Anxiety disorders are a global problem, affecting 300 million people worldwide and placing significant pressure on individuals and healthcare systems. In Europe alone, the economic impact reached 74.380 million in 2010, with 62.2% attributed to healthcare costs and 37.6% to productivity losses. Despite advances in anxiety treatment, these disorders remain highly prevalent due to limited accessibility, treatment adherence challenges, and diagnostic gaps. Even when treatment is available, new cases emerge faster than overall prevalence decreases, highlighting a critical need for preventive strategies. To address this gap, the European Commission has prioritized the prevention of mental disorders. With widespread smartphone and internet access across Europe, digital preventive health programs present a timely and scalable solution.
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Home / Publications / Publication
ONLINE INTERVENTION AIMS TO PREVENT ANXIETY IN THE GENERAL POPULATION
Publication type: Article Summary
Original title: Effectiveness of a universal personalized intervention for the prevention of anxiety disorders: Protocol of a randomized controlled trial (the prevANS project)
Article publication date: December 2023
Source: Repositório Aberto da Universidade do Porto
Authors: Patrícia Moreno-Peral, Alberto Rodríguez-Morejón, Juan Ángel Bellón, Cristina García-Huércano, Carmela Martínez-Vispo, Henar Campos-Paino, Santiago Galán, Sara Reyes-Martín, Natalia Sánchez Aguadero, Margarida Henriques, Emma Motrico & Sonia Conejo-Cerón
What is the goal, target audience, and areas of digital health it addresses?
The prevANS study aims to validate an online personalized intervention that uses a risk algorithm for the prevention of anxiety disorders, specifically targeting adults without an anxiety diagnosis. This research falls within the areas of internet-based intervention technologies and predictive analytics.
What is the context?
Anxiety disorders are a global problem, affecting 300 million people worldwide and placing significant pressure on individuals and healthcare systems. In Europe alone, the economic impact reached 74.380 million in 2010, with 62.2% attributed to healthcare costs and 37.6% to productivity losses. Despite advances in anxiety treatment, these disorders remain highly prevalent due to limited accessibility, treatment adherence challenges, and diagnostic gaps. Even when treatment is available, new cases emerge faster than overall prevalence decreases, highlighting a critical need for preventive strategies. To address this gap, the European Commission has prioritized the prevention of mental disorders. With widespread smartphone and internet access across Europe, digital preventive health programs present a timely and scalable solution.
In a previous study was already validated a risk algorithm that predicts, with high accuracy, the onset of anxiety disorders in the next 12 months. This algorithm, predictA, was tested on 3564 primary care patients across 6 Spanish regions and incorporates the following risk factors: sex, age, physical and mental quality of life, dissatisfaction with paid and unpaid work, financial difficulties, medication for anxiety, depression or stress.
What are the current approaches?
Current approaches to anxiety prevention rely on non-specific, standardized programs that overlook individual risk factors. While internet-based mental health interventions can be as effective as face-to-face treatments, smartphone-based programs for preventing anxiety lack sufficient data with most trials focusing on treatment rather than prevention. These interventions often struggle with user engagement and adherence, and there is a knowledge gap regarding mediators (factors explaining how the intervention works, such as improved stress management) and moderators (factors influencing who benefits most, such as level of initial anxiety, or digital literacy of the users), which could help improve effectiveness. Additionally, limited cost-effectiveness data for these interventions makes it challenging for policymakers to prioritize investment in mental health prevention technologies.
What does innovation consist of? How is the impact of this study assessed?
The innovation of the prevANS intervention lies in its use of the validated predictA algorithm to assess a person’s risk of developing anxiety and, based on that risk level, provide tailored self-guided support through a mobile application or a website. The predictA algorithm categorizes the participants into low-risk and moderate-high risk groups.
Low-risk participants receive weekly psychoeducational materials, mindfulness exercises, personalized information on their risk factors and stress management tools to help them maintain their low anxiety risk. This content is delivered in engaging formats such as videos, audios and quizzes. Moderate-high risk participants receive this foundational content plus cognitive-behavioral training modules focused on problem-solving, communication skills, decision-making, and working with thoughts. This study uses reminders and progress feedback, awarding points for task completion to boost adherence. If participants show low engagement, a research assistant will contact them.
The impact of prevANS is assessed through a randomized controlled trial involving 2000 adults in Spain and Portugal without an anxiety diagnosis, split into an intervention group using prevANS and a control group receiving usual care. Both groups complete the same questionnaires at baseline, 6 months after, and 12 months after, but the control group receives no intervention or personalized feedback. Primary outcomes measure the cumulative incidence of anxiety disorders, while secondary outcomes assess changes in anxiety and depression symptoms, risk probability of anxiety and depression, improvement in quality of life, user acceptability and satisfaction. Cost-effectiveness and cost-utility analyses are conducted from societal and healthcare perspectives. Additionally, mediators and moderators are analyzed to further refine the intervention.
What are the predictable results?
The prevANS intervention is expected to reduce anxiety disorder incidence and improve quality of life in the intervention group compared to control group. Its personalized, self-guided design is expected to boost adherence by engaging users with tailored content, positioning prevANS as a scalable, cost-effective model for digital mental health prevention. By empowering individuals to manage their mental health, prevANS could reduce reliance on intensive health services, thereby lowering healthcare costs and enhancing productivity. Its cost-effectiveness may support its integration into healthcare policy, encouraging further research into personalized, algorithm-driven preventive interventions.
Would you like to know all the details?
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Home / Publications / Publication
ONLINE INTERVENTION AIMS TO PREVENT ANXIETY IN THE GENERAL POPULATION
Publication type: Article Summary
Original title: Effectiveness of a universal personalized intervention for the prevention of anxiety disorders: Protocol of a randomized controlled trial (the prevANS project)
Article publication date: December 2023
Source: Repositório Aberto da Universidade do Porto
Authors: Patrícia Moreno-Peral, Alberto Rodríguez-Morejón, Juan Ángel Bellón, Cristina García-Huércano, Carmela Martínez-Vispo, Henar Campos-Paino, Santiago Galán, Sara Reyes-Martín, Natalia Sánchez Aguadero, Margarida Henriques, Emma Motrico & Sonia Conejo-Cerón
What is the goal, target audience, and areas of digital health it addresses?
The prevANS study aims to validate an online personalized intervention that uses a risk algorithm for the prevention of anxiety disorders, specifically targeting adults without an anxiety diagnosis. This research falls within the areas of internet-based intervention technologies and predictive analytics.
What is the context?
Anxiety disorders are a global problem, affecting 300 million people worldwide and placing significant pressure on individuals and healthcare systems. In Europe alone, the economic impact reached 74.380 million in 2010, with 62.2% attributed to healthcare costs and 37.6% to productivity losses. Despite advances in anxiety treatment, these disorders remain highly prevalent due to limited accessibility, treatment adherence challenges, and diagnostic gaps. Even when treatment is available, new cases emerge faster than overall prevalence decreases, highlighting a critical need for preventive strategies. To address this gap, the European Commission has prioritized the prevention of mental disorders. With widespread smartphone and internet access across Europe, digital preventive health programs present a timely and scalable solution.
In a previous study was already validated a risk algorithm that predicts, with high accuracy, the onset of anxiety disorders in the next 12 months. This algorithm, predictA, was tested on 3564 primary care patients across 6 Spanish regions and incorporates the following risk factors: sex, age, physical and mental quality of life, dissatisfaction with paid and unpaid work, financial difficulties, medication for anxiety, depression or stress.
What are the current approaches?
Current approaches to anxiety prevention rely on non-specific, standardized programs that overlook individual risk factors. While internet-based mental health interventions can be as effective as face-to-face treatments, smartphone-based programs for preventing anxiety lack sufficient data with most trials focusing on treatment rather than prevention. These interventions often struggle with user engagement and adherence, and there is a knowledge gap regarding mediators (factors explaining how the intervention works, such as improved stress management) and moderators (factors influencing who benefits most, such as level of initial anxiety, or digital literacy of the users), which could help improve effectiveness. Additionally, limited cost-effectiveness data for these interventions makes it challenging for policymakers to prioritize investment in mental health prevention technologies.
What does innovation consist of? How is the impact of this study assessed?
The innovation of the prevANS intervention lies in its use of the validated predictA algorithm to assess a person’s risk of developing anxiety and, based on that risk level, provide tailored self-guided support through a mobile application or a website. The predictA algorithm categorizes the participants into low-risk and moderate-high risk groups.
Low-risk participants receive weekly psychoeducational materials, mindfulness exercises, personalized information on their risk factors and stress management tools to help them maintain their low anxiety risk. This content is delivered in engaging formats such as videos, audios and quizzes. Moderate-high risk participants receive this foundational content plus cognitive-behavioral training modules focused on problem-solving, communication skills, decision-making, and working with thoughts. This study uses reminders and progress feedback, awarding points for task completion to boost adherence. If participants show low engagement, a research assistant will contact them.
The impact of prevANS is assessed through a randomized controlled trial involving 2000 adults in Spain and Portugal without an anxiety diagnosis, split into an intervention group using prevANS and a control group receiving usual care. Both groups complete the same questionnaires at baseline, 6 months after, and 12 months after, but the control group receives no intervention or personalized feedback. Primary outcomes measure the cumulative incidence of anxiety disorders, while secondary outcomes assess changes in anxiety and depression symptoms, risk probability of anxiety and depression, improvement in quality of life, user acceptability and satisfaction. Cost-effectiveness and cost-utility analyses are conducted from societal and healthcare perspectives. Additionally, mediators and moderators are analyzed to further refine the intervention.
What are the predictable results?
The prevANS intervention is expected to reduce anxiety disorder incidence and improve quality of life in the intervention group compared to control group. Its personalized, self-guided design is expected to boost adherence by engaging users with tailored content, positioning prevANS as a scalable, cost-effective model for digital mental health prevention. By empowering individuals to manage their mental health, prevANS could reduce reliance on intensive health services, thereby lowering healthcare costs and enhancing productivity. Its cost-effectiveness may support its integration into healthcare policy, encouraging further research into personalized, algorithm-driven preventive interventions.
Would you like to know all the details?
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