Text4Hope Effectiveness in Reducing Psychological Symptoms among Young Adults in Canada: Longitudinal and Naturalistic Controlled Program Evaluation
Abstract
:1. Introduction
2. Methodology
2.1. Study Setting and Design
2.2. Ethics Statement
2.3. Text4Hope Program
2.4. Data Collection
2.5. Outcome Measures
2.6. Hypothesis
2.7. Sample Size Considerations
2.8. Statistical Analysis
3. Results
- A
- Longitudinal study outcomes
- B
- Naturalistic controlled trial
3.1. Differences in the Prevalence of Psychological Problems between the IG and CG
3.2. Differences in Mean Scores on Psychological Symptom Rating Scales between Intervention and Control Groups
4. Discussion
Limitations of the Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | Participants Completed Both Baseline and Sixth-Week Surveys, n (%) N = 114 | Participants Completed Only Baseline Survey, n (%) N = 932 a | Total | Chi2/t-Test Value (df) b | p-Value |
---|---|---|---|---|---|
Gender | |||||
Male | 13 (11.4) | 121 (13.0) | 134 (12.8) | 6.54 | 0.04 |
Female | 94 (82.5) | 790 (84.9) | 884 (84.6) | ||
Other | 7 (6.1) | 20 (2.1) | 27 (2.6) | ||
Ethnicity | |||||
White | 88 (77.2) | 654 (70.4) | 742 (71.1) | 4.09 | 0.25 |
Indigenous | 4 (3.5) | 51 (5.5) | 55 (5.3) | ||
Asian | 6 (5.3) | 96 (10.3) | 102 (9.8) | ||
Other | 16 (14.0) | 128 (13.8) | 144 (13.8) | ||
Education Level | |||||
Less than high school diploma | 25 (21.9) | 214 (23.0) | 239 (22.9) | 0.08 | 0.99 |
High school diploma | 21 (18.4) | 172 (18.5) | 193 (18.5) | ||
Postsecondary education | 67 (58.8) | 536 (57.6) | 603 (57.7) | ||
Other education | 1 (0.9) | 9 (1.0) | 10 (1.0) | ||
Employment Status | |||||
Employed | 39 (34.2) | 356 (38.2) | 395 (37.8) | 6.85 | 0.08 |
Unemployed | 19 (16.7) | 203 (21.8) | 222 (21.2) | ||
student | 54 (47.4) | 334 (35.8) | 388 (37.1) | ||
Other | 2 (1.8) | 39 (4.2) | 41 (3.9) | ||
Relationship Status | |||||
Married, cohabiting, or partnered | 52 (45.6) | 465 (50.1) | 517 (49.6) | 2.42 | 0.49 |
Separated or divorced | 2 (1.8) | 7 (0.8) | 9 (0.9) | ||
Single | 59 (51.8) | 441 (47.5) | 500 (47.9) | ||
Other | 1 (0.9) | 16 (1.7) | 17 (1.6) | ||
Housing Status | |||||
Owns a home | 6 (5.3) | 86 (9.4) | 92 (8.9) | 2.37 | 0.5 |
Living with family/friend | 67 (58.8) | 532 (58.1) | 599 (58.2) | ||
Renting | 39 (34.2) | 286 (31.2) | 325 (31.6) | ||
Other | 2 (1.8) | 12 (1.3) | 14 (1.4) | ||
Likely Stress | |||||
At most mild stress | 2 (1.8) | 32 (3.7) | 34 (3.5) | 0.97 | 0.32 |
Moderate to high stress | 107 (98.2) | 841 (96.3) | 948 (96.5) | ||
Likely MDD | |||||
At most mild depression | 30 (28.8) | 262 (31.9) | 292 (31.6) | 0.4 | 0.53 |
Moderate to severe depression | 74 (71.2) | 559 (68.1) | 633 (68.4) | ||
Likely GAD | |||||
At most mild GAD | 25 (24.5) | 274 (34.0) | 299 (33.0) | 3.72 | 0.054 |
Moderate to severe GAD | 77 (75.5) | 531 (66.0) | 608 (67.0) | ||
Total Score of PSS-10 | |||||
Mean score (SD) | N = 109 | N = 873 | - | 1.90 (148.43) c | 0.06 |
26.62 (5.41) | 25.56 (6.40) | ||||
Total Score of PHQ-9 | |||||
Mean score (SD) | N = 104 | N = 821 | - | 0.86 | 0.39 |
14.01 (6.52) | 13.40 (6.81) | −923 | |||
Total Score of GAD-7 | |||||
Mean score (SD) | N = 102 | N = 805 | - | 2.41 | 0.02 |
13.73 (5.14) | 12.29 (5.73) | −905 |
Clinical Condition | Prevalence n/N (%) | Change from Baseline, % | (df) | p-Value | |
---|---|---|---|---|---|
Baseline | Six Weeks | ||||
Moderate to high stress | 93/95 (97.9) | 86/95 (90.5) | 7.56 | 1 | 0.02 |
Likely MDD | 54/81 (66.7) | 49/81 (60.5) | 9.30 | 1 | 0.42 |
Likely GAD | 59/80 (73.8) | 47/80 (58.8) | 20.33 | 1 | 0.01 |
Thoughts of self-harm/death wish | 39/81 (48.1) | 33/81 (40.7) | 15.38 | 1 | 0.24 |
Measure | Scores | Change from Baseline, % | Mean Difference (95% CI) | p-Value | t-Value | Effect Size (Cohen’s d) | ||
---|---|---|---|---|---|---|---|---|
n | Baseline Score, Mean (SD) | Sixth-Week Score, Mean (SD) | ||||||
PSS-10 total score | 95 | 26.46 (5.54) | 25.33 (6.75) | 4.31 | 1.14 (0.03–2.25) | 0.05 | 2.03 | 0.18 |
PHQ-9 total score | 81 | 13.09 (6.38) | 12.48 (6.53) | 4.66 | 0.61 (−0.50–1.71) | 0.28 | 1.09 | 0.09 |
GAD-7 total score | 80 | 13.19 (4.97) | 10.76 (5.62) | 18.42 | 2.43 (1.34–3.51) | <0.01 | 4.45 | 0.46 |
CMH score | 80 | 51.93 (14.63) | 47.84 (17.24) | 7.88 | 4.09 (1.48–7.03) | <0.01 | 2.77 | 0.26 |
Variable | Control Group | Intervention Group | Total | Chi2/Fisher’s Exact * | p-Value |
---|---|---|---|---|---|
Gender | |||||
Male | 13 (14.1) | 15 (8.7) | 28 (10.6) | 3.48 | 0.18 |
Female | 78 (84.8) | 151 (87.3) | 229 (86.4) | ||
Other | 1 (1.1) | 7(4.0) | 8 (3.0) | ||
Ethnicity | |||||
White | 66 (72.5) | 129 (74.6) | 195 (73.9) | 0.31 | 0.96 |
Indigenous | 4 (4.4) | 6 (3.5) | 10 (3.8) | ||
Asian | 12 (13.2) | 20 (11.6) | 32 (12.1) | ||
Other | 9 (9.9) | 18 (10.4) | 27 (10.2) | ||
Education Level | |||||
Less than a high school diploma | 31 (33.7) | 28 (20.4) | 59 (25.8) | 6.42 | 0.09 |
High school diploma | 18 (19.6) | 24 (17.5) | 42 (18.3) | ||
Postsecondary | 42 (45.7) | 84 (61.3) | 126 (55.0) | ||
Other | 1 (1.1) | 1 (0.7) | 2 (0.9) | ||
Employment Status | |||||
Employed | 43 (47.3) | 53 (38.7) | 96 (42.1) | 17.07 | 0.001 |
Unemployed | 0 (0.0) | 23 (16.8) | 23 (10.1) | ||
Student | 46 (50.5) | 59 (43.1) | 105 (46.1) | ||
Other | 2 (2.2) | 2 (1.5) | 4 (1.8) | ||
Relationship Status | |||||
Married, cohabiting, or partnered | 43 (47.3) | 62 (45.3) | 105 (46.1) | 3.64 * | 0.27 |
Separated or divorced | 0 (0.0) | 2 (1.5) | 2 (0.9) | ||
Single | 46 950.5) | 73 (53.3) | 119 (52.2) | ||
Other | 2 (2.2) | 0 (0.0) | 2 (0.9) | ||
Housing Status | |||||
Owns a home | 6 (6.6) | 7 (5.2) | 13 (5.8) | 2.83 | 0.42 |
Live with family/friend | 62 (68.1) | 84 (62.2) | 146 (64.6) | ||
Renting | 21 (23.1) | 43 (31.9) | 64 (28.3) | ||
Other | 2 (2.2) | 1 (0.7) | 3 (1.3) |
Clinical Condition | Prevalence n/N (%) | χ2 (df) | p-Value * | |
---|---|---|---|---|
IG (Baseline) | CG (Baseline) | |||
Moderate to high stress * | 88/90 (97.8%) | 79/82 (96.3%) | 0.31 (1) | 0.67 |
Likely MDD *** | 60/86 (69.8%) | 62/82 (75.6%) | 0.72 (1) | 0.49 |
Likely GAD ** | 61/84 (72.6%) | 59/80 (73.8%) | 0.03 (1) | 0.99 |
Thoughts of self-harm/death wish | 44/87 (50.6) | 42/73 (57.5) | 0.77 (1) | 0.43 |
Clinical Condition | Prevalence n/N (%) | % Difference in Prevalence between the IG and CG | χ2 (df) | p-Value * | Effect Size (Phi/Cramer’s V) | |
---|---|---|---|---|---|---|
IG (Six Weeks) | CG (Baseline) | |||||
Moderate to high stress * | 140/151 (92.7) | 79/82 (96.3) | 3.9% | 1.24 (1) | 0.39 | 0.07 |
Likely MDD *** | 81/134 (60.4) | 62/82 (75.6) | 25.2% | 5.23 (1) | 0.03 | 0.16 |
Likely GAD ** | 80/131 (61.1) | 59/80 (73.8) | 20.8% | 3.55 (1) | 0.07 | 0.13 |
Thoughts of self-harm/death wish | 54/134 (40.3) | 49/82 (59.8) | 48.4% | 7.72 (1) | 0.01 | 0.19 |
Clinical Variables of Interest | p-Value | Odds Ratio | 95% CI for OR | |
---|---|---|---|---|
Lower | Upper | |||
Moderate/high stress * | 0.29 | 0.46 | 0.11 | 1.93 |
MDD likely *** | 0.07 | 0.51 | 0.25 | 1.07 |
GAD likely ** | 0.03 | 0.44 | 0.21 | 0.92 |
Experienced thoughts of self-harm or death wish | 0.01 | 0.42 | 0.21 | 0.82 |
Measure | Scores | Mean Difference (95% CI) | p Value | t-Value (df) | Effect Size (Hedge’s g) | |||
---|---|---|---|---|---|---|---|---|
n | IG, Mean (SD) | n | CG, Mean (SD) | |||||
PSS-10 total score | 151 | 25.08 (6.81) | 82 | 27.24 (6.84) | 2.16 (0.32–4.01) | 0.022 | 2.31 | 0.32 |
PHQ-9 total score | 134 | 12.55 (7.15) | 82 | 15.78 (6.94) | 3.23 (1.28–5.18) | 0.001 | 3.26 | 0.46 |
GAD-7 total score | 131 | 10.89 (5.90) | 80 | 13.45 (5.74) | 2.57 (0.93–4.20) | 0.002 | 3.10 | 0.44 |
CMH Score | 131 | 48.33 (18.21) | 79 | 56.97 (17.39) | 8.65 (3.62–13.68) | 0.001 | 3.40 | 0.48 |
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Agyapong, B.; Shalaby, R.; Vuong, W.; Gusnowski, A.; Surood, S.; Greenshaw, A.J.; Wei, Y.; Agyapong, V.I.O. Text4Hope Effectiveness in Reducing Psychological Symptoms among Young Adults in Canada: Longitudinal and Naturalistic Controlled Program Evaluation. J. Clin. Med. 2023, 12, 1942. https://doi.org/10.3390/jcm12051942
Agyapong B, Shalaby R, Vuong W, Gusnowski A, Surood S, Greenshaw AJ, Wei Y, Agyapong VIO. Text4Hope Effectiveness in Reducing Psychological Symptoms among Young Adults in Canada: Longitudinal and Naturalistic Controlled Program Evaluation. Journal of Clinical Medicine. 2023; 12(5):1942. https://doi.org/10.3390/jcm12051942
Chicago/Turabian StyleAgyapong, Belinda, Reham Shalaby, Wesley Vuong, April Gusnowski, Shireen Surood, Andrew J. Greenshaw, Yifeng Wei, and Vincent Israel Opoku Agyapong. 2023. "Text4Hope Effectiveness in Reducing Psychological Symptoms among Young Adults in Canada: Longitudinal and Naturalistic Controlled Program Evaluation" Journal of Clinical Medicine 12, no. 5: 1942. https://doi.org/10.3390/jcm12051942