Self-Guided Digital Intervention for Depression in Adolescents: Feasibility and Preliminary Efficacy Study

BackgroundDepression in adolescents is a large and growing problem; however, access to effective mental health care continues to be a challenge. Digitally based interventions may serve to bridge this access gap for adolescents in need of care. Digital interventions that deliv...

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Main Authors: Ian Miller, Emily Peake, Gabriel Strauss, Elise Vierra, Xin Koepsell, Brandon Shalchi, Aarthi Padmanabhan, Jessica Lake
Format: Article
Language:English
Published: JMIR Publications 2023-11-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2023/1/e43260
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author Ian Miller
Emily Peake
Gabriel Strauss
Elise Vierra
Xin Koepsell
Brandon Shalchi
Aarthi Padmanabhan
Jessica Lake
author_facet Ian Miller
Emily Peake
Gabriel Strauss
Elise Vierra
Xin Koepsell
Brandon Shalchi
Aarthi Padmanabhan
Jessica Lake
author_sort Ian Miller
collection DOAJ
description BackgroundDepression in adolescents is a large and growing problem; however, access to effective mental health care continues to be a challenge. Digitally based interventions may serve to bridge this access gap for adolescents in need of care. Digital interventions that deliver components of cognitive behavioral therapy (CBT) have been shown to reduce symptoms of depression, and virtual reality (VR) may be a promising adjunctive component. However, research on these types of treatments in adolescents and young adults is limited. ObjectiveThis study aims to evaluate the feasibility, acceptability, and preliminary efficacy of Spark (v1.0), a 5-week, self-guided, CBT-based digital program using a mobile app and VR experiences to target symptoms of depression in adolescents. MethodsA single-arm, open-label study of the Spark program was conducted with a community sample of 30 adolescents and young adults aged 12 to 21 years with self-reported moderate to severe depression symptoms. Participants completed a weekly depression assessment (Patient Health Questionnaire-8) in the app during the 5-week intervention period as well as web-based baseline, postintervention, and 1-month follow-up self-report assessments. The participants also completed a qualitative postintervention interview. For participants aged <18 years, caregivers completed assessments at baseline and postintervention time points. Feasibility outcomes included recruitment rate (the proportion of participants who enrolled in the study divided by the total number of participants screened for eligibility) and retention rate (the proportion of participants who completed postintervention assessments divided by the total number of participants who received the intervention). Acceptability outcomes included engagement with the program and quantitative and qualitative feedback about the program. Preliminary efficacy was evaluated based on the Patient Health Questionnaire-8. ResultsThe study recruitment (31/66, 47%) and retention (29/30, 97%) rates were high. Participants provided higher ratings for the ease of use of the Spark program (8.76 out of 10) and their enjoyment of both the mobile app (7.00 out of 10) and VR components (7.48 out of 10) of the program, whereas they provided lower ratings for the program’s ability to improve mood (4.38 out of 10) or fit into their daily routines (5.69 out of 10). We observed a clinically and statistically significant reduction in depression scores at postintervention (mean difference 5.36; P<.001) and 1-month follow-up (mean difference 6.44; P<.001) time points. ConclusionsThe Spark program was found to be a feasible and acceptable way to deliver a self-guided CBT-focused intervention to adolescents and young adults with symptoms of depression. Preliminary data also indicated that the Spark program reduced the symptoms of depression in adolescents and young adults. Future studies should evaluate the efficacy of this intervention in an adequately powered randomized controlled trial. Trial RegistrationClinicalTrials.gov NCT04165681; https://classic.clinicaltrials.gov/ct2/show/NCT04165681
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spelling doaj.art-87f6969539044112a1eeccab9ccf8f862023-11-22T13:45:39ZengJMIR PublicationsJMIR Formative Research2561-326X2023-11-017e4326010.2196/43260Self-Guided Digital Intervention for Depression in Adolescents: Feasibility and Preliminary Efficacy StudyIan Millerhttps://orcid.org/0000-0001-8033-2520Emily Peakehttps://orcid.org/0009-0000-4359-8370Gabriel Strausshttps://orcid.org/0009-0006-3960-8760Elise Vierrahttps://orcid.org/0009-0001-2062-4668Xin Koepsellhttps://orcid.org/0009-0000-5442-9636Brandon Shalchihttps://orcid.org/0009-0005-5518-8236Aarthi Padmanabhanhttps://orcid.org/0000-0002-3727-5468Jessica Lakehttps://orcid.org/0000-0003-0682-8725 BackgroundDepression in adolescents is a large and growing problem; however, access to effective mental health care continues to be a challenge. Digitally based interventions may serve to bridge this access gap for adolescents in need of care. Digital interventions that deliver components of cognitive behavioral therapy (CBT) have been shown to reduce symptoms of depression, and virtual reality (VR) may be a promising adjunctive component. However, research on these types of treatments in adolescents and young adults is limited. ObjectiveThis study aims to evaluate the feasibility, acceptability, and preliminary efficacy of Spark (v1.0), a 5-week, self-guided, CBT-based digital program using a mobile app and VR experiences to target symptoms of depression in adolescents. MethodsA single-arm, open-label study of the Spark program was conducted with a community sample of 30 adolescents and young adults aged 12 to 21 years with self-reported moderate to severe depression symptoms. Participants completed a weekly depression assessment (Patient Health Questionnaire-8) in the app during the 5-week intervention period as well as web-based baseline, postintervention, and 1-month follow-up self-report assessments. The participants also completed a qualitative postintervention interview. For participants aged <18 years, caregivers completed assessments at baseline and postintervention time points. Feasibility outcomes included recruitment rate (the proportion of participants who enrolled in the study divided by the total number of participants screened for eligibility) and retention rate (the proportion of participants who completed postintervention assessments divided by the total number of participants who received the intervention). Acceptability outcomes included engagement with the program and quantitative and qualitative feedback about the program. Preliminary efficacy was evaluated based on the Patient Health Questionnaire-8. ResultsThe study recruitment (31/66, 47%) and retention (29/30, 97%) rates were high. Participants provided higher ratings for the ease of use of the Spark program (8.76 out of 10) and their enjoyment of both the mobile app (7.00 out of 10) and VR components (7.48 out of 10) of the program, whereas they provided lower ratings for the program’s ability to improve mood (4.38 out of 10) or fit into their daily routines (5.69 out of 10). We observed a clinically and statistically significant reduction in depression scores at postintervention (mean difference 5.36; P<.001) and 1-month follow-up (mean difference 6.44; P<.001) time points. ConclusionsThe Spark program was found to be a feasible and acceptable way to deliver a self-guided CBT-focused intervention to adolescents and young adults with symptoms of depression. Preliminary data also indicated that the Spark program reduced the symptoms of depression in adolescents and young adults. Future studies should evaluate the efficacy of this intervention in an adequately powered randomized controlled trial. Trial RegistrationClinicalTrials.gov NCT04165681; https://classic.clinicaltrials.gov/ct2/show/NCT04165681https://formative.jmir.org/2023/1/e43260
spellingShingle Ian Miller
Emily Peake
Gabriel Strauss
Elise Vierra
Xin Koepsell
Brandon Shalchi
Aarthi Padmanabhan
Jessica Lake
Self-Guided Digital Intervention for Depression in Adolescents: Feasibility and Preliminary Efficacy Study
JMIR Formative Research
title Self-Guided Digital Intervention for Depression in Adolescents: Feasibility and Preliminary Efficacy Study
title_full Self-Guided Digital Intervention for Depression in Adolescents: Feasibility and Preliminary Efficacy Study
title_fullStr Self-Guided Digital Intervention for Depression in Adolescents: Feasibility and Preliminary Efficacy Study
title_full_unstemmed Self-Guided Digital Intervention for Depression in Adolescents: Feasibility and Preliminary Efficacy Study
title_short Self-Guided Digital Intervention for Depression in Adolescents: Feasibility and Preliminary Efficacy Study
title_sort self guided digital intervention for depression in adolescents feasibility and preliminary efficacy study
url https://formative.jmir.org/2023/1/e43260
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