Telephone coaching for the prevention of depression in farmers: Results from a pragmatic randomized controlled trial
Abstract
Introduction: Farmers have a high risk for depression (MDD). Preventive measures targeting this often remotely living population might reduce depression burden. The study aimed to evaluate the effectiveness of personalized telephone coaching in reducing depressive symptom severity and preventing MDD in farmers compared to enhanced treatment as usual (TAU + ). Methods: In a two-armed, pragmatic randomized controlled trial ( N = 314) with post-treatment at 6 months, farming entrepreneurs, collaborating family members and pensioners with elevated depressive symptoms (PHQ-9 ≥ 5) were randomized to personalized telephone coaching or TAU + . The coaching was provided by psychologists and consists on average of 13 (±7) sessions a 48 min (±15) over 6 months. The primary outcome was depressive symptom severity (QIDS-SR16). Results: Coaching participants showed a significantly greater reduction in depressive symptom severity compared to TAU + ( d = 0.39). Whereas reliable symptom deterioration was significantly lower in the intervention group compared to TAU + , no significant group differences were found for reliable improvement and in depression onset. Further significant effects in favor of the intervention group were found for stress ( d = 0.34), anxiety ( d = 0.30), somatic symptoms ( d = 0.39), burnout risk ( d = 0.24–0.40) and quality of life ( d = 0.28). Discussion: Limiting, we did not apply an upper cutoff score for depressive symptom severity or controlled for previous MDD episodes, leaving open whether the coaching was recurrence/relapse prevention or early treatment. Nevertheless, personalized telephone coaching can effectively improve mental health in farmers. It could play an important role in intervening at an early stage of mental health problems and reducing disease burden related to MDD. Trial registration number and trial register: German Clinical Trial Registration: DRKS00015655
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Recent studies suggest benefits of multi-modal approaches tailored to the farming community, as the aetiology of problems in this community is diverse.
“These studies suggest the benefits of multi-modal approaches that are tailored to the farming community, as the aetiology of problems in this community is diverse.”
From Improving the mental health of farmers: what types of remote support are acceptable, feasible, and improve outcomes? A feasibility RCT (2024) · cites this paper as [34]
The findings in this qualitative study are coherent with the quantitative results observed in the associated RCT that suggested good acceptance (only 11% intervention dropout) and high satisfaction (CSQ-I: M=28.17, SD=5.58) in farmers.
“The findings in this qualitative study are coherent with the quantitative results observed in the associated RCT (Thielecke et al., 2022) that suggested good acceptance (e.g., only 11 % intervention dropout) and high satisfaction with the intervention (CSQ-I: M = 28.17, SD = 5.58) in farmers.”
The associated RCT showed a reduction in depressive symptom severity and further mental health outcomes including stress and anxiety.
“the RCT showed a reduction in depressive symptom severity and further mental health outcomes including stress and anxiety.”
The stated supporting aspects of a good coaching relationship and a realistic goal setting in the interviews corresponded to the observed ratings on the subscales of the working alliance questionnaire in the RCT.
“Similarly, the stated supporting aspects of a good coaching relationship and a realistic goal setting in the interviews corresponded to the observed ratings on the subscales of the working alliance questionnaire in the RCT.”
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Self-citation
- Authors
- Thielecke, J., Buntrock, C., Titzler, I., Braun, L., Freund, J., Berking, M., Baumeister, H., & Ebert, D. D.
- Affiliations
- Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
- Universität Ulm (DE)
- Technical University of Munich (DE)
- Corresponding author
- Thielecke, Janika
- ORCID
- Venue
- Journal of Telemedicine and Telecare
- Publisher
- SAGE Publications
- Published
- 2022-06-12
- Volume
- 30
- Issue
- 6
- Pages
- 918-930
- ISSN
- 1357-633X (ISSN-L)
- 1758-1109
- OpenAlex
- W4282591022
- Cited by
- 8
- References
- 69
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 1 · 2023: 3 · 2022: 1
- FWCI
- 1.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Telemedicine and Telecare (publishedVersion)
- PubMed (publishedVersion)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
- Funders
- German social insurance for farmers, foresters, and gardeners
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- telephone coaching, depression prevention, farmers, major depressive disorder, depressive symptoms, remote communities, personalized coaching, burnout, quality of life, anxiety, somatic symptoms, early intervention
- MeSH terms
- Farmers, Mentoring, Adult, Depression, Female, Humans, Male, Middle Aged, Telephone
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