Investigating the Efficacy of the Web-Based Common Elements Toolbox (COMET) Single-Session Interventions in Improving UK University Student Well-Being: Randomized Controlled Trial
BackgroundMental health problems in university students are associated with many negative outcomes, yet there is a gap between need and timely access to help. Single-session interventions (SSIs) are designed to be scalable and accessible, delivering core evidence-based interv...
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JMIR Publications
2025-01-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2025/1/e58164 |
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| author | Jeffrey Lambert Maria Loades Noah Marshall Nina Higson-Sweeney Stella Chan Arif Mahmud Victoria Pile Ananya Maity Helena Adam Beatrice Sung Melanie Luximon Keren MacLennan Clio Berry Paul Chadwick |
| author_facet | Jeffrey Lambert Maria Loades Noah Marshall Nina Higson-Sweeney Stella Chan Arif Mahmud Victoria Pile Ananya Maity Helena Adam Beatrice Sung Melanie Luximon Keren MacLennan Clio Berry Paul Chadwick |
| author_sort | Jeffrey Lambert |
| collection | DOAJ |
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BackgroundMental health problems in university students are associated with many negative outcomes, yet there is a gap between need and timely access to help. Single-session interventions (SSIs) are designed to be scalable and accessible, delivering core evidence-based intervention components within a one-off encounter.
ObjectiveCOMET (Common Elements Toolbox) is an online self-help SSI that includes behavioral activation, cognitive restructuring, gratitude, and self-compassion. COMET has previously been evaluated in India, Kenya, and the United States with promising results. This study tests the acceptability, appropriateness, perceived utility, and efficacy of COMET among UK university students during the peripandemic period.
MethodsWe conducted a randomized controlled trial evaluating the efficacy of COMET compared with a control group, with 2- and 4-week follow-ups. Outcome variables were subjective well-being, depression severity, anxiety severity, positive affect, negative affect, and perceived stress. We also measured intervention satisfaction immediately after completion of COMET. All UK university students with access to the internet were eligible to participate and were informed of the study online. The data were analyzed using linear mixed models and reported in accordance with the CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile Health Applications and Online Telehealth) checklist.
ResultsOf the 831 people screened, 468 participants were randomized to a condition, 407 completed the postintervention survey, 147 returned the 2-week follow-up survey, 118 returned the 4-week follow-up survey, and 89 returned both. Of the 239 randomized, 212 completed COMET. Significant between-group differences in favor of the COMET intervention were observed at 2-week follow-ups for subjective well-being (Warwick-Edinburgh Mental Well-Being Scale; mean difference [MD] 1.39, 95% CI 0.19-2.61; P=.03), depression severity (9-item Patient Health Questionnaire; MD –1.31, 95% CI –2.51 to –0.12; P=.03), and perceived stress (4-item Perceived Stress Scale; MD –1.33, 95% CI –2.10 to –0.57; P<.001). Overall, participants were satisfied with COMET, with the majority endorsing the intervention and its modules as acceptable, appropriate, and exhibiting high utility. The self-compassion module was most often reported as the participants’ favorite module and the behavioral activation module was their least favorite. Qualitative analysis revealed that participants found COMET generally accessible, but too long, and experienced immediate and long-term beneficial effects.
ConclusionsThis study demonstrated high engagement with the COMET intervention, along with preliminary short-term efficacy. Almost all participants completed the intervention, but study attrition was high. Participant feedback indicated a high level of overall satisfaction with the intervention, with perceived accessibility, immediate benefits, and potential long-term impact being notable findings. These findings support the potential value of COMET as a mental health intervention and highlight important areas for further improvement.
Trial RegistrationClinicalTrials.gov NCT05718141; https://clinicaltrials.gov/ct2/show/NCT05718141 |
| format | Article |
| id | doaj-art-c7d3a97c1c6b44469ca99a16f9ddd9e2 |
| institution | Kabale University |
| issn | 1438-8871 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj-art-c7d3a97c1c6b44469ca99a16f9ddd9e22025-01-31T15:45:34ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-01-0127e5816410.2196/58164Investigating the Efficacy of the Web-Based Common Elements Toolbox (COMET) Single-Session Interventions in Improving UK University Student Well-Being: Randomized Controlled TrialJeffrey Lamberthttps://orcid.org/0000-0003-4774-9054Maria Loadeshttps://orcid.org/0000-0002-0839-3190Noah Marshallhttps://orcid.org/0009-0003-3625-3608Nina Higson-Sweeneyhttps://orcid.org/0000-0002-6926-0463Stella Chanhttps://orcid.org/0000-0003-4088-4528Arif Mahmudhttps://orcid.org/0000-0003-2125-4723Victoria Pilehttps://orcid.org/0000-0002-9177-2844Ananya Maityhttps://orcid.org/0009-0009-6886-9128Helena Adamhttps://orcid.org/0000-0002-9702-3289Beatrice Sunghttps://orcid.org/0009-0000-9988-0703Melanie Luximonhttps://orcid.org/0009-0002-6855-6745Keren MacLennanhttps://orcid.org/0000-0002-3148-3450Clio Berryhttps://orcid.org/0000-0003-1164-9836Paul Chadwickhttps://orcid.org/0000-0002-6765-6325 BackgroundMental health problems in university students are associated with many negative outcomes, yet there is a gap between need and timely access to help. Single-session interventions (SSIs) are designed to be scalable and accessible, delivering core evidence-based intervention components within a one-off encounter. ObjectiveCOMET (Common Elements Toolbox) is an online self-help SSI that includes behavioral activation, cognitive restructuring, gratitude, and self-compassion. COMET has previously been evaluated in India, Kenya, and the United States with promising results. This study tests the acceptability, appropriateness, perceived utility, and efficacy of COMET among UK university students during the peripandemic period. MethodsWe conducted a randomized controlled trial evaluating the efficacy of COMET compared with a control group, with 2- and 4-week follow-ups. Outcome variables were subjective well-being, depression severity, anxiety severity, positive affect, negative affect, and perceived stress. We also measured intervention satisfaction immediately after completion of COMET. All UK university students with access to the internet were eligible to participate and were informed of the study online. The data were analyzed using linear mixed models and reported in accordance with the CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile Health Applications and Online Telehealth) checklist. ResultsOf the 831 people screened, 468 participants were randomized to a condition, 407 completed the postintervention survey, 147 returned the 2-week follow-up survey, 118 returned the 4-week follow-up survey, and 89 returned both. Of the 239 randomized, 212 completed COMET. Significant between-group differences in favor of the COMET intervention were observed at 2-week follow-ups for subjective well-being (Warwick-Edinburgh Mental Well-Being Scale; mean difference [MD] 1.39, 95% CI 0.19-2.61; P=.03), depression severity (9-item Patient Health Questionnaire; MD –1.31, 95% CI –2.51 to –0.12; P=.03), and perceived stress (4-item Perceived Stress Scale; MD –1.33, 95% CI –2.10 to –0.57; P<.001). Overall, participants were satisfied with COMET, with the majority endorsing the intervention and its modules as acceptable, appropriate, and exhibiting high utility. The self-compassion module was most often reported as the participants’ favorite module and the behavioral activation module was their least favorite. Qualitative analysis revealed that participants found COMET generally accessible, but too long, and experienced immediate and long-term beneficial effects. ConclusionsThis study demonstrated high engagement with the COMET intervention, along with preliminary short-term efficacy. Almost all participants completed the intervention, but study attrition was high. Participant feedback indicated a high level of overall satisfaction with the intervention, with perceived accessibility, immediate benefits, and potential long-term impact being notable findings. These findings support the potential value of COMET as a mental health intervention and highlight important areas for further improvement. Trial RegistrationClinicalTrials.gov NCT05718141; https://clinicaltrials.gov/ct2/show/NCT05718141https://www.jmir.org/2025/1/e58164 |
| spellingShingle | Jeffrey Lambert Maria Loades Noah Marshall Nina Higson-Sweeney Stella Chan Arif Mahmud Victoria Pile Ananya Maity Helena Adam Beatrice Sung Melanie Luximon Keren MacLennan Clio Berry Paul Chadwick Investigating the Efficacy of the Web-Based Common Elements Toolbox (COMET) Single-Session Interventions in Improving UK University Student Well-Being: Randomized Controlled Trial Journal of Medical Internet Research |
| title | Investigating the Efficacy of the Web-Based Common Elements Toolbox (COMET) Single-Session Interventions in Improving UK University Student Well-Being: Randomized Controlled Trial |
| title_full | Investigating the Efficacy of the Web-Based Common Elements Toolbox (COMET) Single-Session Interventions in Improving UK University Student Well-Being: Randomized Controlled Trial |
| title_fullStr | Investigating the Efficacy of the Web-Based Common Elements Toolbox (COMET) Single-Session Interventions in Improving UK University Student Well-Being: Randomized Controlled Trial |
| title_full_unstemmed | Investigating the Efficacy of the Web-Based Common Elements Toolbox (COMET) Single-Session Interventions in Improving UK University Student Well-Being: Randomized Controlled Trial |
| title_short | Investigating the Efficacy of the Web-Based Common Elements Toolbox (COMET) Single-Session Interventions in Improving UK University Student Well-Being: Randomized Controlled Trial |
| title_sort | investigating the efficacy of the web based common elements toolbox comet single session interventions in improving uk university student well being randomized controlled trial |
| url | https://www.jmir.org/2025/1/e58164 |
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