指导与接收应用程序推荐对IntelliCare平台上的抑郁、焦虑及参与度的影响比较：析因随机对照试验
Comparison of the Effects of Coaching and Receipt of App Recommendations on Depression, Anxiety, and Engagement in the IntelliCare Platform: Factorial Randomized Controlled Trial.
作者信息
Mohr David C, Schueller Stephen M, Tomasino Kathryn Noth, Kaiser Susan M, Alam Nameyeh, Karr Chris, Vergara Jessica L, Gray Elizabeth L, Kwasny Mary J, Lattie Emily G
机构信息
Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States.
Department of Psychological Science, University of California, Irvine, Irvine, CA, United States.
出版信息
J Med Internet Res. 2019 Aug 28;21(8):e13609. doi: 10.2196/13609.
BACKGROUND
IntelliCare is a modular platform that includes 12 simple apps targeting specific psychological strategies for common mental health problems.
OBJECTIVE
This study aimed to examine the effect of 2 methods of maintaining engagement with the IntelliCare platform, coaching, and receipt of weekly recommendations to try different apps on depression, anxiety, and app use.
METHODS
A total of 301 participants with depression or anxiety were randomized to 1 of 4 treatments lasting 8 weeks and were followed for 6 months posttreatment. The trial used a 2X2 factorial design (coached vs self-guided treatment and weekly app recommendations vs no recommendations) to compare engagement metrics.
RESULTS
The median time to last use of any app during treatment was 56 days (interquartile range 54-57), with 253 participants (84.0%, 253/301) continuing to use the apps over a median of 92 days posttreatment. Receipt of weekly recommendations resulted in a significantly higher number of app use sessions during treatment (overall median=216; P=.04) but only marginal effects for time to last use (P=.06) and number of app downloads (P=.08). Coaching resulted in significantly more app downloads (P<.001), but there were no significant effects for time to last download or number of app sessions (P=.36) or time to last download (P=.08). Participants showed significant reductions in the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) across all treatment arms (P s<.001). Coached treatment led to larger GAD-7 reductions than those observed for self-guided treatment (P=.03), but the effects for the PHQ-9 did not reach significance (P=.06). Significant interaction was observed between receiving recommendations and time for the PHQ-9 (P=.04), but there were no significant effects for GAD-7 (P=.58).
CONCLUSIONS
IntelliCare produced strong engagement with apps across all treatment arms. Coaching was associated with stronger anxiety outcomes, and receipt of recommendations enhanced depression outcomes.
TRIAL REGISTRATION
ClinicalTrials.gov NCT02801877; https://clinicaltrials.gov/ct2/show/NCT02801877.
背景
IntelliCare是一个模块化平台，包含12个针对常见心理健康问题的特定心理策略的简单应用程序。
目的
本研究旨在探讨两种维持与IntelliCare平台互动的方法、指导以及接收尝试不同应用程序的每周推荐对抑郁、焦虑和应用程序使用情况的影响。
方法
共有301名患有抑郁或焦虑症的参与者被随机分配到4种为期8周的治疗方案中的一种，并在治疗后随访6个月。该试验采用2×2析因设计（指导治疗与自我指导治疗以及每周应用程序推荐与无推荐）来比较参与指标。
结果
治疗期间最后一次使用任何应用程序的中位时间为56天（四分位间距54 - 57），253名参与者（84.0%，253/301）在治疗后中位92天内持续使用这些应用程序。接收每周推荐导致治疗期间应用程序使用次数显著增加（总体中位值 = 216；P = 0.04），但对最后一次使用时间（P = 0.06）和应用程序下载次数（P = 0.08）只有边际效应。指导导致应用程序下载次数显著更多（P < 0.001），但对最后一次下载时间、应用程序使用次数（P = 0.36）或最后一次下载时间（P = 0.08）没有显著影响。所有治疗组的患者健康问卷 - 9（PHQ - 9）和广泛性焦虑障碍 - 7（GAD - 7）得分均显著降低（P值 < 0.001）。指导治疗导致GAD - 7得分的降低幅度大于自我指导治疗（P = 0.03），但对PHQ - 9的影响未达到显著水平（P = 0.06）。在接收推荐和时间方面，观察到PHQ - 9有显著交互作用（P = 0.04），但对GAD - 7没有显著影响（P = 0.58）。
结论
IntelliCare在所有治疗组中都能使患者与应用程序保持高度互动。指导与更强的焦虑改善结果相关，接收推荐增强了抑郁改善结果。
试验注册
ClinicalTrials.gov NCT02801877；https://clinicaltrials.gov/ct2/show/NCT02801877 。
Zotero 插件