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J Med Internet Res. 2019 Aug 28;21(8):e13609. doi: 10.2196/13609.

Comparison of the Effects of Coaching and Receipt of App Recommendations on Depression, Anxiety, and Engagement in the IntelliCare Platform: Factorial Randomized Controlled Trial.

Author information

1
Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States.
2
Department of Psychological Science, University of California, Irvine, Irvine, CA, United States.
3
Department of Gastroenterology, Northwestern University, Chicago, IL, United States.
4
Audacious Software, Chicago, IL, United States.
5
Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.

Abstract

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.

KEYWORDS:

anxiety; clinical trial; depression; mHealth

PMID:
31464192
DOI:
10.2196/13609
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