GRECIA Y LA PERVIVENCIA DEL PASADO FILOSOFICO
I. —NUESTRA ACTITUD ANTE LOS GRIEGOS
This pilot study has enabled us to make a more confident but still tentative prediction of effect size for our primary outcome of engagement, we recognise however the limitations of using this effect size to determine sample size for a full trial (Leon, Davis, & Kraemer 2011). The pilot supports optimal adherence to the intervention as being ≥3 logins, and it supports the number of login and page views as being a useful measure of exposure to the intervention. Module completion does not appear to be a useful measure; this may be because exposure to anything less than 100% of the module would not register as module completion whereas participants may benefit from the module without having visited every page. A subjective measure of engagement does appear to be useful, but a more comprehensive measure than the one item measure for this pilot should be used. IWP does not seem to be a measure that is sensitive to the between group changes intended by this CBT based stress
management program, a future study should explore using an alternative measure of occupational outcome (e.g. work engagement or productivity).
One of the challenges of running this pilot study was the recruitment of organisations; out of 780 invitations to individuals to nominate their
organisation to participate in the study, 19 organisations expressed an interest and six organisations were recruited. One explanation for this low take-up by organisations may be that the individuals on the mailing list were not in the position of authority or influence needed to put forward their organisation for the research. Between them, the six organisations taking part in the study recruited 84 participants; a future study may need to spend more time with organisations supporting them to maximise their recruitment of participants.
Thought also needs to be given to recruiting into the discussion groups in order to minimise the wait for the groups to start and to ensure that a larger number of participants are recruited to each group. Increasing the speed of recruitment may provide a solution.
4.9. Limitations
This study had a number of limitations. The first was a limitation of randomising at the level of the individual, which is the potential for contamination between groups: participants in the active conditions
discussing the content of the intervention with the WLC. There is no evidence of contamination at T2 but there is some evidence that between group
conversations had taken place at T3. A second limitation was the generalisability of our findings: participants recruited to this study were
volunteers who had increased levels of stress, and were predominantly well educated females working in social care or the knowledge industry in senior manager or administrator roles, this is not representative of the general workforce. There is a strong need for future research on occupational digital mental health interventions to target industries and occupations that are traditionally under represented in these studies, this includes employees working in blue-collar roles. Only two of the three participating organisations were able to provide demographic data to make a comparison between their workforce, and employees recruited to the study. This information was further limited by a difference between the metrics used by organisations and the metrics used in this study. Future research should work with organisations to collect comparable demographic data so that a better comparison can be made between the workforce and study participants. A third limitation was the recruitment of a targeted population: participants with elevated levels of
stress. Targeting these interventions towards individuals who are perceived to be experiencing stress may add to the stigma of mental health programs impacting on reach and up-take. Future studies may wish to evaluate similar programs with universal populations. Fourthly, some of the measures used in this study were developed or adapted for the study (ie the acceptability and the goal conflict measures), and were found to have relatively low reliability, which may impact on the strength of our findings. Fifthly, a failure in
randomisation in the occupational groups could have effected the outcomes;
we would expect a larger study to correct that. Sixthly, the measures of
engagement used in this study were (with the exception of a limited self-report measure) confined to measures of exposure (i.e. number of login and pages
viewed) future studies of occupational digital mental health interventions may wish to utilise more comprehensive measures of program engagement.
Finally, we recognise the limitations of generalising conclusions from this pilot study and would suggest caution in interpreting our findings.
4.10. Conclusions
The findings of this study suggest that access to an online facilitated discussion group increases engagement with a minimally support occupational digital mental health intervention (as defined by number of logins) but that this increase does not necessarily result in improved
psychological outcomes or increased satisfaction when compared to access to the CBT based stress management intervention on its own. Access to the stress management program resulted in lower levels of depression, anxiety and stress and an increase in comfort and enthusiasm post intervention that were largely maintained at follow-up.
Conflict of interest statement
SC is the founder of WorkGuru, and continues to have a commercial interest in the company.
Authors’ contributions
SC is the principal investigator for the study. SC and KC conceptualised the initial trial design. This was developed with the help of PRH and KG. SC drafted the manuscript and conducted the data analysis. KC, PRH and KG
provided feedback and contributed to the final version of the manuscript. All authors have read and approved the manuscript.
Acknowledgement
Preparation of this manuscript was supported by the Economic and Social Research Council, UK Grant no. ES/L001365/1. Due to ethical concerns, supporting data cannot be made openly available.
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