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Cited by 38Dialysis and Renal Disease ManagementDigital Mental Health InterventionsMindfulness and Compassion Interventions

Effectiveness of Wellbeing Intervention for Chronic Kidney Disease (WICKD): results of a randomised controlled trial

Open access
Dingwall, Kylie M., Sweet, Michelle, Cass, Alan, Hughes, Jaquelyne T., Kavanagh, David, Howard, Kirsten, Barzi, Federica, Brown, Sarah +3 more·2021·BMC Nephrology
DOI 10.1186/s12882-021-02344-8PMC PMC8054368

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Abstract

Background: End stage kidney disease (ESKD) is associated with many losses, subsequently impacting mental wellbeing. Few studies have investigated the efficacy of psychosocial interventions for people with ESKD and none exist for Indigenous people, a population in which the ESKD burden is especially high. Methods: This three-arm, waitlist, single-blind randomised controlled trial examined efficacy of the Stay Strong App in improving psychological distress (Kessler distress scale; K10), depressive symptoms (adapted Patient Health Questionnaire; PHQ-9), quality of life (EuroQoL; EQ. 5D) and dialysis adherence among Indigenous Australians undergoing haemodialysis in central and northern Australia (Alice Springs and Darwin), with follow up over two 3-month periods. Effects of immediate AIMhi Stay Strong App treatment were compared with those from a contact control app (The Hep B Story) and treatment as usual (TAU). Control conditions received the Stay Strong intervention after 3 months. Results: Primary analyses of the full sample ( N = 156) showed statistically significant decreases in K10 and PHQ-9 scores at 3 months for the Hep B Story but not for the Stay Strong app or TAU. Restricting the sample to those with moderate to severe symptoms of distress or depression (K10 > =25 or PHQ-9 > =10) showed significant decreases in K10 and PHQ-9 scores for both Stay Strong and Hep B Story. No significant differences were observed for the EQ-5D or dialysis attendance. Conclusions: Findings suggest that talking to people about their wellbeing and providing information relevant to kidney health using culturally adapted, locally relevant apps improve the wellbeing of people on dialysis. Further research is required to replicate these findings and identify active intervention components. Trial registration: ACTRN12617000249358 ; 17/02/2017.

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  • Recent randomized controlled trials in Australia have promoted culturally adapted mental health apps as a feasible and acceptable means of lowering symptoms of mental illness for First Nations young people and adults.

    “In Australia, recent randomized controlled trials (RCTs) have promoted culturally adapted mental health apps as a feasible and acceptable means of lowering symptoms of mental illness for First Nations young people [16] and adults [14].”

    From Feasibility and Acceptability of the Aboriginal and Islander Mental Health Initiative for Youth App: Nonrandomized Pilot With First Nations Young People (2023) · cites this paper as [14]

    The Discussion says culturally adapted digital interventions can be acceptable and effective, and the trial found reduced distress and depressive symptoms among Indigenous adults on dialysis who had moderate to severe symptoms. The Results report no significant full-sample symptom reduction for the Stay Strong app, so this source does not establish symptom reduction for First Nations adults generally. The citation to this paper is attached to adults, not young people. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • The AIMhi Stay Strong app has demonstrated effectiveness in reducing psychological distress, depressive symptoms, and substance misuse among First Nations adults.

    “Similarly, the AIMhi Stay Strong app (and the paper-based Stay Strong Plan) is a culturally adapted motivational care planning (MCP) therapy that has demonstrated effectiveness in reducing psychological distress, depressive symptoms, and substance misuse among First Nations adults [14,18].”

    From Feasibility and Acceptability of the Aboriginal and Islander Mental Health Initiative for Youth App: Nonrandomized Pilot With First Nations Young People (2023) · cites this paper as [14]

    The Discussion reports reduced distress and depressive symptoms among Indigenous Australian haemodialysis patients who had moderate to severe symptoms, but the Results say the Stay Strong app did not produce statistically significant reductions across the full sample at three months. The trial did not assess substance misuse, so it does not support that part of the claim or its broader implication of effectiveness among First Nations adults generally. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • A recent RCT trialing AIMhi Stay Strong MCP in the form of the AIMhi Stay Strong app demonstrated significant improvements in distress and depression after 2 clinician-supported 20-minute sessions with the app.

    “A recent RCT trialing AIMhi Stay Strong MCP in the form of the AIMhi Stay Strong app demonstrated significant improvements in distress and depression after 2 clinician-supported 20-minute sessions with the app [14].”

    From Feasibility and Acceptability of the Aboriginal and Islander Mental Health Initiative for Youth App: Nonrandomized Pilot With First Nations Young People (2023) · cites this paper as [14]

    Methods > Interventions describes two approximately 20-minute, researcher-delivered Stay Strong app sessions. Abstract > Results reports significant reductions in distress and depressive symptoms with Stay Strong only among participants with moderate to severe symptoms; the full-sample analysis found no significant reduction for that app. The claim omits this important qualification. (LLM, conf=0.90)

    Experimental — accuracy not yet measured

  • A difference of at least 5 points on the K10 is indicative of clinically significant change.

    “We anticipated a difference of at least 5 points would be indicative of clinically significant change [14,55].”

    From Feasibility and Acceptability of the Aboriginal and Islander Mental Health Initiative for Youth App: Nonrandomized Pilot With First Nations Young People (2023) · cites this paper as [14]

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Research works printed but not linked: 1

  1. [2]ANZDATA Registry 42nd report, chapter 10: end stage kidney disease in Aboriginal and Torres Strait islander Australians 2020 Adelaide Australia and New Zealand Dialysis and Transplant Registry

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Authors
Dingwall, K. M., Sweet, M., Cass, A., Hughes, J. T., Kavanagh, D., Howard, K., Barzi, F., Brown, S., Sajiv, C., Majoni, S. W., & Nagel, T.
Affiliations
  • Charles Darwin University (AU)
  • Queensland University of Technology (AU)
  • The University of Sydney (AU)
  • Alice Springs Hospital (AU)
  • Flinders University (AU)
Corresponding author
Dingwall, Kylie M.
ORCID
Venue
BMC Nephrology
Publisher
Springer Science and Business Media LLC
Published
2021-04-19
Volume
22
Issue
1
Pages
136-136
ISSN
1471-2369 (ISSN-L)
DOI
10.1186/s12882-021-02344-8
PMC
PMC8054368
OpenAlex
W3155809552
Cited by
38
References
31
Citations by year
2026: 3 · 2025: 11 · 2024: 9 · 2023: 10 · 2022: 5
FWCI
4.10
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Nephrology (publishedVersion, cc-by)
  • Research Square (acceptedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • QUT ePrints (Queensland University of Technology) (submittedVersion, cc-by-nc-nd)
Funders
  • Medical Research Council
  • National Health and Medical Research Council (1098311, 1092576)
Topics
  • Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Keywords
end-stage renal disease, Indigenous Australians, psychosocial interventions, psychological well-being, psychological distress, depressive symptoms, quality of life, dialysis adherence, mobile health apps, culturally tailored interventions, hemodialysis
MeSH terms
Indigenous Peoples, Counseling, Depression, Female, Renal Dialysis, Humans, Male, Middle Aged, Patient Compliance, Quality of Life, Stress, Psychological, Single-Blind Method, Renal Insufficiency, Chronic, Time-to-Treatment, Mobile Applications

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