The rise in mental health challenges among students globally includes heightened stress levels and deteriorating well-being, subsequently impacting academic performance and leading to mental health disorders. Despite the availability of stress management solutions, stigma, and symptom underestimation often deter students from seeking help. Conversational agents have shown potential in mitigating stress, depression, and anxiety, yet their effectiveness specifically for stressed students remains under-explored.
A recent study aimed to address this gap by developing a conversational agent named MISHA to deliver stress management coaching to students and evaluate its effectiveness, engagement, and acceptance.
Methodology and Participant Allocation
This unblinded randomized controlled trial was conducted with Swiss students experiencing stress, recruited online. Participants (N=140) were randomly assigned to either the intervention group or a waitlist control group using a 1:1 randomization ratio. The primary outcome measured was perceived stress, while secondary outcomes included depression, anxiety, psychosomatic symptoms, and active coping. Self-assessments and evaluations utilized ANOVA for repeated measures and general estimating equations.
Results of the Study
The per-protocol analysis indicated significant improvements in stress, depression, and somatic symptoms, with medium effect sizes (Cohen d=-0.36 to Cohen d=-0.60). In contrast, no significant changes were observed in anxiety and active coping (Cohen d=-0.29 and Cohen d=0.13, respectively). Correspondingly, the intention-to-treat analysis corroborated these findings, showing reduced stress (β estimate=-0.13, 95% CI -0.20 to -0.05; P
The study reported that 60% (42/70) of participants in the intervention group completed the coaching by filling out the post-intervention survey. Participants particularly valued the quality, quantity, credibility, and visual representation of information provided by MISHA. However, individual customization received the lowest ratings, although the perceived fit for the target group was high.
Key Inferences for Users
Key insights from the findings include:
- The MISHA conversational agent effectively reduces perceived stress among students.
- Medium effect sizes were noted for improvements in stress, depression, and somatic symptoms.
- Anxiety and active coping levels did not show significant changes.
- The quality and credibility of information were highly rated by participants.
- Customization features require further enhancement.
The study concludes that MISHA is a feasible, acceptable, and effective tool for reducing perceived stress among Swiss students. Further research is essential, particularly involving students with high stress levels or comparisons with active control groups.
Future studies should continue to explore the potential of conversational agents in various populations, ensuring broader applicability and effectiveness.
Original Article: JMIR Mhealth Uhealth. 2024 Jun 26;12:e54945. doi: 10.2196/54945.
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