低負担予防デジタルメンタルヘルス介入：初年度大学生を対象としたパイロット実現可能性マイクロランダム化試験

Mental health problems among college students have increased significantly and barriers to care contribute to a substantial treatment gap. Digital mental health interventions (DMHIs) show promise for overcoming barriers, but engagement with DMHIs is challenging, underscoring the need for low-burden strategies.

This pilot trial evaluated the feasibility and acceptability of a six-week, low-burden, preventative DMHI that delivered supportive text messages and personalized feedback (PF) to first-semester college students.

Students (N = 120, 64% women, 55% non-Hispanic White) who had mild-to-moderate depressive symptoms (PHQ-9 scores between 5 and 14) and were not engaged in formal mental health care were randomized to intervention (n = 90) or assessment-only (n = 30) conditions. Those in the intervention condition received a weekly PF report and/or supportive text messages at random intervals as part of an embedded micro-randomized trial (MRT). Primary outcomes were feasibility and acceptability of the intervention components. Exploratory analyses examined 1) clinical outcomes after six weeks for the intervention and assessment-only conditions, and 2) weekly clinical outcomes within the intervention group based on the MRT.

The trial demonstrated high feasibility (95% enrollment; 87% retention) and strong intervention acceptability, especially for PF and assessment components. Exploratory analyses did not reveal consistent patterns in between- and within-group comparisons.

Low-burden strategies for assessment and intervention are feasible and acceptable to first-year college students at risk for depression. There is significant potential for integrating these lower-intensity strategies into a full-scale trial that adaptively delivers higher-intensity DMHIs and/or integrate human-delivered components in response to needs over time.