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