 30 · see citing works
“6% women Most (51%) between 30 and 40 309 RCT: experimental and control; recruited from a technology company via email and health fair Web-based stress and mood management multimedia program for employees based on CBT; 12-week access; effectiveness of the program to reduce depression and increase behavioral activation…”
BackgroundMethodInfluentialComputer-based versus in-person interventions for preventing and reducing stress in workers
Kuster, A. T., Dalsbø, T. K., Luong Thanh, B. Y., Agarwal, A., Durand-Moreau, Q. V., & Kirkehei, I. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011899.pub2 · Cited by 28 · see citing works
Domes, G., Stächele, T., von Dawans, B., & Heinrichs, M. (2018) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2018.12.001 · Cited by 27 · see citing works
“, 2015), working adults (Billings et al., 2008), and community-based samples (Heber et al.”
BackgroundKetelaar, S. M., Nieuwenhuijsen, K., Gärtner, F. R., Bolier, L., Smeets, O., & Sluiter, J. K. (2013) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-013-0893-6 · Cited by 25 · see citing works
“Research has shown unguided self-help e-mental health interventions to have positive outcomes for a variety of mental health aspects (e.g. Billings et al. 2008; Riper et al. 2008; Warmerdam et al. 2008), although to our knowledge, their effects on work functioning have not been studied in a…”
BackgroundJonas, B., Leuschner, F., & Tossmann, P. (2016) · Anxiety Stress & Coping · doi:10.1080/10615806.2016.1233324 · Cited by 25 · see citing works
“Most of these interventions are fully automated with either no (Billings et al., 2008; Drozd et al., 2013; Hasson et al., 2005) or limited personal guidance (Ebert et al.”
BackgroundA Web-Based Approach to Address Cardiovascular Risks in Managers
Bennett, J. B., Broome, K. M., Schwab-Pilley, A., & Gilmore, P. L. (2011) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0b013e3182258bd8 · Cited by 25 · see citing works
Jackson, H. M., Calear, A. L., Batterham, P. J., Ohan, J. L., Farmer, G. M., & Farrer, L. M. (2023) · Journal of Medical Internet Research · doi:10.2196/44673 · Cited by 25 · see citing works
“%) reported significant findings in favor of the intervention group at postintervention measurement across all eligible interventions [75,91], 2 (40”
Dugdale, S., Elison, S., Semper, H., Ward, J., & Davies, G. (2019) · Journal of Dual Diagnosis · doi:10.1080/15504263.2019.1652381 · Cited by 26 · see citing works
“…were also reported, with CBIs generally leading to an improvement of mental health and substance misuse symptoms when compared against waitlist controls (Billings et al., 2008; Brief et al., 2013; Postel et al., 2010, 2015; Tossmann et al., 2011) and primary care settings (Acosta et al., 2017).”
BackgroundDeitz, D., Cook, R. F., Hersch, R. K., & Leaf, S. L. (2014) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000000148 · Cited by 21 · see citing works
“Also use in past studies by out group.(19,31) State-Trait Personality Inventory The state-trait personality inventory (STPI) developed by Spielberger,(32) consists of eight subscales: state and trait anxiety, state and trait curiosity, state and trait depression, and state and trait anger.”
Self-citationFactors Contributing to Quarter Life Crisis on Early Adulthood: A Systematic Literature Review
Hasyim, F. F., Setyowibowo, H., & Purba, F. D. (2024) · Psychology Research and Behavior Management · doi:10.2147/prbm.s438866 · Cited by 23 · see citing works
Boß, L., Lehr, D., Berking, M., Riper, H. M., Schaub, M. P., & Ebert, D. D. (2015) · BMC Public Health · doi:10.1186/s12889-015-2375-0 · Cited by 22 · see citing works
Mouthaan, J., Sijbrandij, M., Reitsma, J. B., Gersons, B. P. R., & Olff, M. (2011) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v2i0.8294 · Cited by 21 · see citing works
The effectiveness of workplace interventions for the prevention of alcohol use: A meta‐analysis
Fellbaum, L., Mojzisch, A., Bielefeld, L., Benit, N., & Soellner, R. (2023) · Addiction · doi:10.1111/add.16276 · Cited by 26 · see citing works
Is Usage of a Wellness Center Associated with Improved Quality of Life?
Clark, M. M., Jenkins, S. M., Limoges, K. A., Hagen, P. T., Lackore, K. A., Harris, A. M., Werneburg, B. L., Warren, B. A., & Olsen, K. D. (2013) · American Journal of Health Promotion · doi:10.4278/ajhp.120213-qual-87 · Cited by 20 · see citing works
“The 13 survey items were: (1) How would you rate your current level of physical activity from 0 (not active at all) to 10 (extremely active)? (2) If you walked up two flights of stairs, how would you rate your overall level of fatigue and shortness of breath from 0 (could not do it) to 10 (could do it easily)? (3) How…”
Tong, X., Mauriello, M. L., Mora-Mendoza, M. A., Prabhu, N., Kim, J. P., & Paredes, P. E. (2023) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3544548.3581319 · Cited by 18 · see citing works
“The efectiveness of web-based stress interventions in the work context has been examined in a body of literature that includes both multi-week feld and randomized controlled trial studies with promising outcomes [6, 21, 24, 29, 30].”
BackgroundResultCarruthers, E. C., Rogers, P., Backman, C. L., Goldsmith, C. H., Gignac, M. A. M., Marra, C. A., Village, J. L., LI, L. C., Esdaile, J. M., & Lacaille, D. V. (2014) · BMC Medical Informatics and Decision Making · doi:10.1186/1472-6947-14-59 · Cited by 19 · see citing works
“This evolution is consistent with recent trends in adult learning, health education and in selfmanagement programs [19-31].”
ResultHealth Applications for Corporate Health Management
Steigner, G., Doarn, C. R., Schütte, M., Matusiewicz, D., & Thielscher, C. (2017) · Telemedicine and e-Health · doi:10.1089/tmj.2016.0162 · Cited by 17 · see citing works
“Since earlier findings on Web-based corporate health management (CHM) tools yielded mixed results, it seems to be even more desirable to measure health app efficacy.(8,9) Nevertheless, companies expect app usage to increase, mainly due to younger employees used to smartphones and further app development.”
Skvorc, C., & Wilson, D. (2011) · Biosecurity and Bioterrorism Biodefense Strategy Practice and Science · doi:10.1089/bsp.2010.0048 · Cited by 17 · see citing works
“) Clinically elevated measures of depression, anxiety, and substance abuse are associated with decreased worker productivity, accuracy, and safety.(23) The screening procedures are designed to maintain a balance of worker privacy and public safety.”
Preventing Prescription Drug Misuse: Field Test of the SmartRx Web Program
Deitz, D., Cook, R. F., & Hendrickson, A. (2010) · Substance Use & Misuse · doi:10.3109/10826084.2010.528124 · Cited by 16 · see citing works
Self-citationXiong, J., Wen, J. L., Pei, G., Han, X., & He, D. Q. (2022) · International Journal of Occupational Safety and Ergonomics · doi:10.1080/10803548.2022.2043647 · Cited by 12 · see citing works
“…website was accessible by standard desktop computers using the Internet and offered education, support and guidance via text, video and Flash animations Billings et al., 2008 [47] Japan Based on an RCT design, 309 working adults were randomly assigned a web-based condition or to a wait-list…”
MethodWatanabe, K., Imamura, K., Inoue, A., Otsuka, Y., Shimazu, A., Eguchi, H., Adachi, H., Sakuraya, A., Kobayashi, Y., ARIMA, H., et al. (2019) · Industrial Health · doi:10.2486/indhealth.2019-0074 · Cited by 13 · see citing works
Blankenhagel, K. J., Theilig, M.-M., Koch, H. H., Witte, A.-K., & Zarnekow, R. (2019) · Hawaii International Conference on System Sciences (HICSS) · doi:10.24251/hicss.2019.461 · Cited by 10 · see citing works
Smart technologies for older people
Morris, M. E. (2012) · Cited by 13 · see citing works
Armaou, M., Araviaki, E., Dutta, S., Konstantinidis, S. T., & Blake, H. (2022) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe12100102 · Cited by 11 · see citing works
“Four in five atheoretical interventions showed some positive effects on work-related well-being measures [47,59,93,95].”
BackgroundMethodInfluentialDigi-Exist: Eine digitale Plattform zur Gesundheitsförderung für junge Unternehmen
Ducki, A., Behrendt, D., Boß, L., Brandt, M., Janneck, M., Jent, S., Kunze, D., Lehr, D., Nissen, H., & Wappler, P. (2019) · Springer eBooks · doi:10.1007/978-3-662-59044-7_22 · Cited by 11 · see citing works
The Effectiveness of Online Stress Management Training Interventions: A Systematic Literature Review
van Wingerden, J., & Derks, D. (2018) · International Journal of Learning and Development · doi:10.5296/ijld.v8i3.13600 · Cited by 9 · see citing works
“(2011) 15mn/session/8session 2 Coping skills (+) Anxiety state (-) Anxiety trait reduction (-) 16) Billings et al. (2008) Stress (-) Knowledge of depression and anxiety (+) Positive attitide treatment (+) Approach alcohol consumption (+) 17) van Straten et al. (2008) 45mn/week/4weeks 3 Depression (-) Anxiety (-) Quali…”
BackgroundInfluentialComputerised cognitive behavioural therapy: helping Ireland log on
Twomey, C., O'Reilly, G., & Byrne, M. (2013) · Irish Journal of Psychological Medicine · doi:10.1017/ipm.2012.5 · Cited by 11 · see citing works
Internetbasierte Ansätze in der Therapie von Essstörungen
Fichter, M. M., Quadflieg, N., Nisslmüller, K., Lindner, S., Voderholzer, U., Wünsch‐Leiteritz, W., Osen, B., Huber, T., Zahn, S., Meermann, R., et al. (2011) · Der Nervenarzt · doi:10.1007/s00115-010-3228-9 · Cited by 9 · see citing works
Optimizing Workplace Digital Mental Health Interventions: Systematic Review and Meta-Analysis
Stratton, E., Morris, R. W., Milton, A. C., Deady, M., Choi, I., & Glozier, N. (2025) · Journal of Medical Internet Research · doi:10.2196/71253 · Cited by 15 · see citing works
Behavioral and Psychosocial Characteristics Among Head Start Childcare Providers
Ling, J. (2017) · The Journal of School Nursing · doi:10.1177/1059840517725791 · Cited by 9 · see citing works
Substance Misuse Prevention as Corporate Social Responsibility
Radacsi, G., & Hardi, P. (2013) · Substance Use & Misuse · doi:10.3109/10826084.2013.841242 · Cited by 8 · see citing works
“These findings indicated that a brief and easily adaptable web-based stress management program can simultaneously reduce worker stress and address alcohol misuse and other stigmatized behavioral health problems by embedding prevention material into a more positive stress management program (Billings et al., 2008).”
BackgroundThe Logic and Practice of the Prevention of Mental Disorders
Mendelson, T., Pas, E. T., Leis, J. A., Bradshaw, C. P., Rebok, G. W., & Mandell, W. (2012) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780195390445.003.0017 · Cited by 11 · see citing works
A Framework for Adaptive Stress Testing (Fast) at the Workplace
Jiménez, P., & Bregenzer, A. (2017) · Journal of Ergonomics · doi:10.4172/2165-7556.1000205 · Cited by 5 · see citing works
“Instant feedback can support the individuals to monitor their personal status and can motivate users to maintain or change their personal status [6].”
BackgroundSaha, K., & Iqbal, S. T. (2023) · Annual Symposium on Human-Computer Interaction for Work (CHIWORK) · doi:10.1145/3596671.3598571 · Cited by 6 · see citing works
“Workplace stress leads to not only impaired decision-making, productivity, and job satisfaction but also significant business costs—approximately USD 300 per year in the U.S. [9].”
BackgroundIntervention de gestion du stress par Internet chez les étudiants : revue de la littérature
Saleh, D., Camart, N., & Romo, L. (2016) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2016.03.013 · Cited by 6 · see citing works
Imamura, K., Norito, K., Furukawa, T. A., Matsuyama, Y., Shimazu, A., & Kasai, K. (2015) · BMJ Open · doi:10.1136/bmjopen-2015-007590 · Cited by 6 · see citing works
Alqahtani, F., & Orji, R. (2025) · Human Behavior and Emerging Technologies · doi:10.1155/hbe2/8111089 · Cited by 14 · see citing works
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Design and Evaluation of Online and Mobile Applications for Stress Management and Healthy Eating
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“This result is accordance with Felsten (2004), Billings et al. (2008), Sevani and Silvia (2015), Oguntimilehin, Abiola, and Adeyemo (2015), and Allexandre et al. (2016).”
BackgroundResultThe Potential of Technology in Facilitating Positive Stress Experiences
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“…not found improvements in professional help seeking intentions albeit at longer follow-up time points, with one finding improvement in intentions to seek help from the internet at the 6-month follow-up [78], and the other finding an increase only in help seeking attitudes at posttest (3 mo) [79].”
- Authors
- Billings, D. W., Cook, R. F., Hendrickson, A., & Dove, D. C.
- Affiliations
- Brown University (US)
- Corresponding author
- Billings, Douglas W.
- Venue
- Journal of Occupational & Environmental Medicine
- Published
- 2008-08
- Volume
- 50
- Issue
- 8
- Pages
- 960-968
- ISSN
- 1076-2752 (ISSN-L)
- PMC
- PMC4570566
- OpenAlex
- W2059691179
- Cited by
- 117
- References
- 41
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 3 · 2023: 7 · 2022: 11 · 2021: 3 · 2020: 7 · 2019: 8 · 2018: 7 · 2017: 10 · 2016: 12 · 2015: 7 · 2014: 6 · 2013: 10 · 2012: 7
- FWCI
- 4.76
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Occupational and Environmental Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (2r44mh063610-02a1)
- National Institute of Mental Health (R44 MH063610, 5R44MH063610-03)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- online intervention, occupational stress, stress management, depression prevention, anxiety prevention, substance use prevention, mood disorders, health promotion, alcohol consumption, stigma, treatment attitudes, working adults
- MeSH terms
- Adaptation, Psychological, Adult, Aged, Alcoholism, Efficiency, Female, Health Promotion, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Stress, Psychological, Occupational Health, Treatment Outcome, Mood Disorders, Internet, Young Adult
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