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      Effectiveness of an internet-based intervention for procrastination in college students (StudiCare Procrastination): Study protocol of a randomized controlled trial

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          Abstract

          Background

          Procrastination, defined as irrational and voluntary delaying of necessary tasks, is widespread and clinically relevant. Its high prevalence among college students comes with serious consequences for mental health and well-being of those affected. Research for proper treatment is still relatively scarce and treatment of choice seems to be cognitive behavior therapy (CBT). The aim of this study is to evaluate the effectiveness and acceptability of an internet- and mobile-based intervention (IMI) for procrastination based on CBT for college students.

          Methods

          A two-armed randomized controlled trial with a calculated sample size of N = 120 participants with problematic procrastination behavior will be conducted. Students will be recruited in Germany, Austria and Switzerland via circular emails at 15+ cooperating universities in the framework of StudiCare, a well-established project that provides IMIs to college students for different health related issues. The intervention group will receive the e-coach guided 5-week IMI StudiCare Procrastination. A waitlist-control group will get access to the unguided IMI 12 weeks after randomization. Assessments will take place before as well as 6 and 12 weeks after randomization. Primary outcome is procrastination, measured by the Irrational Procrastination Scale (IPS). Secondary outcomes include susceptibility to temptation, depression, anxiety, wellbeing and self-efficacy as well as acceptability aspects such as intervention satisfaction, adherence and potential side effects. Additionally, several potential moderators as well as the potential mediators self-efficacy and susceptibility to temptation will be examined exploratorily. Data-analysis will be performed on intention-to-treat basis.

          Discussion

          This study will contribute to the evidence concerning effectiveness and acceptability of an intervention for procrastination delivered via the internet. If it shows to be effective, StudiCare Procrastination could provide a low-threshold, cost-efficient way to help the multitude of students suffering from problems caused by procrastination.

          Trial registration: The trial is registered at the WHO International Clinical Trials Registry Platform via the German Clinical Studies Trial Register (DRKS): DRKS00014321 (date of registration: 06.04.2018). In case of important protocol modifications, trial registration will be updated.

          Trial status: This is protocol version number 1, 11th December 2019. Recruitment started 9th of April 2018 and was completed 30th of November 2018. Assessment and intervention are still ongoing and will be completed by April 2019.

          Highlights

          • Procrastination is common among college students and associated with negative consequences on health and academic success.

          • The effectiveness of a guided Internet-based intervention for procrastination will be compared to a waitlist control group.

          • A range of secondary outcomes like depression, anxiety and stress will be investigated.

          • Moderators and mediators as well as potential risks and side-effects will be explored.

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          Most cited references48

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          Persuasive System Design Does Matter: A Systematic Review of Adherence to Web-Based Interventions

          Background Although web-based interventions for promoting health and health-related behavior can be effective, poor adherence is a common issue that needs to be addressed. Technology as a means to communicate the content in web-based interventions has been neglected in research. Indeed, technology is often seen as a black-box, a mere tool that has no effect or value and serves only as a vehicle to deliver intervention content. In this paper we examine technology from a holistic perspective. We see it as a vital and inseparable aspect of web-based interventions to help explain and understand adherence. Objective This study aims to review the literature on web-based health interventions to investigate whether intervention characteristics and persuasive design affect adherence to a web-based intervention. Methods We conducted a systematic review of studies into web-based health interventions. Per intervention, intervention characteristics, persuasive technology elements and adherence were coded. We performed a multiple regression analysis to investigate whether these variables could predict adherence. Results We included 101 articles on 83 interventions. The typical web-based intervention is meant to be used once a week, is modular in set-up, is updated once a week, lasts for 10 weeks, includes interaction with the system and a counselor and peers on the web, includes some persuasive technology elements, and about 50% of the participants adhere to the intervention. Regarding persuasive technology, we see that primary task support elements are most commonly employed (mean 2.9 out of a possible 7.0). Dialogue support and social support are less commonly employed (mean 1.5 and 1.2 out of a possible 7.0, respectively). When comparing the interventions of the different health care areas, we find significant differences in intended usage (p = .004), setup (p < .001), updates (p < .001), frequency of interaction with a counselor (p < .001), the system (p = .003) and peers (p = .017), duration (F = 6.068, p = .004), adherence (F = 4.833, p = .010) and the number of primary task support elements (F = 5.631, p = .005). Our final regression model explained 55% of the variance in adherence. In this model, a RCT study as opposed to an observational study, increased interaction with a counselor, more frequent intended usage, more frequent updates and more extensive employment of dialogue support significantly predicted better adherence. Conclusions Using intervention characteristics and persuasive technology elements, a substantial amount of variance in adherence can be explained. Although there are differences between health care areas on intervention characteristics, health care area per se does not predict adherence. Rather, the differences in technology and interaction predict adherence. The results of this study can be used to make an informed decision about how to design a web-based intervention to which patients are more likely to adhere.
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            The nature of procrastination: a meta-analytic and theoretical review of quintessential self-regulatory failure.

            Procrastination is a prevalent and pernicious form of self-regulatory failure that is not entirely understood. Hence, the relevant conceptual, theoretical, and empirical work is reviewed, drawing upon correlational, experimental, and qualitative findings. A meta-analysis of procrastination's possible causes and effects, based on 691 correlations, reveals that neuroticism, rebelliousness, and sensation seeking show only a weak connection. Strong and consistent predictors of procrastination were task aversiveness, task delay, self-efficacy, and impulsiveness, as well as conscientiousness and its facets of self-control, distractibility, organization, and achievement motivation. These effects prove consistent with temporal motivation theory, an integrative hybrid of expectancy theory and hyperbolic discounting. Continued research into procrastination should not be delayed, especially because its prevalence appears to be growing. (c) 2007 APA, all rights reserved.
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              The client satisfaction questionnaire. Psychometric properties and correlations with service utilization and psychotherapy outcome.

              An 18-item version of the Client Satisfaction Questionnaire (CSQ-18) was included in an experimental study of the effects of pretherapy orientation on psychotherapy outcome. The psychometric properties of the CSQ-18 in this study were compared with earlier findings. In addition, the correlations of the CSQ-18 with service utilization and psychotherapy outcome measures were examined. Results indicated that the CSQ-18 had high internal consistency (coefficient alpha = .91) and was substantially correlated with remainer-terminator status (rs = .61) and with number of therapy sessions attended in one month (r = .54). The CSQ-18 was also correlated with change in client-reported symptoms (r = -.35), indicating that greater satisfaction was associated with greater symptom reduction. Results also demonstrated that a subset of items from the scale (the CSQ-8) performed as well as the CSQ-18 and often better. The excellent performance of the CSQ-8, coupled with its brevity, suggests that it may be especially useful as a brief global measure of client satisfaction.
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                Author and article information

                Contributors
                Journal
                Internet Interv
                Internet Interv
                Internet Interventions
                Elsevier
                2214-7829
                26 March 2019
                September 2019
                26 March 2019
                : 17
                : 100245
                Affiliations
                [a ]Ulm University, Department of Clinical Psychology und Psychotherapy, Institute of Psychology and Education, Ulm, Germany
                [b ]Ulm University, Department of Learning and Instruction, Institute of Psychology and Education, Ulm, Germany
                [c ]VU University Amsterdam, Department of Clinical, Neuro- & Developmental Psychology, Amsterdam, Netherlands
                Author notes
                [* ]Corresponding author at: Ulm University, Department of Clinical Psychology und Psychotherapy, Institute of Psychology and Education, Albert-Einstein-Allee 47, 89081 Ulm, Germany. ann-marie.kuechler@ 123456uni-ulm.de
                Article
                S2214-7829(18)30089-7 100245
                10.1016/j.invent.2019.100245
                6500923
                31080750
                65464b51-89f0-4868-9b49-677e5a89ee7c
                © 2019 The Authors. Published by Elsevier B.V.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 11 December 2018
                : 15 March 2019
                : 19 March 2019
                Categories
                Article

                procrastination,internet-based intervention,online intervention,cognitive behavior therapy,randomized controlled trial,college students

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