PURPOSE To evaluate acceptability and feasibility of a theoretically-based two-part (brief in-person + eight-week automated text-message) depression prevention program, “iDOVE”, for high-risk adolescents. METHODS English speaking emergency department (ED) patients (age 13–17, any chief complaint) were sequentially approached for consent on a convenience sample of shifts, and screened for inclusion based on current depressive symptoms & past year violence. After consent, baseline assessments were obtained; all participants were enrolled in the two-part intervention (brief in-ED + 8-week two-way text-messaging). At 8 weeks, quantitative and qualitative follow-up assessments were obtained. Measures included feasibility, acceptability, and preliminary data on efficacy. Qualitative data was transcribed verbatim, double-coded and interpreted using thematic analysis. Quantitative results were analyzed descriptively and with paired t-tests. RESULTS As planned, 16 participants (8 each gender) were recruited (75% of those who were eligible; 66% non-white, 63% low-income, mean age 15.4). The intervention had high feasibility and acceptability: 93.8% completed 8-week follow-up; 80% of daily text-messages received responses; 31% of participants requested ≥1 “on demand” text-message. In-person and text-message portions were rated as good/excellent by 87%. Qualitatively, participants articulated: (1) iDOVE was welcome and helpful, if unexpected in the ED; (2) the daily text-message mood assessment was “most important”; (3) content was “uplifting”; (4) balancing intervention “relatability” and automation was challenging. Participants’ mean ΔBDI-2 from baseline to eight-week follow-up was −4.9 (p=0.02). CONCLUSIONS This automated preventive text-message intervention is acceptable and feasible. Qualitative data emphasize the importance of creating positive, relevant, and interactive digital health tools for adolescents.
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