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Building emotional competence skills via a mobile app may be an effective, scalable and acceptable way to do this. A particular risk factor for anxiety and depression is elevated worry and rumination (repetitive negative thinking, RNT). An app designed to reduce RNT may prevent future incidence of depression and anxiety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method\/design<\/jats:title>\n                    <jats:p>The Emotional Competence for Well-Being in Young Adults study developed an emotional competence app to be tested via randomised controlled trials in a longitudinal prospective cohort. This off-shoot study adapts the app to focus on targeting RNT (worry, rumination), known risk factors for poor mental health. In this study, 16\u201324\u2009year olds in the UK, who report elevated worry and rumination on standardised questionnaires are randomised to (i) receive the RNT-targeting app immediately for 6\u2009weeks (ii) a waiting list control who receive the app after 6\u2009weeks. In total, the study will aim to recruit 204 participants, with no current diagnosis of major depression, bipolar disorder or psychosis, across the UK. Assessments take place at baseline (pre-randomisation), 6 and 12\u2009weeks post-randomisation. Primary endpoint and outcome for the study is level of rumination assessed on the Rumination Response Styles Questionnaire at 6\u2009weeks. Worry, depressive symptoms, anxiety symptoms and well-being are secondary outcomes. Compliance, adverse events and potentially mediating variables will be carefully monitored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This trial aims to better understand the benefits of tackling RNT via an mobile phone app intervention in young people. This prevention mechanism trial will establish whether targeting worry and rumination directly via an app provides a feasible approach to prevent depression and anxiety, with scope to become a widescale public health strategy for preventing poor mental health and promoting well-being in young people.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      ,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\/ct2\/show\/NCT04950257\">NCT04950257<\/jats:ext-link>\n                      . Registered 6 July 2021 \u2013 Retrospectively registered.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12888-021-03536-0","type":"journal-article","created":{"date-parts":[[2021,10,21]],"date-time":"2021-10-21T08:02:36Z","timestamp":1634803356000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Reducing worry and rumination in young adults via a mobile phone app: study protocol of the ECoWeB (Emotional Competence for Well-Being in Young Adults) randomised controlled trial focused on repetitive negative thinking"],"prefix":"10.1186","volume":"21","author":[{"given":"Daniel","family":"Edge","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Newbold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Ehring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tabea","family":"Rosenkranz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mads","family":"Frost","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2432-5577","authenticated-orcid":false,"given":"Edward R.","family":"Watkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,21]]},"reference":[{"issue":"9820","key":"3536_CR1","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1016\/S0140-6736(11)60871-4","volume":"379","author":"A Thapar","year":"2012","unstructured":"Thapar A, Collishaw S, Pine DS, Thapar AK. 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Institutional review board approval has been obtained from University of Exeter, (10th February 2021, reference number eCLESPsy001977 v5.1). The trial is being conducted as part of a doctoral thesis project for a trainee clinical psychologist at the University of Exeter. The study is currently using trial protocol version 1.5 dated 7th September 2021.The trial sponsor is the University of Exeter, Exeter, UK. Protocol modifications are recorded and communicated to the University of Exeter and the ethics committee. Adverse events and other unintended effects of trial interventions or trial conduct will be self-reported by participants on the website through open questions asking about any problems arising from participation, standardized questions about self-harm and symptoms at each follow up at 6 and 12\u2009weeks, plus spontaneously reported feedback from participants. If any of the participants indicate the trial is causing unnecessary harm, a Data Monitoring Committee (DMC) will be formed to review adverse events. Interim analyses will only be conducted at request of the DMC if there is a concern about harmful effects of the intervention under investigation; based on these analyses, the DMC will decide if the trial should be discontinued on the basis of participant well-being and safety. All serious adverse events will be reported to the University of Exeter ethics committee within 2 working days for review.The study has a risk and safety protocol, which includes action for ancillary care for participants with mental health disorders, including signposting to help, aiding with onward referrals, and contact with the research team.All participants will provide written informed consent prior to baseline assessment. All participants can discontinue allocated interventions at their own choice and request.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests, except for MF, who is a co-founder and shareholder of Monsenso, whose solution delivered the app.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"519"}}