Background
Methods
Patients and methods
Procedure
Module | Contents | Video duration (min) |
---|---|---|
Module Sleep A | Video 1: Knowledge regarding healthy sleep: sleep stages, sleep–wake regulation, why we sleep, consequences of impaired sleep, unchangeable influencing factors | 8:17 |
Interactive part 1: Chronotype questionnaire | ||
Video 2: Relaxation and sleep | 4:47 | |
Interactive part 2: Relaxation exercise | ||
Module Sleep B | Video 1: Influencing factors and sleep disorders: changeable influencing factors, sleep disorders, development of a sleep disorder | 6:46 |
Interactive part 1: Quiz about healthy sleep | ||
Video 2: Rules for good sleep: healthy sleep hygiene, healthy sleep environment | 6:27 | |
Interactive part 2: Relaxation exercise | ||
Module Sleep C | Video 1: Cognitions, rumination and sleep: cognitions as influencing factor, typical sleep disturbing cognitions, contents of sleep disturbing cognitions, sleep myths | 7:45 |
Interactive part 1: Quiz about sleep myths | ||
Video 2: Techniques for nightly ruminations: rumination chair, cognitive designing, how to create healthy sleep-related cognitions | 6:31 | |
Interactive part 2: Exercise for nightly worries and rumination | ||
Module Stress A | Video 1: Development of stress, stress model, positive sides of stress, physical changes in stress, daily stress, consequences of chronic stress, stress-related behavior and thoughts, stress circle | 17:11 |
Interactive part 1: Stress Symptom Identification | ||
Video 2: Identifying stress, stress and body, emotions, cognitions, and behavior | 04:10 | |
Interactive part 2: Exercise self-release techniques | ||
Module Stress B | Video 1: Ways out of stress, stress management, changing of primary appraisal, changing of secondary appraisal, changing of coping, changing of reappraisal, subjective start of stress, contents of system | 11:00 |
Interactive part 1: Day-to-day transfer—how to end stress | ||
Video 2: Stress-related cognitions, resources, goals | 10:37 | |
Interactive part 2: Exercise problem solution training | ||
Module mindfulness | Video 1: What is mindfulness, ways to mindfulness, relation of mindfulness, stress and sleep | 11:12 |
Interactive part 1: Short mindfulness exercise | ||
Interactive part 2: Body scan exercise | ||
Module well-being | Video 1: Subjective well-being, perspectives and well-being, why is happiness so temporary, ways to more happiness | 04:55 |
Interactive part 1: Proven vs. ineffective ways to well-being | ||
Video 2: Flow, gratitude, social contact, connections between well-being and stress and mindfulness and sleep | 08:19 | |
Interactive part 2: Exercise gratitude diary |
Participants
Measurements
Pittsburgh Sleep Quality Index (PSQI)
Online Sleep Treatment Acceptance Questionnaire (OSTA)
Online Sleep Treatment Feedback Questionnaire (OSTF)
Online Sleep Treatment Evaluation Questionnaire (OSTE)
Feedback interview
Online prevention and early intervention adaptation (iCBT-I prevention for adults)
Analysis
Qualitative analysis
Course Content | Content Aspects (CA)—content aspects related to information transfer (what content, quantity, etc.) |
Exercises (EX)—content aspects related to the exercises | |
Implementation of the Course | Course Procedure and Structure (PS)—structure of the program, freedom of choice of the module blocks, sequence of the modules, structure and length of the modules |
Technical Implementation of the Course (TI)—this includes everything that roughly falls into the technical handling | |
Feedback on the Course Material (CM)—aspects of the material: presentation, videos, speech, download material | |
Effects on participants | Effects on Participants (EP)—what do the participants say the course has changed for them? Experiences with the program, etc. |
Other comments | Other Comments (OC)—feedback related to, for example, questionnaires or other aspects |
Results
Acceptance
Questions OSTA | M (SD) |
---|---|
The theoretical and practical knowledge was comprehensibly taught | 1.50 (0.75) |
The topic appealed to me | 1.62 (0.82) |
I will implement strategies of the module | 1.69 (0.52) |
The information of the module was helpful to me | 1.81 (0.78) |
There were enough training possibilities | 1.82 (0.85) |
I got new impulses for my everyday life | 2.13 (1.00) |
Contents of the module were new for me | 2.96 (1.26) |
Questions OSTA | M (SD) | M (SD) | M (SD) | M (SD) | M (SD) | M (SD) | M (SD) |
---|---|---|---|---|---|---|---|
Module | Sleep A | Sleep B | Sleep C | Stress A | Stress B | Mindfulness | Well-being |
The theoretical and practical knowledge was comprehensibly taught | 1.67 (1.11) | 1.50 (0.71) | 1.20 (0.40) | 2.00 (0.71) | 1.25 (0.43) | 1.25 (0.43) | 1.67 (0.47) |
The topic appealed to me | 1.50 (0.50) | 1.75 (0.97) | 1.20 (0.40) | 2.00 (0.71) | 1.25 (0.43) | 2.00 (1.22) | 1.67 (0.47) |
I will implement strategies of the module | 1.83 (0.37) | 1.75 (0.43) | 1.60 (0.49) | 2.25 (0.43) | 1.25 (0.43) | 1.50 (0.50) | 1.67 (0.47) |
The information of the module was helpful to me | 2.50 (1.12) | 2.00 (0.00) | 1.20 (0.40) | 2.00 (0.71) | 1.25 (0.43) | 1.75 (0.83) | 2.00 (0.00) |
There were enough training possibilities | 2.00 (1.00) | 1.50 (0.50) | 1.60 (0.49) | 2.25 (1.09) | 1.25 (0.43) | 1.50 (0.50) | 2.67 (0.94) |
I got new impulses for my everyday life | 2.50 (1.12) | 2.50 (0.87) | 1.40 (0.49) | 2.75 (0.83) | 1.25 (0.43) | 2.50 (1.12) | 2.00 (0.00) |
Contents of the module were new for me | 3.17 (1.21) | 3.50 (0.87) | 2.20 (0.98) | 3.50 (0.87) | 2.00 (1.22) | 3.00 (1.58) | 3.33 (0.94) |
Module | Mean (SD) | Feedback frequency |
---|---|---|
Sleep A | 3.12 (0.60) | 6 |
Sleep B | 2.63 (0.58) | 8 |
Sleep C | 2.13 (0.92) | 5 |
Stress A | 2.50 (0.90) | 4 |
Stress B | 1.75 (0.97) | 4 |
Mindfulness | 2.25 (0.50) | 4 |
Well-being | 2.33 (0.50) | 3 |
OSTE questions | Mean (SD) |
---|---|
How would you rate the usability of the program? | 1.67 (0.71) |
How did you like the program overall? | 2.22 (0.44) |
Were you able to learn anything through the program? | 2.89 (0.60) |
Did you change anything about your behavior in general because of the program? | 3.22 (0.44) |
Do you think the program had a positive impact on you? | 2.67 (0.50) |
How much benefit did the program have for you overall? | 2.89 (0.60) |
Qualitative feedback (open answer format)
Course content
Implementation of the course
Effects on participants (EP)
Other comments (OC)
Freq. | Cat. | |
---|---|---|
Positive feedback | ||
The different exercises (54321, breathing exercise, self-release, body scan, if–then exercise) were very well received | 9 | EX |
The drawings are pretty and descriptive | 8 | CM |
The exercises are easy to implement, can be easily integrated into everyday life | 5 | EX |
The system where you can switch the order between main topics works well | 5 | PS |
Concerning the way of speaking, there was positive feedback | 5 | CM |
The awareness of stress sensations was improved and that was very helpful | 4 | EP |
The contents of the program were understandable and to the point | 3 | CA |
Information on factors influencing sleep was good | 3 | CA |
Everyday mindfulness, flow and individual sleep differences highlighted was of particular interest | 3 | CA |
The online tools require practice/getting used to, but they work and also bring benefits | 3 | TI |
The visibility of the speakers in the video was nice | 3 | CM |
The technical implementation is well done | 2 | TI |
The awareness that poor sleep or interruption of sleep is not a big issue helps improve sleep | 2 | EP |
It is good to have various speakers for better attention throughout the program | 1 | CM |
Concrete action was triggered by the program | 1 | EP |
Suggestions for improvement/negative feedback | ||
Speech rate of the videos was too slow (especially for sleeping parts) | 7 | CM |
Background noise was unpleasant, especially during the exercises. Good audio quality is important | 4 | CM |
Some contents were already known | 3 | CA |
The exercises are sometimes formulated somewhat unclearly and should be better illustrated | 3 | EX |
More variety in the form of presentation would be good, especially more audio options would be appreciated | 3 | TI |
Not everything is helpful | 3 | EP |
Additions to the prequestionnaire, not all topics considered relevant were asked about | 3 | OC |
Extension of the offer by individual consulting appointments desired if feasible | 3 | PS |
Concerning the way of speaking, there was negative feedback | 2 | CM |
It was distracting to see the speaker in the video | 2 | CM |
The term “mindfulness” is difficult for some people and should be used in a reflective way | 2 | OC |