Abstract
BACKGROUND: College students commonly struggle with procrastination, which is linked to mental health complaints and poor academic performance. Interventions based on cognitive behavioral therapy can be effective in reducing procrastination. Traditional face-to-face therapy and online interventions have shown promising outcomes, with the latter overcoming help-seeking barriers such as lengthy referral processes and waiting lists. OBJECTIVE: This study aims to examine the feasibility and acceptability of a new eHealth intervention targeting procrastination for college students ("GetStarted") with guidance by student e-coaches. This cognitive behavioral therapy-based intervention was designed specifically for and together with the target demographic of students studying in the Netherlands. Guidance was offered by trained clinical psychology students in the form of written motivational, supportive messages. METHODS: We conducted a single-arm study. The primary outcomes were satisfaction (8-item Client Satisfaction Questionnaire [CSQ-8]), usability (10-item System Usability Scale [SUS-10]), and adherence (completion rate). The secondary outcomes were changes to procrastination (Irrational Procrastination Scale [IPS]), depression (9-item Patient Health Questionnaire [PHQ-9]), stress (10-item Perceived Stress Scale [PSS-10]), quality of life (Mental Health Quality of Life Questionnaire [MHQoL]), and e-coaching satisfaction (Working Alliance Inventory for Guided Internet Interventions [WAI-I]). RESULTS: Of 734 participants who started the intervention, 335 (45.6%) completed the posttest. Students reported being satisfied with the intervention (CSQ-8: mean 23.48, SD 3.23) and found it very usable (SUS-10: mean 34.39, SD 4.52). Regarding adherence, participants completed 68.95% of the intervention on average, while 36.65% (n=269) of participants completed the full intervention. Participants showed a significant decrease in procrastination (IPS: mean decrease 35.39-32.56, Cohen d=0.63), depression (PHQ-9: mean decrease 9.27-7.73, Cohen d=0.35), and stress (PSS-10: mean decrease 20.79-19.02, Cohen d=0.31) as well as an increase in quality of life (MHQoL: mean increase 12.81-13.65, Cohen d=0.37) from baseline to posttest to follow-up. Participants reported a moderate-to-strong alliance with their e-coach (WAI-I: mean 45.26, SD 7.72). CONCLUSIONS: The internet-based, student-guided intervention "GetStarted" targeting procrastination appears to be acceptable and feasible for college students in the Netherlands. However, high attrition rates and the lack of a control group mean that results must be interpreted with caution. To further examine intervention effectiveness, a randomized controlled trial needs to be conducted.