HeadGear aims to develop and evaluate a smartphone application-based intervention which combines and utilises two therapies (behavioural activation and mindfulness) which have been shown to be effective in the treatment and prevention of common mental disorders.
There are a number of questions that have been asked along the development and evaluation of this product at a range of levels, culminating in two parallel randomised controlled trials (with symptomatic & a non-symptomatic population) with over 3,000 working Australians to evaluate the effectiveness of the program in preventing and treating depression in the workforce.
The prevalence of depression and anxiety among Australians is high and often goes unrecognised, in particular, among men. Two of the biggest obstacles when tackling employee mental health issues in male-dominated workplaces are the difficulty that many workers have in self-awareness about their own mental health and their reluctance to ask for help.
Given the substantial labour cost of mental illness in Australia (estimated to over $12 billion annually), there has been a shift towards interventions which focus on prevention. New technologies, such as interactive applications on smartphones, offer a very efficient way to address each of these challenges.
Our research mains to establish the effectiveness of the app in decreasing a range of mental illness symptoms, increasing wellbeing, and improving employee functioning.
History of the project
A recent review of the evidence found that common psychotherapeutic techniques, such as cognitive behavioural therapy (CBT), may be effective in preventing common mental disorders . However, the relative utility of some of the less complex (and cheaper) techniques, such as behavioural activation remain unknown .
Furthermore, as the workplace is a dominant setting in the lives of many adults, it is increasingly being recognized as a prime location for mental health prevention interventions , especially as 44% of working Australians report workplace issues as a source of stress ).
Recent rapid growth in the areas of e-mental health (healthcare practices supported by Internet or mobile phone technologies) represent new frontiers for delivering and targeting mental health interventions [5-9]. These developments provide a potential solution to the barriers involved in delivering individually tailored prevention measures across a wide population in a practical, anonymous (thereby counteracting mental health stigma), and cost-effective manner.
Following a model of user engagement for the initial development (ADDIE: Analysis, Design, Development, Implementation, Evaluation) we reviewed the relevant literature and conducted workshops and surveys with a range of relevant end users and stakeholders. Initial implementation to test feasibility, usability and preliminary efficacy was also conducted with working Australians recruited via targeted social media advertising and screened via the program website.
We are currently conducting two parallel randomised controlled trials (with symptomatic & a non-symptomatic population) with over 3,000 working Australians to evaluate the effectiveness of the program. This type of trial represents the gold standard of evaluating the effectiveness of an intervention. As the name suggests, this trial involves randomly placing individuals into one of two conditions; treatment and control. A control is used as a point of reference and we use this to see what the treatment does relative to this control.
In this current trial, we are comparing the newly developed Headgear app with a less intensive version of the same app (Headgear Lite) and following users up over 3 months with the aim of a 12 month follow-up subsequently. The study will recruit Australians who are currently employed and will sample more selectively from a range of male-dominated industries, as this industry has been shown to be at specific risk and has low levels of help-seeking.
A male-dominated industry is defined as one in which ≥70% of workers are male. In Australia, these industries include agriculture/forestry/fishing, utility services (electricity, gas, water and waste), wholesale trade, manufacturing, transport/postal/warehousing, mining, and construction. Emergency services and defence also fit this definition, but were not considered unique industries by the ABS, for this study they were considered as such.
Developed in partnership with beyondblue with donations from the Movember Foundation.
Initial results expected March 2018.
- Deady, M., et al., Designing smartphone mental health applications for emergency service workers. Occupational Medicine, 2017.
- Richards, D.A., et al., Cost and Outcome of Behavioural Activation versus Cognitive Behavioural Therapy for Depression (COBRA): a randomised, controlled, non-inferiority trial. The Lancet, 2016. 388(10047): p. 871-880.
- Tan, L., et al., Preventing the development of depression at work: a systematic review and meta-analysis of universal interventions in the workplace. BMC Med, 2014. 12(1): p. 74.
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- Glozier, N., et al., Internet-delivered cognitive behavioural therapy for adults with mild to moderate depression and high cardiovascular disease risks: a randomised attention-controlled trial. PLoS One, 2013. 8(3): p. e59139.