Precision Intervention for Stress and Resilience (PRECISE): A Randomized Clinical Trial

Although stress is a key driver of chronic disease risk and all-cause mortality, it is rarely assessed or treated in most medical settings. Moreover, existing stress management interventions are not tailored to patients’ most pressing needs. To address these issues, we developed a fully remote, 12-week precision stress management program called the Precision Intervention for Stress and Resilience (PRECISE), which identifies each person’s primary stress-related functional problem (i.e., thinking style, social relationships, sleep, eating, physical activity) and assigns treatment accordingly. Diverse participants (N = 426, 18-86 years old) were randomized to a passive control arm (assessment only), active control arm (environmental toxins reduction education), or PRECISE. Average treatment effects (ATEs) revealed that participants receiving PRECISE exhibited greater reductions in the primary outcome, perceived stress, both immediately following treatment (reduction: 15.9%; passive control: ATE = -1.58, 95% CI [-2.83, -0.32], d = -0.42; active control: ATE = -0.71, 95% CI [-1.99, 0.57], d = -0.19) and 12 weeks later (reduction: 18.7%; passive control: ATE = -2.93, 95% CI [-4.20, -1.67], d = -0.78; active control: ATE = -1.49, 95% CI [-2.81, -0.18], d = 0.39). PRECISE is thus a highly efficacious and scalable intervention enabling precision stress management. ClinicalTrials.gov Registration: NCT06063174