Use of a Self-guided Computerized Cognitive Behavioral Tool During COVID-19: Evaluation Study

Area of Science:

• Digital behavioral health interventions
• Online mental health support
• Public health informatics

Background:

• Internet-based programs offer accessible behavioral health care.
• Evaluation of self-referred, open-access online interventions is limited.
• The Dartmouth PATH Program was evaluated during the COVID-19 pandemic.

Purpose of the Study:

• Assess user-reported stress and depression levels and problem types during the COVID-19 pandemic.
• Evaluate the acceptability and usability of the PATH program as a stand-alone resource.
• Understand high dropout rates by comparing usage patterns and efficacy between completers and non-completers.

Main Methods:

• Analyzed cumulative anonymous data from 562 individuals.
• Employed qualitative analysis for stress triggers and problems.
• Used sign test, Wilcoxon signed rank test, and mixed-effects linear modeling for usability, acceptability, and symptom changes.

Main Results:

• Common stress triggers included interpersonal conflicts and work-related issues.
• High attrition rates were observed across modules (13-17%).
• Users who completed sessions showed significant improvements in stress (P=.03) and depression (P=.01).

Conclusions:

• Online interventions effectively address conflicts, worry, and concentration difficulties.
• Engaged users reported improved stress and depression symptoms and high usability/acceptability.
• High attrition remains a significant challenge for freely available online mental health programs.