TY - JOUR
T1 - The Efficacy and Usability of an Unguided Web-Based Grief Intervention for Adults Who Lost a Loved One During the COVID-19 Pandemic
T2 - Randomized Controlled Trial
AU - Dominguez-Rodriguez, Alejandro
AU - Sanz-Gomez, Sergio
AU - González Ramírez, Leivy Patricia
AU - Herdoiza-Arroyo, Paulina Erika
AU - Trevino Garcia, Lorena Edith
AU - de la Rosa-Gómez, Anabel
AU - González-Cantero, Joel Omar
AU - Macias-Aguinaga, Valeria
AU - Miaja, Melina
N1 - Funding Information:
The authors want to thank graphic designers and animators, Javier Velazquez, Edgar Arenas, Karine Tovanche, Alexia Apodaca, Cinthia Holguín, Mariana Martínez, Pedro Gutierrez, and Mitzi Valencia, who created the videos and made more attractive contents for this intervention. The authors would also like to thank Joabián Alvarez Silva, the developer for this intervention, and Dr Flor Rocío Ramírez Martínez for obtaining the funding to conduct the project. The authors also thank Dr Paulina Arenas Landgrave, Sofía Martínez Luna, and Dr María Jesús Hernández Jiménez for their collaboration in the development of the theoretical contents of the intervention. The Autonomous University of Ciudad Juárez provided funds for the development of the Grief COVID platform to provide support to the Mexican population that lost someone to COVID-19 or to any other reasons during the last 6 months. The authors would also like to thank Tecnológico de Monterrey for their support of the manuscript fees. The funding body had no role in the study design, writing of the manuscript, or the decision to submit the paper to a specific journal.
Publisher Copyright:
©Alejandro Dominguez-Rodriguez, Sergio Sanz-Gomez, Leivy Patricia González Ramírez, Paulina Erika Herdoiza-Arroyo, Lorena Edith Trevino Garcia, Anabel de la Rosa-Gómez, Joel Omar González-Cantero, Valeria Macias-Aguinaga, Melina Miaja. Originally published in the Journal of Medical Internet Research.
PY - 2023/4/6
Y1 - 2023/4/6
N2 - BACKGROUND: The death of a loved one was a challenge many people faced during the COVID-19 pandemic within the context of extraordinary circumstances and great uncertainty. Grief is an unavoidable part of life, and for most people, feelings of grief decrease naturally over time. However, for some people, grieving can become a particularly painful process with clinical symptoms that may require professional help to resolve. To provide psychological support to people who had lost a loved one during the COVID-19 pandemic, an unguided web-based psychological intervention was developed.OBJECTIVE: The main objective of this study was to evaluate the efficacy of the web-based treatment, Grief COVID (Duelo COVID in Spanish; ITLAB), in reducing clinical symptoms of complicated grief, depression, posttraumatic stress, hopelessness, anxiety, and suicidal risk in adults. The secondary aim was to validate the usability of the self-applied intervention system.METHODS: We used a randomized controlled trial with an intervention group (IG) and a waitlist control group (CG). The groups were assessed 3 times (before beginning the intervention, upon completing the intervention, and 3 months after the intervention). The intervention was delivered on the web in an asynchronous format through the Duelo COVID web page. Participants created an account that could be used on their computers, smartphones, or tablets. The evaluation process was automated as part of the intervention. RESULTS: A total of 114 participants were randomly assigned to the IG or CG and met criteria for inclusion in the study (n=45, 39.5% completed the intervention and n=69, 60.5% completed the waitlist period). Most participants (103/114, 90.4%) were women. The results indicated that the treatment significantly reduced baseline clinical symptoms in the IG for all variables (P<.001 to P=.006), with larger effect sizes for depression, hopelessness, grief, anxiety, and risk of suicide (all effect sizes ≥0.5). The follow-up evaluation showed that symptom reduction was maintained at 3 months after the intervention. The results from the CG showed that participants experienced significantly decreased levels of hopelessness after completing the time on the waitlist (P<.001), but their suicidal risk scores increased. Regarding the usability of the self-applied intervention system, the results indicated a high level of satisfaction with the Grief COVID.CONCLUSIONS: The self-applied web-based intervention Grief COVID was effective in reducing symptoms of anxiety, depression, hopelessness, risk of suicide risk, posttraumatic stress disorder, and complicated grief disorder. Grief COVID was evaluated by the participants, who reported that the system was easy to use. These results affirm the importance of developing additional web-based psychological tools to help reduce clinical symptoms in people experiencing grief because of the loss of a loved one during a pandemic.TRIAL REGISTRATION: ClinicalTrials.gov NCT04638842; https://clinicaltrials.gov/ct2/show/NCT04638842.
AB - BACKGROUND: The death of a loved one was a challenge many people faced during the COVID-19 pandemic within the context of extraordinary circumstances and great uncertainty. Grief is an unavoidable part of life, and for most people, feelings of grief decrease naturally over time. However, for some people, grieving can become a particularly painful process with clinical symptoms that may require professional help to resolve. To provide psychological support to people who had lost a loved one during the COVID-19 pandemic, an unguided web-based psychological intervention was developed.OBJECTIVE: The main objective of this study was to evaluate the efficacy of the web-based treatment, Grief COVID (Duelo COVID in Spanish; ITLAB), in reducing clinical symptoms of complicated grief, depression, posttraumatic stress, hopelessness, anxiety, and suicidal risk in adults. The secondary aim was to validate the usability of the self-applied intervention system.METHODS: We used a randomized controlled trial with an intervention group (IG) and a waitlist control group (CG). The groups were assessed 3 times (before beginning the intervention, upon completing the intervention, and 3 months after the intervention). The intervention was delivered on the web in an asynchronous format through the Duelo COVID web page. Participants created an account that could be used on their computers, smartphones, or tablets. The evaluation process was automated as part of the intervention. RESULTS: A total of 114 participants were randomly assigned to the IG or CG and met criteria for inclusion in the study (n=45, 39.5% completed the intervention and n=69, 60.5% completed the waitlist period). Most participants (103/114, 90.4%) were women. The results indicated that the treatment significantly reduced baseline clinical symptoms in the IG for all variables (P<.001 to P=.006), with larger effect sizes for depression, hopelessness, grief, anxiety, and risk of suicide (all effect sizes ≥0.5). The follow-up evaluation showed that symptom reduction was maintained at 3 months after the intervention. The results from the CG showed that participants experienced significantly decreased levels of hopelessness after completing the time on the waitlist (P<.001), but their suicidal risk scores increased. Regarding the usability of the self-applied intervention system, the results indicated a high level of satisfaction with the Grief COVID.CONCLUSIONS: The self-applied web-based intervention Grief COVID was effective in reducing symptoms of anxiety, depression, hopelessness, risk of suicide risk, posttraumatic stress disorder, and complicated grief disorder. Grief COVID was evaluated by the participants, who reported that the system was easy to use. These results affirm the importance of developing additional web-based psychological tools to help reduce clinical symptoms in people experiencing grief because of the loss of a loved one during a pandemic.TRIAL REGISTRATION: ClinicalTrials.gov NCT04638842; https://clinicaltrials.gov/ct2/show/NCT04638842.
KW - Anxiety
KW - Complicated grief
KW - Depression
KW - Hopelessness
KW - Mobile phone
KW - Posttraumatic stress
KW - Suicidal risk
KW - Usability
KW - Web-based intervention
UR - http://www.scopus.com/inward/record.url?scp=85152167632&partnerID=8YFLogxK
U2 - 10.2196/43839
DO - 10.2196/43839
M3 - Article
C2 - 36877800
AN - SCOPUS:85152167632
SN - 1439-4456
VL - 25
JO - Journal of medical internet research
JF - Journal of medical internet research
M1 - e43839
ER -