Development and Feasibility of a Digital Acceptance and Commitment Therapy-Based Intervention for Generalized Anxiety Disorder: Pilot Acceptability Study
dc.contributor.author | Hemmings, NR | |
dc.contributor.author | Kawadler, JM | |
dc.contributor.author | Whatmough, R | |
dc.contributor.author | Ponzo, S | |
dc.contributor.author | Rossi, A | |
dc.contributor.author | Morelli, D | |
dc.contributor.author | Bird, G | |
dc.contributor.author | Plans, D | |
dc.date.accessioned | 2021-03-04T15:14:02Z | |
dc.date.issued | 2021-02-09 | |
dc.description.abstract | BACKGROUND: Generalized anxiety disorder (GAD) is characterized by excessive worry that is difficult to control and has high comorbidity with mood disorders including depression. Individuals experience long wait times for diagnosis and often face accessibility barriers to treatment. There is a need for a digital solution that is accessible and acceptable to those with GAD. OBJECTIVE: This paper aims to describe the development of a digital intervention prototype of acceptance and commitment therapy (ACT) for GAD that sits within an existing well-being app platform, BioBase. A pilot feasibility study evaluating acceptability and usability is conducted in a sample of adults with a diagnosis of GAD, self-referred to the study. METHODS: Phase 1 applied the person-based approach (creation of guiding principles, intervention design objectives, and the key intervention features). In Phase 2 participants received the app-based therapeutic and paired wearable for 2 weeks. Self-report questionnaires were obtained at baseline and posttreatment. The primary outcome was psychological flexibility (Acceptance and Action Questionnaire-II [AAQ-II]) as this is the aim of ACT. Mental well-being (Warwick-Edinburgh Mental Well-being Scale [WEMWBS]) and symptoms of anxiety (7-item Generalized Anxiety Disorder Assessment [GAD-7]) and depression (9-item Patient Health Questionnaire [PHQ-9]) were also assessed. Posttreatment usability was assessed via self-report measures (System Usability Scale [SUS]) in addition to interviews that further explored feasibility of the digital intervention in this sample. RESULTS: The app-based therapeutic was well received. Of 13 participants, 10 (77%) completed the treatment. Results show a high usability rating (83.5). Participants found the digital intervention to be relevant, useful, and helpful in managing their anxiety. Participants had lower anxiety (d=0.69) and depression (d=0.84) scores at exit, and these differences were significantly different from baseline (P=.03 and .008 for GAD-7 and PHQ-9, respectively). Participants had higher psychological flexibility and well-being scores at exit, although these were not significantly different from baseline (P=.11 and .55 for AAQ-II and WEMWBS, respectively). CONCLUSIONS: This ACT prototype within BioBase is an acceptable and feasible digital intervention in reducing symptoms of anxiety and depression. This study suggests that this intervention warrants a larger feasibility study in adults with GAD. | en_GB |
dc.description.sponsorship | European Union Horizon 2020 | en_GB |
dc.identifier.citation | Vol. 5 (2), article e21737 | en_GB |
dc.identifier.doi | 10.2196/21737 | |
dc.identifier.grantnumber | 871042 | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/125017 | |
dc.language.iso | en | en_GB |
dc.publisher | JMIR Publications | en_GB |
dc.relation.url | https://www.ncbi.nlm.nih.gov/pubmed/33560232 | en_GB |
dc.rights | ©Nicola R Hemmings, Jamie M Kawadler, Rachel Whatmough, Sonia Ponzo, Alessio Rossi, Davide Morelli, Geoffrey Bird, David Plans. Originally published in JMIR Formative Research (http://formative.jmir.org), 09.02.2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on http://formative.jmir.org, as well as this copyright and license information must be included. | en_GB |
dc.subject | acceptance and commitment therapy | en_GB |
dc.subject | anxiety | en_GB |
dc.subject | depression | en_GB |
dc.subject | digital | en_GB |
dc.subject | mHealth | en_GB |
dc.subject | mental health | en_GB |
dc.subject | mobile phone | en_GB |
dc.subject | person-based approach | en_GB |
dc.subject | remote | en_GB |
dc.subject | smartphone | en_GB |
dc.title | Development and Feasibility of a Digital Acceptance and Commitment Therapy-Based Intervention for Generalized Anxiety Disorder: Pilot Acceptability Study | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2021-03-04T15:14:02Z | |
exeter.place-of-publication | Canada | en_GB |
dc.description | This is the final version. Available on open access from JMIR Publications via the DOI in this record | en_GB |
dc.identifier.eissn | 2561-326X | |
dc.identifier.journal | JMIR Formative Research | en_GB |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | en_GB |
dcterms.dateAccepted | 2020-12-18 | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2021-02-09 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2021-03-04T15:11:39Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2021-03-04T15:14:10Z | |
refterms.panel | C | en_GB |
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Except where otherwise noted, this item's licence is described as ©Nicola R Hemmings, Jamie M Kawadler, Rachel Whatmough, Sonia Ponzo, Alessio Rossi, Davide Morelli, Geoffrey Bird, David Plans. Originally published in JMIR Formative Research (http://formative.jmir.org), 09.02.2021.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on http://formative.jmir.org, as well as this copyright and license information must be included.