A randomized controlled trial of cloud-based instant messaging i-ACT for Life for at-risk young adults during the COVID-19 pandemic

• Main Authors: Abdul Khaiyom, Jamilah Hanum, Abdul Aziz, Amani Fadzlina, Md. Rosli, Ahmad Nabil, Bahari, Che Amnah, Abdullah, Nur Sakinah Thomas
• Format: Proceeding Paper
• Language: English; English; English
• Published: 2023
• Subjects: BF Psychology; BF636 Applied psychology; BL Religion; BP Islam. Bahaism. Theosophy, etc; BP1 Islam; BP174 The Practice of Islam; BP175 Psychology of Islam; RA Public aspects of medicine; RA644.C67 Coronavirus infections. COVID-19 (Disease). COVID-19 Pandemic, 2020; RA790 Mental Health. Mental Illness Prevention
• Online Access: http://irep.iium.edu.my/107607/36/107607_A%20randomized%20controlled%20trial%20of%20cloud-based.pdf; http://irep.iium.edu.my/107607/37/107607_A%20randomized%20controlled%20trial%20of%20cloud-based_Abstract.pdf; http://irep.iium.edu.my/107607/38/107607_A%20randomized%20controlled%20trial%20of%20cloud-based_Certificate.pdf; http://irep.iium.edu.my/107607/

Introduction: The global prevalence of mental health issues in the general population has increased significantly since the start of the COVID-19 pandemic.1 In Malaysia, a majority of those affected are university students2. Acceptance and Commitment Therapy (ACT) heavily features cognitive behavioral and mindfulness strategies, both of which have been emphasized for use during the pandemic3,4. Past research has shown that religio-spiritual integrated psychological treatments have resulted in more significant psychological and spiritual improvements.5,6,7 With rising psychological concerns amidst the pandemic, efforts are needed to preserve the mental health of at-risk populations. Furthermore, the pandemic has challenged the ways of modern healthcare delivery, and remote methods of delivering evidence-based mental healthcare are more important now than before.4 Objective: The present study examined the effectiveness of i-ACT for Life, a cloud-based instant messaging ACT-integrated with an Islamic spiritual prevention program to reduce psychological distress among at-risk young adults in Malaysia during the COVID-19 pandemic. Method: The study was preregistered at ClinicalTrials.gov (NCT04870385). Purposive sampling was used to recruit university students studying in Malaysia (N=93, 78% female) aged 18-29 years old. The adapted WHO ACT-based module with the elements of Islamic spirituality was used. The prevention program consists of five weekly modules (Grounding, Unhooking, Acting on Values, Being Kind, and Making Room). Each corresponded to an ACT core process and was supplemented with Qur’ānic verses, Hadīth, religious/spiritual activities, and spiritual-relevant poems. The program was designed for delivery through cloud-based instant messaging platforms. Participants were randomized to either receive the prevention program (n=46) or be wait-listed (n=47), and were asked to complete assessments at pre-intervention, mid-intervention, post-intervention, and 1-month follow-up. The outcomes assessed were anxiety, stress, depression, self-compassion, psychological flexibility, and resilience. Results: Intention-to-treat analyses using Last Observation Carried Forward reported significant between-group effects at post-intervention and follow-up (p<.05), and a significant overall effect of time across the four-time points (p<.001), for all the outcome measures. Observations of participants' reflections on the Islamic spirituality elements are generally positive. Conclusions: Findings suggest that the i-ACT for Life web-based prevention programs effectively preserve the mental health of Muslim young adults in Malaysia during the pandemic. The program was also found to support the integration of Islamic spiritual elements into traditional cognitive-behavioral and mindfulness techniques in improving the acceptability of mental health interventions. Future studies are encouraged to digitalize the module and its effectiveness is examined among different populations.