Efficacy and acceptability of digital stress management micro-interventions

Tremendous interest exists in the use of brief digital "micro-interventions"for online and mobile intervention. Most digital micro-interventions, however, lack a strong theoretical or empirical basis and have not demonstrated efficacy and acceptability. We developed a suite of brief digital stress management micro-interventions based on theory and empirical evidence and tested the efficacy and acceptability of these micro-interventions in managing stress, mood, and perseverative cognition. Participants were 1,050 US adults (ages 35-65) in good health who received digital micro-intervention content (or comparison content) and then completed post-intervention measures and acceptability ratings. We created 16 brief (<2 min) micro-interventions across four therapeutic domains (relaxation, response modulation, positive experiences, and resource buffers) and a brief active comparison activity. We also created one multi-component micro-intervention (∼20 min) that contained elements of all four domains, and a time-matched active comparison activity. A subset (n=850) of participants received one of the 16 brief micro-interventions or a brief comparator; the remainder (n=200) received either the longer multi-component micro-intervention or the time-matched active comparator task. All micro-intervention stress management content reduced acute stress, negative mood, and perseverative cognitions. For all outcomes, the multi-component intervention showed the strongest effects. Active comparator tasks were more weakly associated with outcomes (except that brief distraction was highly effective at reducing perseverative cognitions). Micro-intervention acceptability was generally high across multiple dimensions. These data demonstrate that a diverse set of 16 brief digital micro-interventions comparison activity were efficacious, and an integrative multi-component micro-intervention was more efficacious. Such micro-interventions hold great potential for scalable digital implementation, including "just-in-time"intervention in response to acute risk states.