A Mobile Health Intervention for Mental Health Promotion among University Students: Randomized Controlled Trial
Open accessAbstract
BACKGROUND: High positive mental health, including the ability to cope with the normal stresses of life, work productively, and be able to contribute to one's community, has been associated with various health outcomes. The role of positive mental health is therefore increasingly recognized in national mental health promotion programs and policies. Mobile health (mHealth) interventions could be a cost-effective way to disseminate positive psychological interventions to the general population. OBJECTIVE: The aim of this study was to estimate the effect of a fully automated mHealth intervention on positive mental health, and anxiety and depression symptomology among Swedish university students using a randomized controlled trial design. METHODS: A 2-arm, single-blind (researchers), parallel-groups randomized controlled trial with an mHealth positive psychology program intervention group and a relevant online mental health information control group was employed to estimate the effect of the novel intervention. Participants were recruited using digital advertising through student health care centers in Sweden. Inclusion criteria were (1) university students, (2) able to read and understand Swedish, (3) and have access to a mobile phone. Exclusion criteria were high positive mental health, as assessed by the Mental Health Continuum Short Form (MHC-SF), or high depression and anxiety symptomology, as assessed by the Hospital Anxiety Depression Scale (HADS). The primary outcome was positive mental health (MHC-SF), and the secondary outcomes were depression and anxiety symptomatology (HADS). The subscales of MHC-SF were also analyzed as exploratory outcomes. Outcomes were measured 3 months after randomization through questionnaires completed on the participants' mobile phones. RESULTS: A total of 654 participants (median age 25 years), including 510 (78.0%) identifying as female, were randomized to either the intervention (n=348) or control group (n=306). At follow-up, positive mental health was significantly higher in the intervention group compared with the control group (incidence rate ratio [IRR]=1.067, 95% CI 1.024-1.112, P=.002). For both depression and anxiety symptomatology, the intervention group showed significantly lower scores at follow-up compared with the control group (depression: IRR=0.820, 95% CI 0.714-0.942, P=.005; anxiety: IRR=0.899, 95% CI 0.840-0.962, P=.002). Follow-up rates were lower than expected (58.3% for primary outcomes and 52.3% for secondary outcomes); however, attrition analyses did not identify any systematic attrition with respect to baseline variables. CONCLUSIONS: The mHealth intervention was estimated to be superior to usual care in increasing positive mental health among university students. A protective effect of the intervention was also found on depressive and anxiety symptoms. These findings demonstrate the feasibility of using an automated mobile phone format to enhance positive mental health, which offers promise for the use of mHealth solutions in public mental health promotion. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Registry ISRCTN54748632; http://www.isrctn.com/ISRCTN54748632.
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The most common strategy was positive psychology (n = 2).
“positive psychology [13,25] (n = 2)”
From Analysis of Mobile App-Based Mental Health Solutions for College Students: A Rapid Review (2023) · cites this paper as [25]
The most extended intervention lasted ten weeks, while the shortest lasted one week.
“The most extended intervention lasted ten weeks, [25] while the shortest lasted one week [23].”
From Analysis of Mobile App-Based Mental Health Solutions for College Students: A Rapid Review (2023) · cites this paper as [25]
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- Authors
- Bendtsen, M., Müssener, U., Linderoth, C., & Thomas, K.
- Affiliations
- Linköping University (SE)
- Corresponding author
- Thomas, Kristin
- Venue
- JMIR mhealth and uhealth
- Publisher
- JMIR Publications Inc.
- Published
- 2020-03-20
- Volume
- 8
- Issue
- 3
- Pages
- e17208
- ISSN
- 2291-5222 (ISSN-L)
- PMC
- PMC7125436
- OpenAlex
- W3012103240
- Cited by
- 71
- References
- 29
- Citations by year
- 2026: 14 · 2025: 10 · 2024: 5 · 2023: 9 · 2022: 13 · 2021: 15 · 2020: 5
- FWCI
- 9.49
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR mhealth and uhealth (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DiVA (Linkoping University) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Keywords
- mobile health, positive mental health, positive psychology interventions, university students, depression, anxiety, Mental Health Continuum-Short Form, Hospital Anxiety and Depression Scale, mental health promotion, smartphone-based intervention, student mental health, online mental health information, mental health help-seeking, help-seeking barriers, help-seeking facilitators, help-seeking self-efficacy
- MeSH terms
- Adult, Female, Health Promotion, Humans, Male, Students, Sweden, Universities, Single-Blind Method, Telemedicine, Young Adult
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