Effectiveness of Wellbeing Intervention for Chronic Kidney Disease (WICKD): results of a randomised controlled trial

Kylie M. Dingwall; Michelle Sweet; Alan Cass; Jaquelyne T. Hughes; David Kavanagh; Kirsten Howard; Federica Barzi; Sarah Brown; Cherian Sajiv; Sandawana W. Majoni; Tricia Nagel

doi:10.1186/s12882-021-02344-8

Effectiveness of Wellbeing Intervention for Chronic Kidney Disease (WICKD): results of a randomised controlled trial

Kylie M. Dingwall, Michelle Sweet, Alan Cass, Jaquelyne T. Hughes, David Kavanagh, Kirsten Howard, Federica Barzi, Sarah Brown, Cherian Sajiv, Sandawana W. Majoni, Tricia Nagel

Menzies School of Health Research

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Abstract

Background: End stage kidney disease (ESKD) is associated with many losses, subsequently impacting mental wellbeing. Few studies have investigated the efficacy of psychosocial interventions for people with ESKD and none exist for Indigenous people, a population in which the ESKD burden is especially high.

Methods: This three-arm, waitlist, single-blind randomised controlled trial examined efficacy of the Stay Strong App in improving psychological distress (Kessler distress scale; K10), depressive symptoms (adapted Patient Health Questionnaire; PHQ-9), quality of life (EuroQoL; EQ. 5D) and dialysis adherence among Indigenous Australians undergoing haemodialysis in central and northern Australia (Alice Springs and Darwin), with follow up over two 3-month periods. Effects of immediate AIMhi Stay Strong App treatment were compared with those from a contact control app (The Hep B Story) and treatment as usual (TAU). Control conditions received the Stay Strong intervention after 3 months.

Results: Primary analyses of the full sample (N = 156) showed statistically significant decreases in K10 and PHQ-9 scores at 3 months for the Hep B Story but not for the Stay Strong app or TAU. Restricting the sample to those with moderate to severe symptoms of distress or depression (K10 > =25 or PHQ-9 > =10) showed significant decreases in K10 and PHQ-9 scores for both Stay Strong and Hep B Story. No significant differences were observed for the EQ-5D or dialysis attendance.

Conclusions: Findings suggest that talking to people about their wellbeing and providing information relevant to kidney health using culturally adapted, locally relevant apps improve the wellbeing of people on dialysis. Further research is required to replicate these findings and identify active intervention components.

Original language	English
Article number	136
Pages (from-to)	1-12
Number of pages	12
Journal	BMC Nephrology
Volume	22
Issue number	1
DOIs	https://doi.org/10.1186/s12882-021-02344-8
Publication status	Published - 19 Apr 2021

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s12882-021-02344-8Final published version, 1.21 MBLicence: Other

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@article{a1460578d9ea4682b2e5fdc61e5ccca1,

title = "Effectiveness of Wellbeing Intervention for Chronic Kidney Disease (WICKD): results of a randomised controlled trial",

abstract = "Background: End stage kidney disease (ESKD) is associated with many losses, subsequently impacting mental wellbeing. Few studies have investigated the efficacy of psychosocial interventions for people with ESKD and none exist for Indigenous people, a population in which the ESKD burden is especially high. Methods: This three-arm, waitlist, single-blind randomised controlled trial examined efficacy of the Stay Strong App in improving psychological distress (Kessler distress scale; K10), depressive symptoms (adapted Patient Health Questionnaire; PHQ-9), quality of life (EuroQoL; EQ. 5D) and dialysis adherence among Indigenous Australians undergoing haemodialysis in central and northern Australia (Alice Springs and Darwin), with follow up over two 3-month periods. Effects of immediate AIMhi Stay Strong App treatment were compared with those from a contact control app (The Hep B Story) and treatment as usual (TAU). Control conditions received the Stay Strong intervention after 3 months. Results: Primary analyses of the full sample (N = 156) showed statistically significant decreases in K10 and PHQ-9 scores at 3 months for the Hep B Story but not for the Stay Strong app or TAU. Restricting the sample to those with moderate to severe symptoms of distress or depression (K10 > =25 or PHQ-9 > =10) showed significant decreases in K10 and PHQ-9 scores for both Stay Strong and Hep B Story. No significant differences were observed for the EQ-5D or dialysis attendance. Conclusions: Findings suggest that talking to people about their wellbeing and providing information relevant to kidney health using culturally adapted, locally relevant apps improve the wellbeing of people on dialysis. Further research is required to replicate these findings and identify active intervention components. ",

keywords = "E-mental health, Indigenous, Kidney disease, Renal, Wellbeing",

author = "Dingwall, {Kylie M.} and Michelle Sweet and Alan Cass and Hughes, {Jaquelyne T.} and David Kavanagh and Kirsten Howard and Federica Barzi and Sarah Brown and Cherian Sajiv and Majoni, {Sandawana W.} and Tricia Nagel",

note = "Funding Information: This project is supported by a National Health and Medical Research Council (NHMRC) project grant (GNT# 1098311). JH was supported by NHMRC Fellowship (GNT# 1092576). The funding source had no input into the design of the study or the preparation of this manuscript and the views expressed in this publication are those of the authors and do not reflect the views of NHMRC. Publisher Copyright: {\textcopyright} 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = apr,

day = "19",

doi = "10.1186/s12882-021-02344-8",

language = "English",

volume = "22",

pages = "1--12",

journal = "BMC Nephrology",

issn = "1471-2369",

publisher = "BioMed Central",

number = "1",

}

TY - JOUR

T1 - Effectiveness of Wellbeing Intervention for Chronic Kidney Disease (WICKD)

T2 - results of a randomised controlled trial

AU - Dingwall, Kylie M.

AU - Sweet, Michelle

AU - Cass, Alan

AU - Hughes, Jaquelyne T.

AU - Kavanagh, David

AU - Howard, Kirsten

AU - Barzi, Federica

AU - Brown, Sarah

AU - Sajiv, Cherian

AU - Majoni, Sandawana W.

AU - Nagel, Tricia

N1 - Funding Information: This project is supported by a National Health and Medical Research Council (NHMRC) project grant (GNT# 1098311). JH was supported by NHMRC Fellowship (GNT# 1092576). The funding source had no input into the design of the study or the preparation of this manuscript and the views expressed in this publication are those of the authors and do not reflect the views of NHMRC. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/4/19

Y1 - 2021/4/19

N2 - Background: End stage kidney disease (ESKD) is associated with many losses, subsequently impacting mental wellbeing. Few studies have investigated the efficacy of psychosocial interventions for people with ESKD and none exist for Indigenous people, a population in which the ESKD burden is especially high. Methods: This three-arm, waitlist, single-blind randomised controlled trial examined efficacy of the Stay Strong App in improving psychological distress (Kessler distress scale; K10), depressive symptoms (adapted Patient Health Questionnaire; PHQ-9), quality of life (EuroQoL; EQ. 5D) and dialysis adherence among Indigenous Australians undergoing haemodialysis in central and northern Australia (Alice Springs and Darwin), with follow up over two 3-month periods. Effects of immediate AIMhi Stay Strong App treatment were compared with those from a contact control app (The Hep B Story) and treatment as usual (TAU). Control conditions received the Stay Strong intervention after 3 months. Results: Primary analyses of the full sample (N = 156) showed statistically significant decreases in K10 and PHQ-9 scores at 3 months for the Hep B Story but not for the Stay Strong app or TAU. Restricting the sample to those with moderate to severe symptoms of distress or depression (K10 > =25 or PHQ-9 > =10) showed significant decreases in K10 and PHQ-9 scores for both Stay Strong and Hep B Story. No significant differences were observed for the EQ-5D or dialysis attendance. Conclusions: Findings suggest that talking to people about their wellbeing and providing information relevant to kidney health using culturally adapted, locally relevant apps improve the wellbeing of people on dialysis. Further research is required to replicate these findings and identify active intervention components.

AB - Background: End stage kidney disease (ESKD) is associated with many losses, subsequently impacting mental wellbeing. Few studies have investigated the efficacy of psychosocial interventions for people with ESKD and none exist for Indigenous people, a population in which the ESKD burden is especially high. Methods: This three-arm, waitlist, single-blind randomised controlled trial examined efficacy of the Stay Strong App in improving psychological distress (Kessler distress scale; K10), depressive symptoms (adapted Patient Health Questionnaire; PHQ-9), quality of life (EuroQoL; EQ. 5D) and dialysis adherence among Indigenous Australians undergoing haemodialysis in central and northern Australia (Alice Springs and Darwin), with follow up over two 3-month periods. Effects of immediate AIMhi Stay Strong App treatment were compared with those from a contact control app (The Hep B Story) and treatment as usual (TAU). Control conditions received the Stay Strong intervention after 3 months. Results: Primary analyses of the full sample (N = 156) showed statistically significant decreases in K10 and PHQ-9 scores at 3 months for the Hep B Story but not for the Stay Strong app or TAU. Restricting the sample to those with moderate to severe symptoms of distress or depression (K10 > =25 or PHQ-9 > =10) showed significant decreases in K10 and PHQ-9 scores for both Stay Strong and Hep B Story. No significant differences were observed for the EQ-5D or dialysis attendance. Conclusions: Findings suggest that talking to people about their wellbeing and providing information relevant to kidney health using culturally adapted, locally relevant apps improve the wellbeing of people on dialysis. Further research is required to replicate these findings and identify active intervention components.

KW - E-mental health

KW - Indigenous

KW - Kidney disease

KW - Renal

KW - Wellbeing

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U2 - 10.1186/s12882-021-02344-8

DO - 10.1186/s12882-021-02344-8

M3 - Article

C2 - 33866968

AN - SCOPUS:85104533882

SN - 1471-2369

VL - 22

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EP - 12

JO - BMC Nephrology

JF - BMC Nephrology

IS - 1

M1 - 136

ER -

Effectiveness of Wellbeing Intervention for Chronic Kidney Disease (WICKD): results of a randomised controlled trial

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