About the lab

The Protect Lab is an interdisciplinary research unit headed by David Daniel Ebert PhD PD. We focus on the development, scientific evaluation and implementation of Behavioral Health Technology interventions to promote public health, with a special focus on mental illness.

The ProtectLab is associated with the Friedrich-Alexander-University Erlangen-Nuremberg's Department of Clinical Psychology and Psychotherapy and works in close cooperation with a cluster of national and international research institutes, service providers, and public policy representatives.


Featured projects (1)

The E-Health interest group consists of clinical psychologists who, within the framework of their scientific and practical activities, deal with issues of digitisation in clinical psychology and psychotherapy. E-Health: Technology-based and IT-supported psychological interventions for health promotion, prevention and therapy of mental disorders and physical diseases The use of new media for diagnosis, health promotion and treatment of mental disorders and physical diseases represents an innovative way of further improving the quality of care in our health system. Research on Internet- and mobile-based interventions (IMIs), virtual realities and artificial-intelligent systems has been one of the most productive areas of research within psychotherapy research over the last decade. E-health approaches are being discussed as promising technology-based solutions for the expansion and optimization of health care services both at various stages of health promotion and treatment (education, prevention, diagnostics, treatment and relapse prevention) and in various counselling and treatment settings (outpatient, (partially) inpatient, BGM). IMIs refer to a heterogeneous field of measures ranging from therapeutically accompanied or unaccompanied self-help interventions, to interlinked online/offline offers ("blended therapy") and synchronous online-based intervention, e.g. via video conferencing. In addition to IMIs, the possibility of using virtual reality and artificial-intelligent systems will significantly change the (digitalised) healthcare of the future. There is now a very comprehensive evidence base on the effectiveness and cost-effectiveness of technology and IT-based intervention approaches in relation to a wide range of mental health problems and disorders, health behaviour and physical illnesses. Of particular importance here is not only the question of whether e-health offers are effective, but also why. In addition, the investigation of relevant subgroups with specific risk profiles and special treatment requirements is of great importance. An important milestone for the implementation of these digital interventions in our health care system will be to establish technical and organizational, as well as data protection, professional and social legal frameworks and quality criteria in order to ensure sufficient treatment safety. In the area of technology development, however, it is also necessary to address and critically question social and ethical aspects of the digitalization of our health care. The aim of the interest group is Networking and communication among members of the group with a research and/or practical focus on e-health. To systematize the broad and heterogeneous field of psychological e-health interventions for the prevention and treatment of mental disorders and physical illnesses and for the improvement of health behaviour. Dissemination of the group's comprehensive expertise in this field, e.g. within the framework of satellite symposia at congresses of neighbouring and complementary subjects, by issuing statements and participating in task forces, committees, etc. Supporting the translation of research results into care practice and in health care institutions as well as into education and training. Establishment as a central contact for stakeholders (ministries, service providers, service providers, professional associations, patient representatives, etc.) in the field of digitisation in the health care system; representation of the department's interests in cooperation with other departments and societies. Acquisition of new specialist group members through active dissemination of the comprehensive activities and the associated increased visibility of the specialist group and its activities. Creation of a platform for the necessary interdisciplinary exchange with complementary specialist areas (e.g. computer science, media design, medicine, law, business administration and economics, public health and health care research, etc.) Promotion of the development of quality criteria for research, intervention safety, indication and implementation of e-health interventions. Founding members in alphabetical order: Harald Baumeister, Matthias Berking, David Ebert, Severin Hennemann, Gitta Jacob, Corinna Jacobi, Christine Knaevelsrud, Lena Krämer, Jiaxi Lin, Andreas Maercker, Andreas Mühlberger, Thomas Probst, Lasse Sander, Rüdiger Zwerenz.

Featured research (24)

Introduction Farmers have a high risk for depression (MDD). Preventive measures targeting this often remotely living population might reduce depression burden. The study aimed to evaluate the effectiveness of personalized telephone coaching in reducing depressive symptom severity and preventing MDD in farmers compared to enhanced treatment as usual (TAU + ). Methods In a two-armed, pragmatic randomized controlled trial ( N = 314) with post-treatment at 6 months, farming entrepreneurs, collaborating family members and pensioners with elevated depressive symptoms (PHQ-9 ≥ 5) were randomized to personalized telephone coaching or TAU + . The coaching was provided by psychologists and consists on average of 13 (±7) sessions a 48 min (±15) over 6 months. The primary outcome was depressive symptom severity (QIDS-SR16). Results Coaching participants showed a significantly greater reduction in depressive symptom severity compared to TAU + ( d = 0.39). Whereas reliable symptom deterioration was significantly lower in the intervention group compared to TAU + , no significant group differences were found for reliable improvement and in depression onset. Further significant effects in favor of the intervention group were found for stress ( d = 0.34), anxiety ( d = 0.30), somatic symptoms ( d = 0.39), burnout risk ( d = 0.24–0.40) and quality of life ( d = 0.28). Discussion Limiting, we did not apply an upper cutoff score for depressive symptom severity or controlled for previous MDD episodes, leaving open whether the coaching was recurrence/relapse prevention or early treatment. Nevertheless, personalized telephone coaching can effectively improve mental health in farmers. It could play an important role in intervening at an early stage of mental health problems and reducing disease burden related to MDD. Trial registration number and trial register German Clinical Trial Registration: DRKS00015655
Aims: To perform an economic evaluation of guided and unguided internet-based interventions to reduce problematic alcohol consumption in employees compared with a waitlist control condition (WLC) with unrestricted access to treatment-as-usual. Design: A cost-effectiveness analysis (CEA) and cost-utility analysis (CUA) from a societal and a cost-benefit analysis from the employer's perspective with a 6-month time horizon. Setting: Open recruitment in the German working population. Participants: Employees (178 males, 256 females, mean age 47 years) consuming at least 14 (women) or 21 (men) standard units of alcohol (SUAs) per week and scoring ≥ 8 (men) or 6 (women) on the Alcohol Use Disorders Identification Test. Measurements: Online questionnaires administered to assess SUAs, quality of life (AQoL-8D) and resource use. Outcome measure was responder (≤14/≤21 SUAs) for the CEA and quality-adjusted life years (QALYs) for the CUA. Net benefit regression was used to estimate cost-effectiveness for each study arm. Bootstrapping and sensitivity analyses were performed to account for uncertainty. Interventions: Five weekly modules including personalized normative feedback, motivational interviewing, goal setting, problem-solving and emotion regulation, provided with adherence-focused guidance (n=142; responders: n=73 [51.4%]; QALYs=0.364, SE=0.006) or without guidance (n=146; n=66 [45.2%]; 0.359, 0.007). Controls were on a waiting list (n=144; n=38 [26.4%]; 0.342, 0.007). Findings: From a societal perspective, the guided intervention had a probability of 55% (54%) of being the most efficient strategy at a willingness-to-pay (WTP) of €0 per responder (QALY) gained, compared with the unguided intervention and the control condition. At a WTP of €20,000 per QALY gained, the probability was 78%. From an employer's perspective, the guided intervention had the highest probability of a positive return on investment (81%), compared with the unguided intervention and the control condition. Conclusion: A guided internet-based intervention to reduce problematic alcohol consumption in employees appears to be both cost-beneficial and cost-effective.
This book serves as an accessible introduction into how meta-analyses can be conducted in R. Essential steps for meta-analysis are covered, including pooling of outcome measures, forest plots, heterogeneity diagnostics, subgroup analyses, meta-regression, methods to control for publication bias, risk of bias assessments and plotting tools. Advanced, but highly relevant topics such as network meta-analysis, multi-/three-level meta-analyses, Bayesian meta-analysis approaches, SEM meta-analysis are also covered. The programming and statistical background covered in the book are kept at a non-expert level. A print version of this book has been published with Chapman & Hall/CRC Press (Taylor & Francis). The complete book can be accessed online: https://bookdown.org/MathiasHarrer/Doing_Meta_Analysis_in_R/.
Chronic medical conditions are increasingly common and associated with a high burden for persons affected by them. Digital health interventions might be a viable way to support persons with a chronic illness in their coping and self-management. The present special issue's editorial on digital health interventions in chronic medical conditions summarizes core findings and discusses next steps needed to further the field while avoiding to reinvent the wheel, thereby elaborating on four topics extracted from the special issue's articles: 1) Needs assessment and digital intervention development, 2) Efficacy and (cost-)effectiveness, 3) Dissemination and implementation research: reach and engagement as well as 4) next generation of digital interventions.
Background: Depression and harmful alcohol use are two of the top five leading causes of years of life lost to disability in high-income countries. Integrated treatment targeting both at the same time is often considered more complicated and difficult and, therefore, more expensive. Consequently, integrated internet-based interventions could be a valuable addition to traditional care. Methods: A three-arm randomized controlled trial was conducted comparing the effectiveness of (1) an integrated, minimal-guidance, adherence-focused self-help intervention designed to reduce both alcohol use and depression symptoms (AFGE-AD); (2) a similar intervention designed to reduce alcohol use only (AFGE-AO), and (3) internet access as usual (IAU) as a control condition, in at least moderately depressed alcohol misusers from February 2016—March 2020. We recruited 689 alcohol misusers (51.6% males, mean age = 42.8 years) with at least moderate depression symptoms not otherwise in treatment from the general population. Six months after baseline, 288 subjects (41.8%) were reachable for the final assessment. Results: All interventions yielded reduced alcohol-use after six months (AFGE-AD: -16.6; AFGE-AO: -19.8; IAU: -13.2). Those who undertook active-interventions reported significantly fewer standard drinks than controls (AFGE-AD: p = .048, d=0.10; AFGE-AO: p = .004, d=0.20). The two active-intervention groups also reported significantly less severe depression symptoms than controls (AFGE-AD: p = .006, d=0.41; AFGE-AO: p = .008, d=0.43). Testing revealed noninferiority between the two interventions. Conclusions: This study documented sustained effectiveness of the first integrated, fully internet-based self-help intervention developed for the reduction of both alcohol use and depression symptoms in at least moderately depressed adult alcohol misusers recruited from the general population.

Lab head

David Daniel Ebert
  • Faculty of Sport and Health Science
About David Daniel Ebert
  • My work focuses on the evaluation of internet and mobile-based interventions for the prevention and treatment of mental health disorders.Together with my team I have developed fifteen different internet/mobile-interventions including for the prevention of depression, relapse prevention, panic , work-related stress, insomnia, hazardous alcohol use, self-compassion.The (cost)-effectiveness of these interventions have been/are currently being evaluated in over 30 randomized controlled trials.

Members (15)

Claudia Buntrock
  • Friedrich-Alexander-University of Erlangen-Nürnberg
Mathias Harrer
  • Technische Universität München
Anna-Carlotta Zarski
  • Friedrich-Alexander-University of Erlangen-Nürnberg
Ingrid Titzler
  • Friedrich-Alexander-University of Erlangen-Nürnberg
Sandra Schlicker
  • Friedrich-Alexander-University of Erlangen-Nürnberg
Anne Etzelmüller
  • Friedrich-Alexander-University of Erlangen-Nürnberg
Kiona K. Weisel
  • Friedrich-Alexander-University of Erlangen-Nürnberg
Fanny Kählke
  • Friedrich-Alexander-University of Erlangen-Nürnberg

Alumni (1)

Rebecca Fleischmann
  • Friedrich-Alexander-University of Erlangen-Nürnberg