An Evaluation of the Effectiveness of a Simple Marketing Intervention in Changing Student Attitudes to Depression

• The primary outcome was the proportion of participants responding positively to the question ‘Can depression be effectively treated?’
  

• Secondary outcomes included the correct identification of the symptoms of depression and the effectiveness of certain treatments.
  

Depression is a major public health problem. It is common, affecting approximately 10 percent of the United Kingdom (UK) community at any one time. Britain’s student population is particularly at risk.

Knowledge of effective treatments for depression is burgeoning thanks to a rapid increase in the quantity and quality of relevant research. Regardless of these advances, depression is still under-reported (Freeling et al., 1985) and general practitioners often fail to diagnose it.

When depression is correctly diagnosed, most patients in primary care will receive a prescription for an antidepressant. However, some patients will not have the prescription dispensed, and most will not complete the full recommended course. Compliance with psychological treatments is also a problem.

Study Design:

• Pilot work: The intervention consisted of mailing (to each undergraduate student’s pigeon-hole) a pack of 4 postcards which provided brief information on depression in an attractive format. One postcard summarised information on depression as an illness; one summarised information on the causes of depression; one summarised information on the treatment of depression; and one summarised information on how to seek help for depression. Prior to the trial, the drafts were revised through feedback from a focus group of 5 students, who discussed the design and content of the draft postcards. The focus group participants were recruited from the Queen’s College, as this college did not participate in the trial. The focus group contributed to the revision of the draft questionnaire.
• The trial: The design was a cluster, randomised, controlled trial. Individual Oxford University colleges which accept undergraduate students were the units of randomisation. Twenty-eight colleges were randomised. Permanent private halls and postgraduate colleges were excluded, as was the Queen’s College (due to it being the lead investigator’s college) and Harris Manchester College (a college for mature students).

Half of the randomised colleges received no intervention; the other half received the intervention.

A questionnaire was administered before and after the intervention to half of the undergraduate students in each of the colleges. The same questionnaire was used for both time points. Questions addressed knowledge of, and attitudes towards:

• depression as an illness;
• symptoms of depression;
• treatment for depression;
• sources of help for depression.