Guided Internet-based Interventions in Primary Care Effectiveness-implementation Randomized Controlled Trial

NCT ID: NCT05118828

Last Updated: 2024-12-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

1000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-20

Study Completion Date

2026-06-30

Brief Summary

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Internet-based cognitive behavioral therapy for anxiety and depression have far-reaching potential to overcome common barriers to accessing evidence-based treatment, such as waiting lists, travel distance and costs. Despite the undeniable promise of iCBT, several aspects remain poorly understood and warrants further study.

The INTERMENTAL project is a joint effort between Norwegian Institute of Public Health, Norwegian Directorate of Health and six Prompt Mental Health Care (PMHC) services, situated in 11 municipalities, to evaluate the iCBT interventions developed by the technology company "Assistert Selvhjelp" (AS-iCBT). We will conduct a large-scale hybrid effectiveness-implementation randomized controlled non-inferiority trial that will provide new knowledge on the effectiveness, cost-effectiveness and implementation of AS-iCBT in primary care.

Primary objective: Examine the non-inferiority of guided internet-based cognitive behavioural treatment "Assistert Selvhjelp" (AS-iCBT) compared to treatment as usual in the primary care service Prompt Mental Health Care (TAU-PMHC) with regard to effects on symptoms of anxiety and depression.

Secondary objectives: (i) Examine the non-inferiority of AS-iCBT compared to TAU-PMHC on other outcomes such as quality of life, functional level, specific anxiety measures (social anxiety, panic disorder), sleep and employment status; (ii) Examine the cost-effectiveness of AS-iCBT compared to TAU-PMHC; (iii) Examine to what extent moderators and mediators of change are associated with treatment effectiveness of AS-iCBT; (iv) Assess whether AS-iCBT is as acceptable and appropriate for treatment of anxiety and depression as TAU-PMHC, and examine barriers/facilitators for their further implementation.

Detailed Description

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Conditions

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Anxiety Mild to Moderate Depression

Keywords

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Anxiety Depression Guided internet-based interventions CBT Outcome monitoring Dissemination Routine services

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Guided internet-based treatment (AS-iCBT)

Group Type EXPERIMENTAL

Guided internet-based cognitive behavioural therapy

Intervention Type BEHAVIORAL

AS-iCBT offers guided CBT intervention for anxiety and depression, each consisting of 6 modules. It is recommended for clients to complete 1 module weekly. The structure and content of the programme modules follow evidence-based CBT principles, and comprises cognitive and behavioural components such as self-monitoring, gradual stimulus control, exposure, behavioural activation, and cognitive restructuring. It is recommended that therapist support is provided weekly during short sessions that focus on progress monitoring and feedback on completed work. Support sessions should last 15-20 minutes and are preferably delivered by phone or video conference.

Treatment as usual in Prompt Mental Health Care (TAU-PMHC)

Group Type ACTIVE_COMPARATOR

Treatment as usual in Prompt Mental Health Care (TAU-PMHC)

Intervention Type BEHAVIORAL

TAU-PMHC includes both low-intensity (guided self-help, group-based psychoeducation) and high-intensity CBT (F2F-CBT). The TAU-PMHC condition basically represents how PMHC services currently operates (i.e. a pragmatic stepped care model) and provides therapists with more flexibility to accommodate client needs and preferences.

Interventions

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Guided internet-based cognitive behavioural therapy

AS-iCBT offers guided CBT intervention for anxiety and depression, each consisting of 6 modules. It is recommended for clients to complete 1 module weekly. The structure and content of the programme modules follow evidence-based CBT principles, and comprises cognitive and behavioural components such as self-monitoring, gradual stimulus control, exposure, behavioural activation, and cognitive restructuring. It is recommended that therapist support is provided weekly during short sessions that focus on progress monitoring and feedback on completed work. Support sessions should last 15-20 minutes and are preferably delivered by phone or video conference.

Intervention Type BEHAVIORAL

Treatment as usual in Prompt Mental Health Care (TAU-PMHC)

TAU-PMHC includes both low-intensity (guided self-help, group-based psychoeducation) and high-intensity CBT (F2F-CBT). The TAU-PMHC condition basically represents how PMHC services currently operates (i.e. a pragmatic stepped care model) and provides therapists with more flexibility to accommodate client needs and preferences.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Presence of anxiety and/or mild to moderate depression.
* Being above 18 years of age and a resident in the pilot sites.
* Basic verbal and oral Norwegian proficiency.
* Having internet access and ability to use it.

Exclusion Criteria

* Entitled to secondary care services due to eating disorder, suicide risk, bipolar disorder, severe depression, psychotic symptoms, severe substance abuse, and/or personality disorder.
* Two or more previous treatment attempts in secondary care services without effect.
* Serious physical health problem as primary problem.
* Clients that have had treatment at PMHC before and only require a booster session.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Norwegian Directorate of Health

OTHER_GOV

Sponsor Role collaborator

University of Bergen

OTHER

Sponsor Role collaborator

Göteborg University

OTHER

Sponsor Role collaborator

University of Tromso

OTHER

Sponsor Role collaborator

Sussex Partnership NHS Foundation Trust

OTHER

Sponsor Role collaborator

Norwegian Institute of Public Health

OTHER_GOV

Sponsor Role lead

Responsible Party

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Robert Smith

Research Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Robert Smith, PhD

Role: PRINCIPAL_INVESTIGATOR

Norwegian Institute of Public Health

Locations

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PMHC Fosen

Brekstad, , Norway

Site Status

PMHC Karmøy

Kopervik, , Norway

Site Status

PMHC Vestvågøy

Leknes, , Norway

Site Status

PMHC Notodden

Notodden, , Norway

Site Status

PMHC Sandnes

Sandnes, , Norway

Site Status

PMHC Modum

Vikersund, , Norway

Site Status

Countries

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Norway

Other Identifiers

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20-397

Identifier Type: -

Identifier Source: org_study_id