Transdiagnostic internet intervention for Indonesian university students with depression and anxiety: evaluation of feasibility and acceptability
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Abstract
BACKGROUND: University students with depression and anxiety do not easily receive or seek treatment; therefore, internet-based interventions have been suggested to be a promising way to improve treatment accessibility and availability. However, it has not been examined whether a guided, culturally adapted, transdiagnostic, internet-based intervention is effective for treating symptoms of depression, anxiety, or both among university students in Indonesia. OBJECTIVE: This study aims to investigate the feasibility (acceptability and satisfaction, usability, and uptake) of a guided, culturally adapted, transdiagnostic, internet-based intervention among university students with symptoms of depression, anxiety, or both in Indonesia. METHODS: Students from Universitas Gadjah Mada, Yogyakarta, Indonesia, were screened for symptoms of depression, anxiety, or both, and filled online informed consent, demographic questionnaires, and a quality of life measure at pretreatment assessment (T0). Subsequently, the participants started the intervention. Seven weeks after T0, the primary outcomes of this feasibility study were analyzed at posttreatment assessment (T1) using the 8-item Client Satisfaction Questionnaire (CSQ-8) and the System Usability Scale (SUS). Mean and SDs for the CSQ-8 and SUS were calculated to examine feasibility. Within-group secondary outcomes (depression, anxiety, and quality of life) were inspected for outliers and normal distribution. Paired-sample t tests were used to investigate differences between time points of secondary outcomes. A mixed-method approach of quantitative and qualitative analyses was adopted. Both the primary and secondary outcomes were additionally explored with an individual semistructured interview and synthesized descriptively. RESULTS: A total of 50 participants completed the intervention. We found a moderate to high level of satisfaction and acceptability, a slightly below-average level of desirable usability (≥70), and an adherence rate of 52% which was higher than expected given the novelty of the intervention. Results for the secondary outcomes indicated a decrease in depression and anxiety. For depression, the overall mean difference between the 2 time points for depression was 3.92 (95% CI 2.75-5.1; Hedges g 1.15; P<.001). For anxiety, the overall mean difference between the 2 time points was 3.34 (95% CI 2.06-4.61; Hedges g 1.02; P<.001). Further, a moderate effect in improving quality of life was found (g=0.50). Overall, participants were positive about the online intervention and ECoaches (online guidance), and they found the intervention to be culturally appropriate. CONCLUSIONS: A culturally adapted, transdiagnostic, internet-based intervention appears to be acceptable and feasible for reducing symptoms of depression, anxiety, or both, and increasing quality of life in university students in Indonesia. Future studies should include a randomized controlled trial to assess the effectiveness of such interventions as they may supplement existing counseling services in universities, reduce the treatment costs, and maximize treatment accessibility in low-resourced settings. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1016/j.invent.2018.11.002.
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The intervention reach is similar to that found in other studies administering transdiagnostic treatments for depression and anxiety.
“the intervention reach is similar to that found in other studies administering transdiagnostic treatments for depression and anxiety (Rahmadiana et al., 2021).”
From Feasibility, acceptability, and preliminary efficacy of a blended transdiagnostic group CBT for the treatment of emotional disorders (2025) · cites this paper as Rahmadiana et al., 2021
The Results (Participants; page not available) report that 96 of 240 interested students started the intervention, an uptake of 40.0%. The paper does not compare that reach with reach in other transdiagnostic-treatment studies, so the claimed similarity is unsupported. (LLM, conf=0.83)
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A blended intervention for adjustment disorder: Results from a feasibility trial
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- Authors
- Rahmadiana, M., Karyotaki, E., Schulte, M., Ebert, D. D., Passchier, J., Cuijpers, P., Berger, T., van Ballegooijen, W., Wimbarti, S., & Riper, H.
- Affiliations
- Amsterdam Public Health (NL)
- Harvard University (US)
- Leuphana University of Lüneburg (DE)
- University of Bern (CH)
- Universitas Gadjah Mada (ID)
- Corresponding author
- Rahmadiana, Metta
- ORCID
- Venue
- JMIR Mental Health
- Publisher
- JMIR Publications Inc.
- Published
- 2021-03-05
- Volume
- 8
- Issue
- 3
- Pages
- e20036
- ISSN
- 2368-7959 (ISSN-L)
- PMC
- PMC7980121
- OpenAlex
- W3112909852
- Cited by
- 44
- References
- 62
- Citations by year
- 2026: 3 · 2025: 14 · 2024: 6 · 2023: 8 · 2022: 8 · 2021: 5
- FWCI
- 4.74
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Mental Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, other-oa)
- Multilingual Matters (Channel View Publications) (publishedVersion, cc-by)
- VU Research Portal (publishedVersion, other-oa)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- Bern Open Repository and Information System (University of Bern) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Pure Amsterdam UMC (submittedVersion, cc-by)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Open Access CRIS of the University of Bern
- Funders
- Lembaga Pengelola Dana Pendidikan
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- depression, anxiety, university students, feasibility, acceptability, culturally tailored interventions, quality of life, client satisfaction, usability, adherence, Indonesia, treatment accessibility
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