The feasibility, acceptability and efficacy of an app-based intervention (the Coping Camp) in reducing stress among Chinese school adolescents: A cluster randomised controlled trial

PLoS One. 2023 Nov 27;18(11):e0294119. doi: 10.1371/journal.pone.0294119. eCollection 2023.

Abstract

Objectives: This study aimed to determine the efficacies of the Coping Camp app in reducing stress, depression, and anxiety and improving stress-coping behaviours and mental health wellbeing. Additionally, feasibility and acceptability of Coping Camp were evaluated.

Methods: In this unblinded cluster RCT, 540 participants from two high schools in China were randomly assigned to the Coping Camp intervention (n = 6 classes; 275 students) or treatment as usual (n = 5 classes; 265 students) at the class level. Coping Camp was an automated self-help app, consisting of 11 sessions delivered over 11 weeks, with primary outcomes including perceived stress, depression, anxiety, stress-coping behaviours, and mental health well-being. All outcomes were assessed at baseline, post-intervention (11 weeks), and follow-up (19 weeks), with efficacy analysed using linear mixed models and feasibility/acceptability measured by a 5-point Likert scale and qualitative feedback.

Results: At post-intervention and follow-up assessments, 75.4% and 81.7% of participants respectively attended. On average, participants logged in for 8.56 out of 11 sessions. Compared to the control group, the intervention group had significant reductions in levels of perceived stress (p = 0.01, d = 0.15 at T1; p < 0.001, d = 0.18 at T2), anxiety (p = 0.11; d = 0.08 at T1; p = 0.01; d = 0.13 at T2) and depression (p = 0.04, d = 0.11 at T1; p = 0.05, d = 0.10 at T2) but did not have a greater increase in stress-coping behaviours (p = 0.10 at T1; p = 0.97 at T2) or mental health wellbeing (p = 0.93 at T1; p = 0.08 at T2). The average ratings for each session were above 4, and qualitative feedback showed that most participants found the intervention to be "great," "good," and "useful."

Conclusions: The Coping Camp is feasible, acceptable and effective in stress management among Chinese school adolescents.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adaptation, Psychological*
  • Adolescent
  • Anxiety / therapy
  • East Asian People*
  • Feasibility Studies
  • Humans
  • Mobile Applications*
  • Students* / psychology

Grants and funding

XZ, UQ Research Training Scholarship, there is no grant number for this funding, https://scholarships.uq.edu.au/scholarship/graduate-school-scholarships-uqgss---includes-rtp, the sponsors did not play any role in the study design, data collection and analysis, decision to publish or preparation of the manuscript.