A three-armed randomised controlled trial investigating the comparative impact of guidance on the efficacy of a web-based stress management intervention and health impairing and promoting mechanisms of prevention
Open accessAbstract
Abstract Background Web-based stress management interventions (SMI) fit increasingly digital lifestyles, reduce barriers of uptake and are easily scalable. SMIs might lower levels of stress in employees and thereby contribute to the prevention of depressive symptomatology. Different guidance formats can impact the efficacy of SMIs, with higher intensity assumed to result in larger effects. However, head-to-head comparisons of guidance formats are rare. This is the first trial to examine the impact of adherence-focused guidance compared to self-help on the efficacy of an occupational SMI compared to a wait list control condition. Additionally, it will be investigated if the SMI enfolds its impact on preventing depressive symptomatology by different pathways through reducing health impairing and increasing promoting factors. Methods A three-armed randomised controlled trial (RCT) on an occupational SMI was conducted. 404 employees with elevated levels of perceived stress (PSS-10 ≥ 22) were randomly assigned to: adherence-focused guidance (AFG), self-help (SH) or a wait list control group (WLC). The primary outcome was perceived stress (PSS-10). Secondary outcomes included health- and work-related measures. A parallel mediation analysis with stress and resilience as mediators for the effect on depression (CES-D) was carried out. Data collection took place at baseline (T1), after 7 weeks (T2) and 6 months (T3). Results The SMI was effective for all groups on the primary and secondary outcomes. For stress, analyses of covariance (ANCOVA) revealed significant group effects at T2 (F2,400 = 36.08, P < .001) and T3 (F2,400 = 37.04, P < .001) with large effect sizes for AFG (T2: d = 0.83; T3: d = 0.85) and SH (T2: d = 0.88; T3: d = 0.91) compared to WLC. No significant group differences were found for the efficacy between AFG and SH on the outcomes. Adherence in terms of completed modules was significantly higher for AFG compared to SH. The SMI’s impact on depression was mediated by perceived stress: a1b1 = − 0.77, 95% CI [− 1.26, − 0.34] and resilience: a2b2 = − 0.62, 95% CI [− 1.05, − 0.26]. Conclusions The SMI was effective for reducing stress and improving other health- and work-related outcomes, irrespective of the guidance format. Results did not demonstrate superiority of adherence-focused guidance for the efficacy but for adherence in terms of completed modules. Among other reasons, better communication strategies about offered guidance and awareness-raising measures are discussed. Results from mediation analysis suggest that preventive SMIs should be designed to reach two goals: reducing the risk factor of stress and simultaneously increasing health promoting factors such as resilience. Trial registration German Clinical Trial Registration (DRKS) DRKS00005687 , 6/6/2014.
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Human support has been associated with higher numbers of completed sessions and increased completer rates, which could be related to better intervention outcomes.
“Human support has been seen as a possible mechanism of change, as it was found to be associated with higher numbers of completed sessions and increased completer rates (Domhardt et al., 2019; Karyotaki et al., 2021; Nixon et al., 2021), which could be related to better intervention outcomes (Karyotaki et al., 2021).”
From Effects of self-guided stress management interventions in college students: A systematic review and meta-analysis (2022) · cites this paper as Nixon et al., 2021
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Ebert, D. D., Lehr, D., Heber, E., Riper, H., Cuijpers, P., & Berking, M. (2016) · Scandinavian Journal of Work, Environment & Health · doi:10.5271/sjweh.3573 · Cited by 120 · cited 4× · see citing works
“Interestingly, several studies on web-based SMI reported that the vast majority of participants have no experiences with previous face-to-face trainings [36, 49, 61], indicating that both delivery modes (traditional vs.”
BackgroundInfluentialSelf-citationEbert, D. D., Lehr, D., Boß, L., Riper, H., Cuijpers, P., Andersson, G., Thiart, H., Heber, E., & Berking, M. (2014) · Scandinavian Journal of Work, Environment & Health · doi:10.5271/sjweh.3449 · Cited by 115 · cited 2× · see citing works
“Interestingly, several studies on web-based SMI reported that the vast majority of participants have no experiences with previous face-to-face trainings [36, 49, 61], indicating that both delivery modes (traditional vs.”
BackgroundMethodZarski, 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 · cited 4× · see citing works
“Therefore, more heterogeneous trials on the impact of guidance are still necessary and could for example compare adherencefocused to content-focused guidance [38].”
BackgroundMethodInfluentialLehr, D., Hillert, A., Schmitz, E., & Sosnowsky-Waschek, N. (2008) · Diagnostica · doi:10.1026/0012-1924.54.2.61 · Cited by 107 · cited 6× · see citing works
“Health impairing and promoting mediators Secondary outcomes included the examination of depression severity with the short version of the Centre for Epidemiological Studies’ Depression Scale (CES-D) [72, 73], with 15 items that are responded to on a four-point Likert scale from 0 to 3 (α = .”
MethodInfluentialApolinário-Hagen, J., Kemper, J., & Stürmer, C. (2017) · JMIR Mental Health · doi:10.2196/mental.6186 · Cited by 98 · see citing works
Lin, J., Faust, B., Ebert, D. D., Krämer, L., & Baumeister, H. (2018) · Journal of Medical Internet Research · doi:10.2196/jmir.9925 · Cited by 97 · see citing works
Andrea, H., Bültmann, U., van Amelsvoort, L. G. P. M., & Kant, Y. (2009) · Depression and Anxiety · doi:10.1002/da.20516 · Cited by 95 · cited 1× · see citing works
“Experiencing stressors at work is associated with an elevated risk of sickness absence due to a diagnosed mental disorder [5] and can precede depressive symptoms over time, thereby increasing the risk for subsequent depression [6, 7].”
BackgroundEbert, D. D., Lehr, D., Smit, F., Zarski, A.-C., Riper, H., Heber, E., Cuijpers, P., & Berking, M. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-807 · Cited by 82 · cited 9× · see citing works
“At T2, analysis of covariance according to the study protocol [35] revealed a significant group effect (F2,400 = 36.”
BackgroundMethodResultInfluentialSelf-citationTitov, N., Dear, B. F., Johnston, L., McEvoy, P. M., Wootton, B., Terides, M. D., Gandy, M., Fogliati, V., Kayrouz, R., & Rapee, R. M. (2014) · PLoS ONE · doi:10.1371/journal.pone.0089591 · Cited by 81 · see citing works
Boß, L., Lehr, D., Schaub, M. P., Castro, R. P., Riper, H. M., Berking, M., & Ebert, D. D. (2017) · Addiction · doi:10.1111/add.14085 · Cited by 80 · cited 3× · see citing works
“Another study investigated the comparative efficacy of AFG and SH under similar conditions within an Internet Intervention for problematic drinking in employees and also showed that despite missing between group differences, adherence was better for AFG [94].”
BackgroundEbert, D. D., Buntrock, C., Lehr, D., Smit, F., Riper, H., Baumeister, H., Cuijpers, P., & Berking, M. (2018) · Behavior Therapy · doi:10.1016/j.beth.2017.05.004 · Cited by 75 · cited 4× · see citing works
“First, this would be a false conclusion since the utilisation rate of AFG was low, not only in the present trial but also previous ones [50, 94].”
BackgroundInfluentialSelf-citationWatanabe, K., Sakuraya, A., Kawakami, N., Imamura, K., Ando, E., Asai, Y., Eguchi, H., Kobayashi, Y., Nishida, N., Arima, H., et al. (2018) · Obesity Reviews · doi:10.1111/obr.12725 · Cited by 75 · see citing works
Heckendorf, H., Lehr, D., Ebert, D. D., & Freund, H. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2019.103415 · Cited by 74 · cited 1× · see citing works
“A similar pattern with interventional effects based on reducing negative factors on the one hand and building up positive ones on the other hand was also found in an earlier study on a web-based gratitude training which examined mediation analyses based on the same approach of a dual pathway [97].”
Iyengar Yoga for Distressed Women: A 3-Armed Randomized Controlled Trial
Michalsen, A., Jeitler, M., Brunnhuber, S., Lüdtke, R., Büssing, A., Musial, F., Dobos, G. J., & Keßler, C. S. (2012) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2012/408727 · Cited by 70 · see citing works
Schueller, S. M., Tomasino, K. N., & Mohr, D. C. (2017) · Clinical Psychology: Science and Practice · doi:10.1037/h0101740 · Cited by 70 · cited 1× · see citing works
“The support provided usually is of a technical or clinical kind or focusses on the correct usage of the intervention [41].”
BackgroundLehr, 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
Siegrist, J., & Wege, N. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00066 · Cited by 61 · see citing works
Ebert, D. D., Kählke, F., Buntrock, C., Berking, M., Smit, F., Heber, E., Baumeister, H., Funk, B., Riper, H. M., & Lehr, D. (2017) · Scandinavian Journal of Work Environment & Health · doi:10.5271/sjweh.3691 · Cited by 57 · cited 2× · see citing works
“Furthermore, health economic evaluations showed that a guided version of the utilised SMI from prior studies was cost-effective [20, 21].”
BackgroundLi, J., Loerbroks, A., Jarczok, M. N., Schöllgen, I., Bosch, J. A., Mauss, D., Siegrist, J., & Fischer, J. E. (2012) · American Journal of Industrial Medicine · doi:10.1002/ajim.22018 · Cited by 48 · cited 3× · see citing works
“In addition, the Effort Reward Imbalance Questionnaire – Short Form (ERI-SF) [81] was used with 10 items with a Likert-scale from 1 to 4 that compose the three scales effort, reward and overcommitment (αs = .”
MethodSautier, L., Scherwath, A., Weis, J., Sarkar, S., Bosbach, M., Schendel, M., Ladehoff, N., Koch, U., & Mehnert, A. (2015) · Die Rehabilitation · doi:10.1055/s-0035-1555912 · Cited by 31 · see citing works
Junge, M. N., Lehr, D., Bockting, C., Berking, M., Riper, H. M., Cuijpers, P. J., & Ebert, D. D. (2014) · Internet Interventions · doi:10.1016/j.invent.2014.11.007 · Cited by 27 · cited 1× · see citing works
“Based on Lazarus’ transactional model of stress [60], the intervention was developed for employees and focusses on problem solving [61, 62] and emotion regulation skills [63, 64].”
MethodNeubach, B., & Schmidt, K. (2000) · Zeitschrift für Arbeits- und Organisationspsychologie A&O · doi:10.1026//0932-4089.44.3.140 · Cited by 26 · cited 4× · see citing works
“Emotional exhaustion was measured with the corresponding subscale of the Maslach Burnout Inventory (MBI-GS-D) [75, 76].”
MethodInfluentialFischer, S., Cacace, M., & Wiencke, M. (2016) · Springer eBooks · doi:10.1007/978-3-319-32331-2 · Cited by 21 · see citing works
Kählke, F., Buntrock, C., Smit, F., Berking, M., Lehr, D., Heber, E., Funk, B., Riper, H. M., & Ebert, D. D. (2018) · JMIR Mental Health · doi:10.2196/10866 · Cited by 18 · cited 1× · see citing works
“Furthermore, health economic evaluations showed that a guided version of the utilised SMI from prior studies was cost-effective [20, 21].”
BackgroundTan, L., Wang, M., Modini, M., Joyce, S., Mykletun, A., Christensen, H. M., & Harvey, S. B. (2014) · BMC Medicine · doi:10.1186/s12916-014-0212-4 · Cited by 8 · cited 1× · see citing works
“Against this background, effects of SMI on depression were also investigated and found to be positive at post-intervention and at 6-month follow-up, although larger for the former [15, 30, 33, 34].”
Background
Flagged first, then by citations
1 of the 98 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- [91]Hayes AF Introduction to mediation, moderation and conditional process analysis. A regression-based approach. Second 2018 New York The Guilford Press
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Sorted by citations
Amanvermez, Y., Zhao, R., Cuijpers, P., de Wit, L. M., Ebert, D. D., Kessler, R. C., Bruffaerts, R., & Karyotaki, E. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100503 · Cited by 110 · see citing works
Svärdman, F., Sjöwall, D., & Lindsäter, E. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100553 · Cited by 47 · see citing works
“…of which six used versions of the Perceived Stress Scale (Ebert et al., 2016a; Ebert et al., 2016b; Heber et al., 2016; Harrer and Adam, 2018; Nixon et al., 2021; Rose et al., 2013), one used the Maslach Burnout Inventory (MBI) (Jonas et al., 2016), and one used the Brief Adjustment Disorder…”
BackgroundMethodInfluentialNixon, P., Ebert, D. D., Boß, L., Angerer, P., Dragano, N., & Lehr, D. (2022) · Journal of Medical Internet Research · doi:10.2196/40488 · Cited by 38 · see citing works
“In this study, participants in the IG received adherence-focused guidance that was established and shown to be effective in previous studies [45,67].”
InfluentialEngels, M., Boß, L., Engels, J., Kuhlmann, R., Kuske, J., Lepper, S., Lesener, L., Pavlista, V., Diebig, M., Lunau, T., et al. (2022) · BMC Public Health · doi:10.1186/s12889-022-12921-7 · Cited by 22 · see citing works
Schäfer, A., Jírů-Hillmann, S., Widmann, J., Montellano, F. A., Salmen, J., Pryss, R., Wöckel, A., & Heuschmann, P. U. (2025) · Journal of Cancer Survivorship · doi:10.1007/s11764-023-01470-6 · Cited by 23 · see citing works
“…however, higher usage time or frequency does not appear to be related to an effect on mental health outcomes, which was also shown in another study on mHealth interventions, where the intervention was effective for both the guided group with higher use and the self-help group with lower use [61].”
Juniar, D., van Ballegooijen, W., Schulte, M. H. J., van Schaik, A., Passchier, J., Heber, E., Lehr, D., Sadarjoen, S. S., & Riper, H. M. (2022) · JMIR Formative Research · doi:10.2196/37278 · Cited by 15 · 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
Improving mental health literacy using web- or app-based interventions: A scoping review
Tian, L., Wong, E. L., Dong, D., Cheung, A. W.-L., Chan, S. K. W., Cao, Y., Mok, P. K. H., Zhou, L.-M., & Xu, R. H. (2024) · Digital Health · doi:10.1177/20552076241243133 · Cited by 13 · see citing works
“These included (1) recognition ability 29,30,35 of symptoms, mood changes, and mental illness manifestations; (2) coping strategies and emotion regulation skills 30 – 36”
BackgroundInfluentialWeiss, E. M., Harder, M., Staggl, S., Holzner, B., Dresen, V., & Canazei, M. (2025) · BMC Public Health · doi:10.1186/s12889-025-23399-4 · Cited by 9 · see citing works
Kurisu, K., Song, Y. H., & Yoshiuchi, K. (2022) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000002700 · Cited by 9 · see citing works
Harrer, M., Nixon, P., Sprenger, A. A., Heber, E., Boß, L., Heckendorf, H., Buntrock, C., Ebert, D. D., & Lehr, D. (2024) · BMJ Mental Health · doi:10.1136/bmjment-2023-300846 · Cited by 9 · see citing works
“%) posterior probability that the fully guided and unguided formats produce equivalent effects, and the majority preferred the guided format.”
InfluentialHeckendorf, H., & Lehr, D. (2025) · Journal of Medical Internet Research · doi:10.2196/58475 · Cited by 9 · see citing works
“The effect size ( d= 0.52) for perceived stress in this study is somewhat smaller than effects ranging from d= 0.71 to d= 0.96 in the general working population with guidance [95], as well as with adherence-focused guidance [98,99] and with self-help [96,97,99].”
InfluentialVásquez-Carrasco, E., Hernandez-Martinez, J., Cid-Calfucura, I., Guzmán-Muñoz, E., Ruiz, C., Baeza, C., Márquez, M. J., Herrera-Valenzuela, T., Branco, B. H. M., Carmine-Peña, E., et al. (2025) · Life · doi:10.3390/life15071049 · Cited by 7 · see citing works
“Given the importance of RCTs with active comparators and the increased statistical power provided by trials with three or more arms [24,25], the aim of this study was to evaluate the effects of TKD and BOX interventions, relative to EBT, on body composition and physical function in Chilean older…”
Fasthoff, R. M., Nolte, L., & Kortsch, T. (2023) · Merits · doi:10.3390/merits3040037 · Cited by 9 · see citing works
“Although modern research recommends the inclusion of health-promoting variables [32], these results show a discrepancy between the current work and prior studies that did find evidence for positive-psychological variables [33,46].”
BackgroundResultInfluentialEngels, M., Scheepers, L., Engels, J., Boß, L., Kuhlmann, R., Kuske, J., Lesener, L., Pavlista, V., Schmidt-Stiedenroth, K., Diebig, M., et al. (2024) · BMC Public Health · doi:10.1186/s12889-024-19102-8 · Cited by 9 · see citing works
“ON Stress has been shown to be effective in reducing stress and depressive symptoms in employees with elevated levels of perceived stress with intensive [48] and minimal guidance [52] as well as without any guidance [53].”
Zarski, A., Bernstein, K., Baumeister, H., Lehr, D., Wernicke, S., Küchler, A., Kählke, F., Spiegelhalder, K., & Ebert, D. D. (2025) · Journal of Medical Internet Research · doi:10.2196/58024 · Cited by 7 · see citing works
“Previous studies using the same feedback mechanism found low demand around 10%, leading to the conclusion in our study that the intervention was practically unguided [92].”
Ciumărnean, L., Milaciu, M. V., Vesa, Ș. C., Rebeleanu, C. H., Orasan, O. H., Para, I., Leach, N. V., Hirişcău, E. I., & Dogaru, G. (2023) · Balneo and PRM Research Journal · doi:10.12680/balneo.2023.600 · Cited by 6 · see citing works
“This interventional process is based on three components: 1. physical management, 2. nutritional care, and 3. psychological management [23].”
BackgroundBoß, L., Hannibal, S., & Lehr, D. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1524285 · Cited by 4 · see citing works
von Boros, L., Schaubruch, L. M., Arnold, M., Rigotti, T., Helmreich, I., Lieb, K., Wessa, M., Tüscher, O., & Schäfer, S. K. (2026) · Work & Stress · doi:10.1080/02678373.2026.2618071 · Cited by 2 · see citing works
“Nixon et al. (2021) tested a web-based intervention (eHealth only) informed by the transactional stress model (Lazarus & Folkman, 1984) and problem-solving trainings, additionally providing participants with written feedback from an online coach.”
InfluentialBetriebliche Gesundheitsförderung
Lehr, D., & Boß, L. (2023) · Springer eBooks · doi:10.1007/978-3-662-65816-1_23 · Cited by 3 · see citing works
Svärdman, F., Sjöwall, D., & Lindsäter, E. (2022) · doi:10.31234/osf.io/e7cxd · Cited by 3 · see citing works
Heber, E., Lehr, D., Ebert, D. D., Fraunhofer, L., & Großmann, I. (2023) · Springer eBooks · doi:10.1007/978-3-662-65816-1_13 · Cited by 1 · see citing works
Kalon, L., Boß, L., Wiencke, C., Zarski, A., & Lehr, D. (2026) · Frontiers in Digital Health · doi:10.3389/fdgth.2026.1680033 · Cited by 1 · see citing works
Nixon, P., Ebert, D. D., Boß, L., Angerer, P., Dragano, N., & Lehr, D. (2022) · doi:10.2196/preprints.40488
Fliedner, G. (2022) · Universal Journal of Operations and Management · doi:10.37256/ujom.1220221419
“Recent research investigations have been conducted to test the effectiveness of virtual reality-based SMI offerings (e.g., see Boß et al., 2021; Eklund et al., 2021; Nixon et al., 2021).”
BackgroundBoß, L., Hannibal, S., & Lehr, D. (2024) · doi:10.2196/preprints.56093
Stress Management in Small and Medium-sized Enterprises
Soukupová, N. (2022) · Economics Working Papers · doi:10.32725/ewp.2022.005
Rico, H. F., Pacheco, M. A. D. L. P., Rico, F., & Londoño, T. (2025) · Critical Public Health · doi:10.1080/09581596.2025.2547499
“Nixon et al. (2021) evaluated web-based stress management programs, noting that guided interventions yielded enhanced outcomes compared to self-directed approaches.”
InfluentialEngels, M., Boß, L., Engels, J., Kuhlmann, R., Kuske, J., Lepper, S., Lesener, L., Pavlista, V., Diebig, M., Lunau, T., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19445545
Engels, M., Scheepers, L., Engels, J., Boß, L., Kuhlmann, R., Kuske, J., Lesener, L., Pavlista, V., Schmidt-Stiedenroth, K., Diebig, M., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26735478
Engels, M., Scheepers, L., Engels, J., Boß, L., Kuhlmann, R., Kuske, J., Lesener, L., Pavlista, V., Schmidt-Stiedenroth, K., Diebig, M., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26735496
Engels, M., Boß, L., Engels, J., Kuhlmann, R., Kuske, J., Lepper, S., Lesener, L., Pavlista, V., Diebig, M., Lunau, T., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19445539
Engels, M., Scheepers, L., Engels, J., Boß, L., Kuhlmann, R., Kuske, J., Lesener, L., Pavlista, V., Schmidt-Stiedenroth, K., Diebig, M., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26735487
Engels, M., Scheepers, L., Engels, J., Boß, L., Kuhlmann, R., Kuske, J., Lesener, L., Pavlista, V., Schmidt-Stiedenroth, K., Diebig, M., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26735490
Engels, M., Scheepers, L., Engels, J., Boß, L., Kuhlmann, R., Kuske, J., Lesener, L., Pavlista, V., Schmidt-Stiedenroth, K., Diebig, M., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26735484
Engels, M., Boß, L., Engels, J., Kuhlmann, R., Kuske, J., Lepper, S., Lesener, L., Pavlista, V., Diebig, M., Lunau, T., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19445542
Engels, M., Scheepers, L., Engels, J., Boß, L., Kuhlmann, R., Kuske, J., Lesener, L., Pavlista, V., Schmidt-Stiedenroth, K., Diebig, M., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26735481
Engels, M., Scheepers, L., Engels, J., Boß, L., Kuhlmann, R., Kuske, J., Lesener, L., Pavlista, V., Schmidt-Stiedenroth, K., Diebig, M., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26735493
Wirksame Stressmanagement-Trainings für die Polizei gestalten
Kortsch, T. (2026) · Springer eBooks · doi:10.1007/978-3-662-71991-6_32
Dan, P.-L.-Y.-M. R., Nalipay, M. J., Simon, P. D., Liu, S.-X., & King, R. B. (2026) · Psychology in the schools (Print) · doi:10.1002/pits.70157 · Cited by 1 · see citing works
“Asynchronous formats, such as self‐help or web‐based programs, offer flexibility and accessibility (Jayawardene et al. 2017; Nixon et al. 2021).”
Thomsen, A., Syrek, C. J., Brückner, H., de Bloom, J., Janneck, M., Domin, M., Reins, J. A., & Lehr, D. (2026) · Frontiers in Digital Health · doi:10.3389/fdgth.2026.1698339
“While some studies indicate that targeting transdiagnostic risk factors, such as stress or repetitive negative thinking, show no significant advantage over control conditions in reducing depressive symptoms in the general working population (90), others have reported significant differences (91).”
Boß, L., Grolig, L., Apolinário-Hagen, J., Mallwitz, T., Janneck, M., & Lehr, D. (2026) · doi:10.2196/preprints.110720
Lange, M., Hasselmann, O., Schauerte, B., & Lennefer, T. (2026) · Fehlzeiten-Report · doi:10.1007/978-3-662-73665-4_17
- Authors
- Nixon, P., Boß, L., Heber, E., Ebert, D. D., & Lehr, D.
- Affiliations
- Leuphana University of Lüneburg (DE)
- Technical University of Munich (DE)
- Corresponding author
- Lehr, Dirk
- Venue
- BMC Public Health
- Published
- 2021-08-05
- Volume
- 21
- Issue
- 1
- Pages
- 1511-1511
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC8339390
- OpenAlex
- W3193230329
- Cited by
- 43
- References
- 98
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 11 · 2023: 5 · 2022: 13
- FWCI
- 6.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Multilingual Matters (Channel View Publications) (publishedVersion, cc-by)
- Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion, other-oa)
- Funders
- European Union (EFRE: ZW6-80119999, CCI 2007DE161PR001)
- Barmer GEK
- Leuphana Universität Lüneburg
- 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 › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- occupational stress, perceived stress, depressive symptoms, self-help, resilience, mediation analysis, health-promoting factors, employee mental health, intervention adherence, digital mental health interventions, workplace mental health promotion, work-life balance
- MeSH terms
- Internet-Based Intervention, Counseling, Humans, Psychotherapy, Health Behavior, Internet
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