Development and Preliminary Feasibility Study of a Brief Behavioral Activation Mobile Application (Behavioral Apptivation) to Be Used in Conjunction With Ongoing Therapy

Dahne, Jennifer; Kustanowitz, Jacob; Lejuez, Carl W.

doi:10.1016/j.cbpra.2017.05.004

Cited by 22 publications

(21 citation statements)

References 28 publications

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“…CSE is positively associated with psychological thriving (Sirois & Hirsch, 2013) and negatively associated with depression (Philip, Merluzzi, Zhang, & Heitzmann, 2013 and overall psychological distress (Benka et al, 2014;Pritchard & Gow, 2012;Smith, Benight, & Cieslak, 2013). While the outcomes of using some CBT-based MHapps have been studied (Dahne, Kustanowitz, & Lejuez, 2017;e.g., Huguet et al, 2016), the role of improving CSE to elicit mental health benefits remains unclear. Kuhn et al (2017) conducted a Randomised Controlled Trial (RCT) comparing the "PTSD Coach" app, for Post Traumatic Stress Disorder, to a waitlist condition over 3 months of treatment.…”

Section: Apps Like Moodmission May Prevent Depressive and Anxietymentioning

confidence: 99%

“…Apps like MoodMission may prevent depressive and anxiety disorders and serve as an adjunct to clinical treatments. While the outcomes of using some CBT-based MHapps have been studied (Dahne, Kustanowitz, & Lejuez, 2017;e.g., Huguet et al, 2016), the role of improving CSE to elicit mental health benefits remains unclear. CSE is positively associated with psychological thriving (Sirois & Hirsch, 2013) and negatively associated with depression (Philip, Merluzzi, Zhang, & Heitzmann, 2013 and overall psychological distress (Benka et al, 2014;Pritchard & Gow, 2012;Smith, Benight, & Cieslak, 2013).…”

Section: Introductionmentioning

confidence: 99%

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Engagement with a cognitive behavioural therapy mobile phone app predicts changes in mental health and wellbeing: MoodMission

Bakker

Rickard

2019

Australian Psychologist

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Objective: There is an abundance of evidence supporting the efficacy of computerised cognitive behavioural therapy (CBT), but few studies have evaluated mobile applications (apps) that provide CBT strategies. This study investigating the relationships between mental health outcomes and engagement with a mobile app that recommended short CBT strategies. Method: Participants downloaded the MoodMission app from the iOS and Android app stores, completed in-app baseline assessments, and final assessments 30 days later. Participants reported their mood to MoodMission when they were feeling low or anxious and received a list of short CBT strategies to choose from and engage in. Data from 617 assessment completers (71% female; M age = 27 years) were analysed via hierarchical and mediated regressions. Results: App engagement ratings predicted increases in mental wellbeing. Mediation analyses revealed that there were indirect effects of app engagement on depression, anxiety, and mental wellbeing via the mediator of coping self-efficacy. Subsample analyses found this only for participants who were experiencing a moderate level of depression or anxiety at the time of the baseline assessment. Conclusions: Engaging with an app that provides CBT strategies can increase mental wellbeing, and coping self-efficacy may mediate effects of the app in individuals experiencing moderate depression or anxiety. K E Y W O R D Sanxiety, cognitive behavioural therapy, computer/internet technology, depression, mobile

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Section: Apps Like Moodmission May Prevent Depressive and Anxietymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Engagement with a cognitive behavioural therapy mobile phone app predicts changes in mental health and wellbeing: MoodMission

Bakker

Rickard

2019

Australian Psychologist

View full text Add to dashboard Cite

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“…Providing a list of suggested activities to the participant was also used in other apps based on behavioral activation to lower depressive symptoms [67,68]. Previous behavioral activation research suggested a list of 11 activity categories in which patients could start doing activities [66].…”

Section: Methodsmentioning

confidence: 99%

“…Although in-person interventions based on behavioral activation usually have a duration of 5 to 12 weekly sessions, with each session lasting approximately 45 min [69,70], interventions using technology need to deliver the core elements of the treatment by adapting them to the interface used and not as a mere copy of the content [71]. Other mobile interventions using behavioral activation were typically designed for a duration of 8 to 10 weekly sessions but were also accompanied with weekly psychotherapy sessions [67,68] or pharmacotherapy [72]. Considering the nurse accompanying the CONEMO intervention would only give technical support and that app developers recommend designing interventions of “high frequency, low intensity, and shorter time commitment” [71], it was decided to include 18 sessions in total, delivered 3 times a week over a period of 6 weeks.…”

Section: Methodsmentioning

confidence: 99%

Addressing Depression Comorbid With Diabetes or Hypertension in Resource-Poor Settings: A Qualitative Study About User Perception of a Nurse-Supported Smartphone App in Peru

et al. 2019

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Background Smartphone apps could constitute a cost-effective strategy to overcome health care system access barriers to mental health services for people in low- and middle-income countries. Objective The aim of this paper was to explore the patients’ perspectives of CONEMO (Emotional Control, in Spanish: Control Emocional), a technology-driven, psychoeducational, and nurse-supported intervention delivered via a smartphone app aimed at reducing depressive symptoms in people with diabetes, hypertension or both who attend public health care centers, as well as the nurses’ feedback about their role and its feasibility to be scaled up. Methods This study combines data from 2 pilot studies performed in Lima, Peru, between 2015 and 2016, to test the feasibility of CONEMO. Interviews were conducted with 29 patients with diabetes, hypertension or both with comorbid depressive symptoms who used CONEMO and 6 staff nurses who accompanied the intervention. Using a content analysis approach, interview notes from patient interviews were transferred to a digital format, coded, and categorized into 6 main domains: the perceived health benefit, usability, adherence, user satisfaction with the app, nurse’s support, and suggestions to improve the intervention. Interviews with nurses were analyzed by the same approach and categorized into 4 domains: general feedback, evaluation of training, evaluation of study activities, and feasibility of implementing this intervention within the existing structures of health system. Results Patients perceived improvement in their emotional health because of CONEMO, whereas some also reported better physical health. Many encountered some difficulties with using CONEMO, but resolved them with time and practice. However, the interactive elements of the app, such as short message service, android notifications, and pop-up messages were mostly perceived as challenging. Satisfaction with CONEMO was high, as was the self-reported adherence. Overall, patients evaluated the nurse accompaniment positively, but they suggested improvements in the technological training and an increase in the amount of contact. Nurses reported some difficulties in completing their tasks and explained that the CONEMO intervention activities competed with their everyday work routine. Conclusions Using a nurse-supported smartphone app to reduce depressive symptoms among people with chronic diseases is possible and mostly perceived beneficial by the patients, but it requires context-specific adaptations regarding the implementation of a task shifting approach within the public health care system. These results provide valuable information about user feedback for those building mobile health interventions for depression.

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“…BAT-D is a promising treatment approach for a targeted mHealth smoking cessation intervention because it has shown promise helping smokers with depressive symptoms quit smoking in the face-to-face format [9,13], its components are well suited to translation into an app (eg, scheduling valued activities and tracking their completion), and it has a strong foundation in behavioral theory [11]. Indeed, other groups have begun developing and testing BAT-D apps for depression either to be used in conjunction with therapist support [18,19] or in self-guided format and designed for a primary care context [20,21]. With the most advanced evaluation of a BAT-D app to date being pilot RCTs not adequately powered to test efficacy [18,22,23] and the remainder of the published work limited to intervention descriptions or single-arm feasibility studies [19-21], there remains much to be learned about how to effectively translate BAT-D principles into mHealth interventions.…”

Section: Introductionmentioning

confidence: 99%

A Behavioral Activation Mobile Health App for Smokers With Depression: Development and Pilot Evaluation in a Single-Arm Trial

et al. 2019

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BackgroundThe integration of Behavioral Activation Treatment for Depression (BAT-D) into smoking cessation interventions is a promising approach to address depression as a barrier to quitting. However, this approach has only been tested as a face-to-face intervention, which has low reach.ObjectiveThe aims of the study were to develop a BAT-D mobile health app with high potential reach and determine its feasibility, acceptability, and preliminary effects on theory-based behavioral processes of behavioral activation, reduced depressive symptoms, and smoking cessation.MethodsFollowing a user-centered design process consisting of competitive analysis, focus groups, and prototype testing, we conducted a single-arm pilot trial of Actify!, a BAT-D app for depressed smokers. Participants used SmokefreeTXT along with Actify! to provide cessation content that had not yet been built into the app for this initial phase of pilot testing. Participants in the trial were current, daily smokers with mild to moderate depressive symptoms. We examined use outcomes for all enrolled participants and process and cessation outcomes at 6 weeks postenrollment for study completers (16/17, 94% retention).ResultsRegarding acceptability, average number of log-ins per participant was 16.6 (SD 13.7), and 63% (10/16) reported being satisfied overall with the app. Posttreatment interviews identified some usability challenges (eg, high perceived burden of planning and scheduling values-based activities). There was a significant decrease in depressive symptoms from baseline to follow-up (mean change in Patient Health Questionnaire–9 scores was –4.5, 95% CI –7.7 to –1.3; P=.01). Additionally, carbon monoxide (CO)-confirmed, 7-day point prevalence abstinence (PPA) at 6-week follow-up was 31% (5/16), and the 30-day PPA was 19% (3/16).ConclusionsResults demonstrate promising engagement with Actify! and potential for impact on theory-based change processes and cessation outcomes. Preliminary quit rates compare favorably to previous trials of smoking cessation apps for the general population (ie, short-term, self-reported 30-day quit rates in the 8% to 18% range) and a previous trial of face-to-face BAT-D for depressed smokers (ie, CO-confirmed, 7-day PPA rate of 17% at end of treatment).

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Development and Preliminary Feasibility Study of a Brief Behavioral Activation Mobile Application (Behavioral Apptivation) to Be Used in Conjunction With Ongoing Therapy

Cited by 22 publications

References 28 publications

Engagement with a cognitive behavioural therapy mobile phone app predicts changes in mental health and wellbeing: MoodMission

Engagement with a cognitive behavioural therapy mobile phone app predicts changes in mental health and wellbeing: MoodMission

Addressing Depression Comorbid With Diabetes or Hypertension in Resource-Poor Settings: A Qualitative Study About User Perception of a Nurse-Supported Smartphone App in Peru

A Behavioral Activation Mobile Health App for Smokers With Depression: Development and Pilot Evaluation in a Single-Arm Trial

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