E-mail-based Exercises in Happiness, Physical Activity and Readings: A Randomized Trial on 3274 Finns Kaisla Joutsenniemi 2* ,Carl Kaattari 1 , Tommi Härkänen 2 , Maiju Pankakoski 2 , Heimo Langinvainio 3 , Jouko Lönnqvist 2 , Antti S Mattila 4 , Pekka Mustonen 5 1 University of Helsinki, Helsinki, Finland 2 National Institute for Health and Welfare, Department of Health, Functional Capacity and Welfare, , Helsinki, Finland 3 Competence Audit Center, Espoo, Finland 4 Psychotherapist, Antifon, Eteläinen Hesperiankatu 22, FI-00100 Helsinki, Finland 5 * Corresponding author: Kaisla Joutsenniemi, National Institute for Health and Welfare, Mental Health Problems and Substance Abuse Services Unit, PO Box 30, FI-00271 Helsinki, Finland, Tel: +358503300 142; E-mail: kaisla.joutsenniemi@icloud.com Received date: April 2, 2014, Accepted date: September 1, 2014, published date: September 10, 2014 Copyright: © 2014 Kaisla Joutsenniemi et al., This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Objective: Rigorous research in the last decade has demonstrated the efficacy of specific techniques in positive psychology that enhance psychological well-being. Online positive psychology interventions have the potential to enhance positive well-being in large audiences, including hard-to-reach target groups. There is lack of data on the effect of positive psychology exercises on happiness and on depressive symptoms in comparison with physical activity exercises and a placebo group. Methods: The Finnish Happiness-Flourishing Study (FHFS) included a TV-program on happiness interventions, a happiness website and an email-based happiness exercise intervention. A three-armed randomized controlled trial was conducted on 3274 Finnish adults in 2011. The participants were assigned to receive happiness exercises, tailored physical activity exercises or reading exercises on happiness (i.e. placebo). The statistical analyses were based on the intention-to-treat principle and linear random effects models. Results: The overall happiness scores increased (X 2 =7.83, df=3, p=0.05) and depressive symptoms decreased (X 2 =5.5, df=1, p=0.02) during the intervention, with more pronounced changes among women. The order of the four different happiness exercises did not have a systematic effect on the happiness score. The exercise on good deeds had the strongest effect on the improvement of the happiness score (change =4.50, 95% CI=2.47-6.52) whereas for the optimism exercise there was no improvement (change=0.46, 95% CI=-1.55-2.48). In the physical exercise group, there was an increase in the proportion of physically active subjects as compared with the placebo reading-group (X 2 =8.4, df=1, p=0.004). Conclusions: This study produced further evidence on the effectiveness of web-based happiness exercises. The results amplify the need for tailored online interventions for reducing well-being disparities. Further studies also need to increase the current understanding of the relative importance of variety in the application of positive interventions. Online positive psychology interventions are a potential tool in helping reduce well-being disparities, particularly among populations with little access to other services. Keywords: Web-based; Online; Randomized study; Intervention; Happiness; Physical exercise; Depressive symptoms Introduction Positive psychology is the scientific study of psychological well- being and optimal functioning, which provides a perspective to mental health beyond the absence of psychiatric symptoms [1]. Rigorous research in the last decade has demonstrated the efficacy of specific techniques that enhance psychological well-being [2,3]. In particular, internet-based interventions have proved to be a valuable tool in spreading information and exercises based on positive psychology. In a national sample from the US, two thirds of internet users have been estimated to search for health information in 2005 [4]. Individuals seeking for enhanced well-being or happiness, who would be unable or unwilling to receive face-to-face counseling, might have motivation and access to online intervention options, thus, online interventions have the potential to promote mental well-being on a broad scale. Other advantages of online interventions include their cost- and time-effectiveness [5]. In a previous study on 912 self-help seeking adults in the United States, the subjects arrived at the study website either by web-browsing or via a well-known positive psychology website. The participants reported depressive symptoms above the mean of the general population and life satisfaction below the average [6]. There is great potential in offering web-based interventions to happiness seekers with mild symptoms of mental disorders, as depressive symptoms may be decreased [3] and the development of more serious mental health disorders may be prevented [7,8]. TV-programs and movies based on happiness may also attract individuals with needs to increase their own well-being. As a recent review [9] points out, the potentially advantageous Joutsenniemi et al., J Psychiatry 2014, 17:6 DOI: 10.4172/2378-5756.1000140 Research Article Open Access J Psychiatry Journal of Psychiatry, an open access Volume 17 • Issue 6 • Psychiatry-14-29 Journal of Psychiatry J o u r n a l o f P s y c h i a t r y ISSN: 2378-5756