Is there a cure for the Turker blues? A randomized controlled trial of a digital intervention for depression in adult online workers

Online workers, individuals who participate in crowdsourced online work, experience greater internalizing symptoms than the general population. This phenomenon, has been dubbed the “Turker blues.” Three well-powered trials of online interventions failed to find statistical or clinically significant treatment effects in this population with single-session interventions (SSI). Objective: We conducted a nationwide fully remote 2-arm randomized controlled trial to test the efficacy of a self-guided online low-intensity treatment (LIT) for depression in online workers. The intervention was a 4-week behavioral activation (BA) program designed as part of the Common Element Toolbox (COMET). Methods: 804 online workers were randomized to COMET-BA or a waitlist control (WLC). Self-report measures of depression, anxiety, subjective well-being, behavioral activation, psychosocial function, and emotion regulation were collected weekly for 4 weeks, 1-week post-intervention, then at a 1-month follow-up. Results: There was a significant time-by-treatment interaction during the intervention phase on the study, suggesting those in the COMET-BA arm improved significantly more than those in the WLC, with a small-medium effect on depression symptoms (SMD=-0.32; 95% CI: -0.47, -0.17). All but two outcomes demonstrated significant improvement. Improvements were maintained during the 1-month follow-up period. Conclusion: BA may be effectively delivered as an unguided online intervention for depression.