Mobile Acceptance and Commitment Therapy With Distressed First-Generation College Students: Microrandomized Trial
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Abstract
Background: Extant gaps in mental health services are intensified among first-generation college students. Improving access to empirically based interventions is critical, and mobile health (mHealth) interventions are growing in support. Acceptance and commitment therapy (ACT) is an empirically supported intervention that has been applied to college students, via mobile app, and in brief intervals. Objective: This study evaluated the safety, feasibility, and effectiveness of an ACT-based mHealth intervention using a microrandomized trial (MRT) design. Methods: Participants (N=34) were 18- to 19-year-old first-generation college students reporting distress, who participated in a 6-week intervention period of twice-daily assessments and randomization to intervention. Participants logged symptoms, moods, and behaviors on the mobile app Lorevimo. After the assessment, participants were randomized to an ACT-based intervention or no intervention. Analyses examined proximal change after randomization using a weighted and centered least squares approach. Outcomes included values-based and avoidance behavior, as well as depressive symptoms and perceived stress. Results: The findings indicated the intervention was safe and feasible. The intervention increased values-based behavior but did not decrease avoidance behavior. The intervention reduced depressive symptoms but not perceived stress. Conclusions: An MRT of an mHealth ACT-based intervention among distressed first-generation college students suggests that a larger MRT is warranted. Future investigations may tailor interventions to contexts where intervention is most impactful. Trial Registration: ClinicalTrials.gov NCT04081662; https://clinicaltrials.gov/show/NCT04081662 International Registered Report Identifier (IRRID): RR2-10.2196/17086
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In a microrandomized trial of an ACT-based mobile intervention on distress symptoms in first-generation university students, interventions prompting mindful awareness and acceptance of internal experience were the most impactful for decreasing depressive symptoms.
“the results suggest that interventions prompting mindful awareness and acceptance of internal experience (ie, thoughts, emotions, and physical sensations) were the most impactful for decreasing depressive symptoms.”
From Optimization of a Transdiagnostic Mobile Emotion Regulation Intervention for University Students: Protocol for a Microrandomized Trial (2023) · cites this paper as [56]
In a microrandomized trial, interventions delivered in the evening were more predictive of decreases in distress symptoms than those delivered in the morning.
“In addition, interventions delivered in the evening were more predictive of decreases in distress symptoms than those delivered in the morning [56].”
From Optimization of a Transdiagnostic Mobile Emotion Regulation Intervention for University Students: Protocol for a Microrandomized Trial (2023) · cites this paper as [56]
These factors seem to play a role in intervention functioning.
“These factors seem to play a role in intervention functioning [51,55,56].”
From Optimization of a Transdiagnostic Mobile Emotion Regulation Intervention for University Students: Protocol for a Microrandomized Trial (2023) · cites this paper as [56]
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Self-citation
- Authors
- Thomas, E. B. K., Sagorac Gruichich, T., Maronge, J. M., Hoel, S., Victory, A., Stowe, Z. N., & Cochran, A.
- Affiliations
- University of Iowa (US)
- The University of Texas MD Anderson Cancer Center (US)
- University of Wisconsin–Madison (US)
- University of Michigan (US)
- Corresponding author
- Thomas, Emily Brenny Kroska
- ORCID
- Venue
- JMIR Mental Health
- Publisher
- JMIR Publications Inc.
- Published
- 2023-05-15
- Volume
- 10
- Pages
- e43065
- ISSN
- 2368-7959 (ISSN-L)
- PMC
- PMC10227702
- OpenAlex
- W4361772788
- Cited by
- 9
- References
- 58
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 1 · 2023: 1
- FWCI
- 2.32
- 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)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institutes of Health (UL1TR002373)
- National Institute of Mental Health (K01MH112876)
- National Center for Advancing Translational Sciences
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- acceptance and commitment therapy, mobile health, first-generation college students, student mental health, depressive symptoms, perceived stress, avoidance behavior, mobile health apps
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