Coached Mobile App Platform for the Treatment of Depression and Anxiety Among Primary Care Patients

Graham, Andrea K.; Greene, Carolyn J.; Kwasny, Mary J.; Kaiser, Susan M.; Lieponis, Paul; Powell, Thomas; Mohr, David C.

doi:10.1001/jamapsychiatry.2020.1011

Cited by 126 publications

(125 citation statements)

References 46 publications

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“…We note that the study was underpowered to detect changes in psychosocial targets, so we are unable to determine if the lack of change was because of chance. Compared with previous studies of IntelliCare in which participants were encouraged to use IntelliCare daily, participants in this study were not given this instruction and used IntelliCare less frequently during the 8-week study than had been observed in these previous studies [ 6 - 8 ]. Participants enrolled in this study during the summer months, and the 8-week follow-up for many participants took place after the fall semester began.…”

Section: Discussionmentioning

confidence: 92%

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Examining an App-Based Mental Health Self-Care Program, IntelliCare for College Students: Single-Arm Pilot Study

Lattie¹,

Cohen²,

Winquist³

et al. 2020

JMIR Ment Health

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Background In recent years, there has been an increase in symptoms of depression, anxiety, and other mental illnesses in college student populations alongside a steady rise in the demand for counseling services. Digital mental health programs, such as those delivered through mobile apps, can add to the array of available services but must be tested for usability and acceptability before implementation. Objective This study aims to examine how students used IntelliCare for College Students over an 8-week period to examine the preliminary associations between app use and psychosocial targets and to gather user feedback about usability issues that need to be remedied before a larger implementation study. Methods IntelliCare for College Students is an app-based platform that provides symptom assessments with personalized feedback, information about campus resources, lessons on mental health and wellness topics, and access to the suite of interactive skill–focused IntelliCare apps. A total of 20 students were recruited to participate in an 8-week study. To test for a broad range of potential users, we recruited a mixed sample of students with elevated symptoms of depression or anxiety and students without elevated symptoms. Participants completed psychosocial questionnaires at baseline, week 4, and week 8. Participants also completed user feedback interviews at weeks 4 and 8 in which they provided feedback on their experience using the app and suggestions for changes they would like to be made to the app. Results Of the 20 students who downloaded the app, 19 completed the study, indicating a high rate of retention. Over the study period, participants completed an average of 5.85 (SD 2.1; range 1-8) symptom assessments. Significant improvements were observed in the Anxiety Literacy Questionnaire scores (Z=−2.006; P=.045) and in the frequency with which participants used both cognitive (Z=−2.091; P=.04) and behavioral (Z=−2.249; P=.03) coping skills. In the feedback interviews, we identified a high degree of usability with minor bugs in the app software, which were quickly fixed. Furthermore, in feedback interviews, we identified that users found the app to be convenient and appreciated the ability to use the program in short bursts of time. Conclusions The findings indicate that the IntelliCare for College Students program was perceived as largely usable and engaging. Although the program demonstrated usability and preliminary benefits to students, further testing is needed to determine its clinical utility among college students. Trial Registration ClinicalTrials.gov NCT04035577; https://clinicaltrials.gov/ct2/show/NCT04035577

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Section: Discussionmentioning

confidence: 92%

“…The IntelliCare app platform has demonstrated efficacy in reducing symptoms of depression and anxiety in general adult populations [ 6 - 8 ]. IntelliCare is a collection of quick and easy-to-use apps that each present a different evidence-based mood management strategy (eg, cognitive restructuring, behavioral activation).…”

Section: Introductionmentioning

confidence: 99%

Examining an App-Based Mental Health Self-Care Program, IntelliCare for College Students: Single-Arm Pilot Study

Lattie¹,

Cohen²,

Winquist³

et al. 2020

JMIR Ment Health

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“…This is a case study report of 3 participants of the 146 adults enrolled in a randomized controlled trial investigating the efficacy of the IntelliCare intervention among primary care patients with depression and/or anxiety [ 15 ]. The UAMS Institutional Review Board approved this study, and all participants provided informed consent.…”

Section: Methodsmentioning

confidence: 99%

“…We conducted a clinical trial evaluating IntelliCare, an evidence-based mobile intervention for depression and anxiety, among adults recruited from primary care clinics at the University of Arkansas for Medical Sciences (UAMS) [ 14 , 15 ]. IntelliCare has been publicly available since 2014 and has shown favorable results in 2 previous trials, with past users demonstrating high engagement (>90% continued use through 8 weeks of treatment in coached deployments) and substantial improvements in depression symptoms from pre- to postintervention [ 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Engagement and Clinical Improvement Among Older Adult Primary Care Patients Using a Mobile Intervention for Depression and Anxiety: Case Studies

et al. 2020

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Background Technology-based mental health interventions are an increasingly attractive option for expanding access to mental health services within the primary care system. Older adults are among the groups that could potentially benefit from the growing ubiquity of technology-based mental health interventions; however, older adults are perceived to be averse to using technology and have reported barriers to use. Objective The aim of this paper is to present a case study of 3 participants from a clinical trial evaluating IntelliCare, an evidence-based mobile intervention for depression and anxiety, among adults recruited from primary care clinics. Our report of these 3 participants, who were aged 60 years or older, focuses on their engagement with the IntelliCare service (ie, app use, coach communication) and clinical changes in depression or anxiety symptoms over the intervention period. Methods The 3 case study participants were offered IntelliCare with coaching for 8 weeks. The intervention consisted of 5 treatment intervention apps that support a variety of psychological skills, a Hub app that contained psychoeducational content and administered weekly assessments, and coaching for encouragement, accountability, and technical assistance as needed. The 3 case study participants were selected to reflect the overall demographics of participants within the trial and because their interactions with IntelliCare provided a good illustration of varied experiences regarding engagement with the intervention. Results The 3 participants’ unique experiences with the intervention are described. Despite potential barriers and experiencing some technical glitches, the participants showed proficient ability to use the apps, high levels of participation through frequent app use and coach interaction, and decreased depression and anxiety scores. At the end of the 8-week intervention, each of these 3 participants expressed great enthusiasm for the benefit of this program through feedback to their coach, and they each identified a number of ways they had seen improvements in themselves. Conclusions These 3 cases provide examples of older individuals who engaged with and benefitted from the IntelliCare service. Although the results from these 3 cases may not generalize to others, they provide an important, informed perspective of the experiences that can contribute to our understanding of how older adults use and overcome barriers to mental health technologies. The findings also contribute toward the ultimate goal of ensuring that the IntelliCare intervention is appropriate for individuals of all ages.

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“…The IntelliCare app platform has demonstrated efficacy in reducing symptoms of depression and anxiety in general adult populations [6][7][8]. IntelliCare is a collection of quick and easy-to-use apps that each present a different evidence-based mood management strategy (eg, cognitive restructuring, behavioral activation).…”

Section: Introductionmentioning

confidence: 99%

Examining an App-Based Mental Health Self-Care Program, IntelliCare for College Students: Single-Arm Pilot Study (Preprint)

Lattie¹,

Cohen²,

Winquist³

et al. 2020

Preprint

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BACKGROUND In recent years, there has been an increase in symptoms of depression, anxiety, and other mental illnesses in college student populations alongside a steady rise in the demand for counseling services. Digital mental health programs, such as those delivered through mobile apps, can add to the array of available services but must be tested for usability and acceptability before implementation. OBJECTIVE This study aims to examine how students used IntelliCare for College Students over an 8-week period to examine the preliminary associations between app use and psychosocial targets and to gather user feedback about usability issues that need to be remedied before a larger implementation study. METHODS IntelliCare for College Students is an app-based platform that provides symptom assessments with personalized feedback, information about campus resources, lessons on mental health and wellness topics, and access to the suite of interactive skill–focused IntelliCare apps. A total of 20 students were recruited to participate in an 8-week study. To test for a broad range of potential users, we recruited a mixed sample of students with elevated symptoms of depression or anxiety and students without elevated symptoms. Participants completed psychosocial questionnaires at baseline, week 4, and week 8. Participants also completed user feedback interviews at weeks 4 and 8 in which they provided feedback on their experience using the app and suggestions for changes they would like to be made to the app. RESULTS Of the 20 students who downloaded the app, 19 completed the study, indicating a high rate of retention. Over the study period, participants completed an average of 5.85 (SD 2.1; range 1-8) symptom assessments. Significant improvements were observed in the Anxiety Literacy Questionnaire scores (Z=−2.006; P=.045) and in the frequency with which participants used both cognitive (Z=−2.091; P=.04) and behavioral (Z=−2.249; P=.03) coping skills. In the feedback interviews, we identified a high degree of usability with minor bugs in the app software, which were quickly fixed. Furthermore, in feedback interviews, we identified that users found the app to be convenient and appreciated the ability to use the program in short bursts of time. CONCLUSIONS The findings indicate that the IntelliCare for College Students program was perceived as largely usable and engaging. Although the program demonstrated usability and preliminary benefits to students, further testing is needed to determine its clinical utility among college students. CLINICALTRIAL ClinicalTrials.gov NCT04035577; https://clinicaltrials.gov/ct2/show/NCT04035577

show abstract

Coached Mobile App Platform for the Treatment of Depression and Anxiety Among Primary Care Patients

Cited by 126 publications

References 46 publications

Examining an App-Based Mental Health Self-Care Program, IntelliCare for College Students: Single-Arm Pilot Study

Examining an App-Based Mental Health Self-Care Program, IntelliCare for College Students: Single-Arm Pilot Study

Engagement and Clinical Improvement Among Older Adult Primary Care Patients Using a Mobile Intervention for Depression and Anxiety: Case Studies

Examining an App-Based Mental Health Self-Care Program, IntelliCare for College Students: Single-Arm Pilot Study (Preprint)

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