The objective of this experimental study (randomized controlled trial) is to evaluate the effectiveness of an internet-based stress management program, inspired by the French program "Je gère mon stress," among healthcare students in Sfax, Tunisia.

The target population includes all healthcare students over 18 years old, from any field (paramedical, nursing, medicine, etc.), regardless of their baseline level of perceived stress.

The main questions this study aims to answer are:

Does the online program significantly reduce the level of perceived stress (measured using the Perceived Stress Scale - PSS-10)? Does the program have a beneficial impact on symptoms of anxiety and depression (measured with the Hospital Anxiety and Depression Scale - HADS)? Does it improve sleep quality (assessed using the Pittsburgh Sleep Quality Index - PSQI)?

Comparison group:

Researchers will compare the outcomes of the intervention group (who will access the online stress management program for 8 weeks) with those of the control group (waiting list, no initial access), to evaluate the specific effects of the program.

Participants will:

Complete three validated questionnaires (PSS-10, HADS, and PSQI) before and after the intervention; Be invited to follow a weekly series of psychoeducational modules over 8 weeks, including short educational videos, breathing techniques, guided relaxation, and practical exercises, all accessible through a secure web platform; Receive weekly motivational messages to support engagement.

This randomized controlled trial aims to assess the effectiveness of an internet-based stress management program tailored for healthcare students in Sfax, Tunisia. The intervention is an adaptation of the validated French program "Je gère mon stress," redesigned to fit the local sociocultural context.

The study targets healthcare students aged 18 and above, from various disciplines (nursing, physiotherapy, midwifery, anesthesia, etc.), regardless of their baseline perceived stress levels.

Participants in the intervention group will receive access to an 8-week structured online program composed of:

Weekly psychoeducational video capsules (covering stress mechanisms, coping strategies, relaxation techniques, etc.), Guided breathing and relaxation exercises, Simple cognitive-behavioral tools, Time management and lifestyle advice.

All participants will be assessed at baseline (pre-intervention) and post-intervention using three validated instruments:

PSS-10 (Perceived Stress Scale) to evaluate perceived stress, HADS (Hospital Anxiety and Depression Scale) to assess symptoms of anxiety and depression, PSQI (Pittsburgh Sleep Quality Index) to measure sleep quality. A control group will not receive any intervention during the 8-week period but will be offered the program after the study ends (waiting list design). This design allows a fair comparison between groups and ensures ethical access to the intervention.

The program is fully accessible online via a secure platform and requires no in-person attendance. Participants will receive weekly reminders to complete the sessions and questionnaires.

The main outcome is the change in perceived stress levels. Secondary outcomes include changes in anxiety, depression, and sleep quality.

This study contributes to addressing the high psychological burden observed in healthcare students in Tunisia and promotes the use of digital tools for mental health support in academic settings.

Inclusion Criteria:

• The target population includes all students enrolled in the third year at the Higher Institute of Nursing Sciences (ISSIS) and the Higher School of Health Sciences and Techniques (ESSTSS) for the 2025-2026 academic year.
• Own a smartphone, tablet, or computer.
• Have internet access.
• Have an email address.
• Be willing to be randomized.
• Have given informed consent to participate in the study.
• Be available and committed to completing the entire online intervention program and participating in all evaluations.

Exclusion Criteria:

• Current enrollment in another stress management program;
• History of chronic psychiatric illness;
• Current use of anxiolytic or psychotropic medication.

Data will be available beginning 6 months after publication of the main results in a peer-reviewed journal.

Qualified researchers affiliated with academic or health research institutions will be able to access anonymized individual participant data (IPD), the study protocol, and statistical analysis plan upon request. Access will be granted for scientifically valid research purposes, such as meta-analyses or secondary analyses on mental health interventions. Data will be shared via secured email or encrypted file transfer, following the approval of a data use agreement and submission of a research proposal to the principal investigator.

Complete participant blinding was not feasible given the behavioral nature of the digital intervention, as participants were necessarily aware of their group allocation. Outcome data were collected via automated self-administered online questionnaires, precluding assessor bias. The randomization sequence was concealed from the doctoral candidate coordinating the intervention throughout the study period. The original registration entry indicating quadruple blinding is hereby corrected to reflect actual blinding procedures implemented.