Feasibility of an internet-based cognitive behavioral treatment for university students with depression and/or anxiety: A mixed-methods single arm repeated measures study

Identifier:  imarina:9599417

Handle: https://hdl.handle.net/20.500.11797/imarina9599417

Authors:  Huguet, Anna; Canals-Sans, Josefa; Williams, Christopher

Abstract:
Mental health problems are prevalent among university students, with anxiety and depression being the most common conditions. Despite available campus services, barriers to access persist, creating a substantial treatment gap. Internet-based cognitive behavioral therapy (iCBT) offers a scalable alternative, although evidence in university settings remains limited. This study assessed the feasibility and preliminary effects of VIVIM, an adapted iCBT program delivered through interactive eBooks for Spanish- and Catalan-speaking university students with anxiety and/or depression. It also evaluated the feasibility of conducting a future randomized controlled trial (RCT). Feasibility was evaluated through recruitment, retention, adherence, engagement, and acceptability. Thirty-three students from Rovira i Virgili University accessed the intervention over eight weeks. Recruitment targets were achieved within the planned timeframe, whereas retention was limited, with 45.45% and 39.39% of participants completing post-treatment and follow-up assessments, respectively. Adherence was low: only 12.12% of participants accessed all six predefined core eBooks, and 6.1% remained engaged throughout the intervention period. Nevertheless, participants who completed post-treatment assessments reported moderate-to-high levels of engagement and satisfaction. Completers and intention-to-treat sensitivity analyses showed significant improvements in depression and anxiety, although the uncontrolled single-arm design does not permit attribution of these changes to the intervention. Exploratory analyses suggested a possible association between greater eBooks use and larger symptom improvements, although findings were based on small subgroups and partly LOCF −imputed data. The findings suggest that both the intervention and study procedures require further optimization before progression to a full-scale RCT, despite encouraging preliminary evidence of improved mental health outcomes.