Medical University of South Carolina.
University of Kansas.
Behav Ther. 2019 Jul;50(4):817-827. doi: 10.1016/j.beth.2018.12.003. Epub 2018 Dec 19.
Mobile technologies can be leveraged to meet the need for evidence-based psychological depression treatment via primary care. The purpose of the present study was to preliminarily examine the feasibility and efficacy of a self-help brief behavioral activation mobile application (app; "Moodivate") for depressive symptoms among adults treated via primary care. Participants (N = 52) were recruited from primary care practices between January and December 2017 and were randomized 2:2:1 to receive (a) Moodivate, (b) an active control cognitive-behavioral therapy-based mobile app ("MoodKit"), or (c) treatment as usual (TAU; no app). Participants completed assessments of depressive symptoms weekly for 8 weeks. App analytics data were captured to examine Moodivate feasibility (analytics unavailable for control app). Moodivate participants on average had 46.76 (SD = 30.10) app sessions throughout the trial duration, spent 3.50 (2.76) minutes using the app per session, and spent 120.76 (101.02) minutes using the app in total throughout the trial. Nearly 70% of Moodivate participants continued to use the app 1 month after trial enrollment and 50% at the end of the 8-week follow-up period. A generalized estimating equation model examining change in depressive symptoms over time by treatment condition indicated a significant interaction between time and treatment condition (χ = 42.21, df = 14, p < .001). As compared to TAU, participants in both app conditions evidenced significant decreases in depressive symptoms over time, and these treatment gains were sustained across the trial period. These results preliminarily indicate feasibility of Moodivate as well as efficacy of both Moodivate and MoodKit for the treatment of depression among adults recruited via primary care. Future studies should focus on larger-scale examinations of treatment efficacy and effectiveness across primary care settings.
移动技术可以被利用来满足通过初级保健进行基于证据的心理抑郁治疗的需求。本研究的目的是初步检查自我帮助的简短行为激活移动应用程序（应用程序；“Moodivate”）在初级保健治疗的成年人中的抑郁症状的可行性和疗效。参与者（N=52）于 2017 年 1 月至 12 月期间从初级保健实践中招募，并按 2:2:1 的比例随机分配接受（a）Moodivate、（b）积极对照基于认知行为疗法的移动应用程序（“MoodKit”）或（c）常规治疗（TAU；无应用程序）。参与者每周完成 8 周的抑郁症状评估。应用程序分析数据被捕获以检查 Moodivate 的可行性（控制应用程序的分析不可用）。在整个试验过程中，Moodivate 参与者平均有 46.76（SD=30.10）个应用程序会话，每次会话使用应用程序 3.50（2.76）分钟，整个试验期间共使用应用程序 120.76（101.02）分钟。近 70%的 Moodivate 参与者在试验入组后 1 个月继续使用该应用程序，50%在 8 周随访结束时继续使用。一项考察随时间推移按治疗条件变化的抑郁症状的广义估计方程模型表明，时间和治疗条件之间存在显著的交互作用（χ=42.21，df=14，p<.001）。与 TAU 相比，两个应用程序条件下的参与者的抑郁症状随时间明显减轻，并且这些治疗效果在整个试验期间都得以维持。这些结果初步表明 Moodivate 的可行性，以及 Moodivate 和 MoodKit 对通过初级保健招募的成年人进行抑郁症治疗的疗效。未来的研究应重点关注在初级保健环境中对治疗效果和有效性的更大规模检验。
