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The development and evaluation of an online intervention, ‘MePlusMe’, supporting mood, wellbeing, study skills, and everyday functioning in students in higher education

Patapia Tzotzoli1, 2*, Marietta Papadatou-Pastou3, Rhianna Goozée4, Ruth Ohlsen5, Elizabeth Barley5 and Mark Haddad6
  • 1 Chartered Clinical Psychologist in Private Practice, United Kingdom
  • 2 CEO & Founder of iConcipio Ltd, United Kingdom
  • 3 School of Education, Research Centre for Psychophysiology and Education, National and Kapodistrian University of Athens, Greece
  • 4 Department of Psychosis Studies, Institute of Psychiatry, King’s College London, United Kingdom
  • 5 Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, United Kingdom
  • 6 School of Health Sciences, City University, United Kingdom

Background Higher education institutions (HEIs) have an obligation to provide support for the mental health and wellbeing of their enrolled students. There is growing concern about the mental health and wellbeing of higher education (HE) students, not least because of associations with academic performance. The proportion of UK HE students failing to complete their studies has risen to more than 16%. Demand for student support services (SSS) is increasing, which is likely to result in increased waiting times. This may increase the likelihood of problems escalating and negative consequences for both the individual and HEIs. HEIs are facing major cuts to their budgets, with cuts of up to 40% over four years announced in the last UK Governmental Spending Review. Recent fee increases add further pressure on UK HEIs to be cost-effective, show quality and value for money, and enhance ‘student experience’ - important influences on the ratings, intake, and income of HEIs. This further challenges the ability of UK HEIs to offer effective SSS. There is a need of HEIs SSS to employ alternative means of supporting students. Aims We aimed to develop and evaluate an online multimedia intervention to meet current demand for a system addressing mild to moderate psychological and/or study skill difficulties of HE students. Methods & Results The development of our system followed the Medical Research Council (MRC) guidelines for developing complex interventions. To date, we have conducted two stages of development: a) HEI student survey We administered an online survey to university students at King’s College London between February and April 2012, comprising seven questions regarding difficulties faced by students at university, their views (acceptability and engagement) about online support systems, and what features make such systems useful to them. Data from open-ended and closed questions were explored using descriptive statistics. Respondents (n=61) identified difficulties they faced, which were grouped into three broad categories: time management/work load, social life, and finances. The majority of respondents stated that they would use an online support system if they faced difficulties at university (75.4%), although most of them (95.1%) had never heard of or accessed any online support systems. Respondents expressed a preference for the system to contain a tool to assess which techniques are relevant to the user and direct them to those resources (75.4%), the ability to track progress (67.2%), and the inclusion of tailor-made workshops (65.6%). Respondents also stated that learning techniques to manage their difficulties either via written (56%) or animated videos (56%) was more important to them than understanding their difficulties. The most desirable capability of a system was to be able to function as a mobile application (68.9%). Using these findings, we outlined our system conception, including several key features: • A screening process identifying students with more significant difficulties and redirecting them to appropriate sources of support. • Access for students with mild to moderate difficulties to the system and its techniques via two routes: i) Questionnaire route, where students identify their symptoms and are presented with a package of techniques relevant to their difficulties ii) Workshop route, where students access up to two ready-made packages of techniques by choosing the title relevant to their difficulties • A personal space (“My Place”) where they can access the packages with techniques presented in animated video format, use a rating system to monitor their progress, and receive reminders to return to the system. • A social network. b) Proof of Concept Study Subsequently, we conducted a proof of concept study between September and October 2012 to investigate the acceptability of the system’s design and its reflection of end users’ needs. Five UK HEIs (King’s College London, University of Edinburgh, University of Roehampton, Bournemouth University, and University of Warwick; n = 873 students) participated. Students were presented with an online demo of the system comprising slides and videos demonstrating the proposed aesthetics, elements, and functions of the system. They completed five surveys consisting of 36 open-ended and forced-choice questions with the option to provide further information. Analysis of the quantitative (descriptive) and qualitative (thematic analysis) data showed a positive impression of the questionnaire. Students suggested that questions could be shorter and graphics could be revised to appeal to older users. Students’ impression of the Workshop route was also positive, but they requested removal of the restriction of just two workshops at a time. In “My Place” students suggested that reminder messages be restricted in number and that certain functionalities be added, such as a “blackout” button. Students suggested altered wordings and graphics in the animated videos to suit older age groups and to offer a variety of characters. About half of the students found the system useful, and the vast majority reported that they would use it frequently or somewhat frequently. Whilst fear of stigma and lack of time were key barriers to using the system, students stressed the advantage of privacy it offered for dealing with difficulties. Further development of our system was informed by these results, with the following amendments incorporated: • Simplification of questions in the questionnaire. • Replacement of the Workshops route with a more liberal option, the Library route in which relevant techniques may be chosen without restriction on the number that can be selected. • Optional reminder emails and reduction in their frequency. • Enriched animated videos with more characters to offer variety. • Amended wording, phrasing and graphic design for the system ensuring that it is appropriate for all student age groups. • Added functionalities, e.g., blackout buttons. • The name MePlusMe. Conclusions Findings from the above studies contributed significantly to the development of a system format which appears to facilitate engagement and meet students’ aesthetics and needs. The next step will be a full-scale feasibility study, which is under way. This study will evaluate potential effects on students’ mood (symptoms of anxiety and depression), mental wellbeing, study skills, and everyday functioning, and their engagement and satisfaction with a full-functioning system. The outcomes of this crucial step will inform a randomised controlled trial (RCT), leading to

Keywords: online intervention, mood, Mental Health, wellbeing, Depression, Anxiety, Study Skills, Academic self-efficacy, higher education

Conference: 2nd Behaviour Change Conference: Digital Health and Wellbeing, London, United Kingdom, 24 Feb - 25 Feb, 2016.

Presentation Type: Poster presentation

Topic: Academic

Citation: Tzotzoli P, Papadatou-Pastou M, Goozée R, Ohlsen R, Barley E and Haddad M (2016). The development and evaluation of an online intervention, ‘MePlusMe’, supporting mood, wellbeing, study skills, and everyday functioning in students in higher education. Front. Public Health. Conference Abstract: 2nd Behaviour Change Conference: Digital Health and Wellbeing. doi: 10.3389/conf.FPUBH.2016.01.00027

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Received: 04 Dec 2015; Published Online: 09 Jan 2016.

* Correspondence: Dr. Patapia Tzotzoli, Chartered Clinical Psychologist in Private Practice, London, United Kingdom, patapia@iconcipio.com