Adolescent Health Promotion Interventions Using Well-Care Visits and a Smartphone Cognitive Behavioral Therapy App: Randomized Controlled Trial
BackgroundAdolescent health promotion is important in preventing risk behaviors and improving mental health. Health promotion during adolescence has been shown to contribute to the prevention of late onset of the mental health disease. However, scalable interventions have not...
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| Format: | Article |
| Language: | English |
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JMIR Publications
2022-05-01
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| Series: | JMIR mHealth and uHealth |
| Online Access: | https://mhealth.jmir.org/2022/5/e34154 |
| _version_ | 1797735067332640768 |
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| author | Shinichiro Nagamitsu Ayako Kanie Kazumi Sakashita Ryoichi Sakuta Ayumi Okada Kencho Matsuura Masaya Ito Akiko Katayanagi Takashi Katayama Ryoko Otani Tasuku Kitajima Naoki Matsubara Takeshi Inoue Chie Tanaka Chikako Fujii Yoshie Shigeyasu Ryuta Ishii Sayaka Sakai Michiko Matsuoka Tatsuyuki Kakuma Yushiro Yamashita Masaru Horikoshi |
| author_facet | Shinichiro Nagamitsu Ayako Kanie Kazumi Sakashita Ryoichi Sakuta Ayumi Okada Kencho Matsuura Masaya Ito Akiko Katayanagi Takashi Katayama Ryoko Otani Tasuku Kitajima Naoki Matsubara Takeshi Inoue Chie Tanaka Chikako Fujii Yoshie Shigeyasu Ryuta Ishii Sayaka Sakai Michiko Matsuoka Tatsuyuki Kakuma Yushiro Yamashita Masaru Horikoshi |
| author_sort | Shinichiro Nagamitsu |
| collection | DOAJ |
| description |
BackgroundAdolescent health promotion is important in preventing risk behaviors and improving mental health. Health promotion during adolescence has been shown to contribute to the prevention of late onset of the mental health disease. However, scalable interventions have not been established yet.
ObjectiveThis study was designed to test the efficacy of two adolescent health promotion interventions: a well-care visit (WCV) with a risk assessment interview and counseling and self-monitoring with a smartphone cognitive behavioral therapy (CBT) app. Our hypothesis was that participants who had received both WCV and the CBT app would have better outcomes than those who had received only WCV or those who had not received any intervention. We conducted a prospective multi-institutional randomized controlled trial.
MethodsParticipants were 217 adolescents aged 13-18 years. They were randomly divided into two intervention groups (WCV group and WCV with CBT app group) and a nonintervention group. WCV comprised a standardized physical examination along with a structured interview and counseling for youth risk assessment, which was designed with reference to the Guideline for Health Supervision of Adolescents of Bright Futures. A smartphone-based CBT program was developed based on the CBT approach. The CBT app comprised a 1-week psychoeducation component and a 1-week self-monitoring component. During the CBT program, participants created several self-monitoring sheets based on the CBT model with five window panels: event, thoughts, feelings, body response, and actions. The primary outcome was the change in scores for depressive symptoms. Secondary outcomes included changes in scores for self-esteem, quality of life, self-monitoring, and an adolescent health promotion scale. These outcomes were evaluated at baseline and at 1, 2, and 4 months after baseline. The exploratory outcome was the presence of suicidal ideation during the observation period. Intervention effects were estimated using mixed effect models.
ResultsIn total, 94% (204/217) of the participants completed the 4-month evaluation. Both intervention groups showed a significant effect in the form of reduced scores for depressive symptoms at 1 month in high school students; however, these effects were not observed at 2 and 4 months. The intervention effect was significantly more predominant in those scoring above cutoff for depressive symptoms. There was significantly less suicidal ideation in the intervention groups. As for secondary outcomes, there was significant increase in health promotion scale scores at the 4-month follow-up among junior high school students in the WCV group. Moreover, the CBT app was significantly effective in terms of obtaining self-monitoring skills and reducing depressive symptoms.
ConclusionsAlthough adolescent health promotion interventions may have short-term benefits, the frequency of WCV and further revision of the CBT app should be considered to evaluate long-term effectiveness.
Trial RegistrationUniversity Hospital Medical Information Network Clinical Trials Registry UMIN 000036343; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000041246 |
| first_indexed | 2024-03-12T12:52:41Z |
| format | Article |
| id | doaj.art-9799a2e728364aec956b316c7e897869 |
| institution | Directory Open Access Journal |
| issn | 2291-5222 |
| language | English |
| last_indexed | 2024-03-12T12:52:41Z |
| publishDate | 2022-05-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR mHealth and uHealth |
| spelling | doaj.art-9799a2e728364aec956b316c7e8978692023-08-28T21:49:41ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222022-05-01105e3415410.2196/34154Adolescent Health Promotion Interventions Using Well-Care Visits and a Smartphone Cognitive Behavioral Therapy App: Randomized Controlled TrialShinichiro Nagamitsuhttps://orcid.org/0000-0001-7156-6050Ayako Kaniehttps://orcid.org/0000-0001-8480-7001Kazumi Sakashitahttps://orcid.org/0000-0002-4588-8221Ryoichi Sakutahttps://orcid.org/0000-0002-5444-0568Ayumi Okadahttps://orcid.org/0000-0002-9414-1650Kencho Matsuurahttps://orcid.org/0000-0001-8607-4024Masaya Itohttps://orcid.org/0000-0003-2295-9733Akiko Katayanagihttps://orcid.org/0000-0002-1417-9801Takashi Katayamahttps://orcid.org/0000-0002-0603-395XRyoko Otanihttps://orcid.org/0000-0002-0668-6838Tasuku Kitajimahttps://orcid.org/0000-0003-3333-7139Naoki Matsubarahttps://orcid.org/0000-0002-4233-7723Takeshi Inouehttps://orcid.org/0000-0002-7262-0482Chie Tanakahttps://orcid.org/0000-0003-3920-4986Chikako Fujiihttps://orcid.org/0000-0002-0167-9065Yoshie Shigeyasuhttps://orcid.org/0000-0002-2469-7637Ryuta Ishiihttps://orcid.org/0000-0003-0326-7299Sayaka Sakaihttps://orcid.org/0000-0001-6264-5902Michiko Matsuokahttps://orcid.org/0000-0002-7481-9305Tatsuyuki Kakumahttps://orcid.org/0000-0002-3713-3099Yushiro Yamashitahttps://orcid.org/0000-0001-8677-3183Masaru Horikoshihttps://orcid.org/0000-0001-9336-8813 BackgroundAdolescent health promotion is important in preventing risk behaviors and improving mental health. Health promotion during adolescence has been shown to contribute to the prevention of late onset of the mental health disease. However, scalable interventions have not been established yet. ObjectiveThis study was designed to test the efficacy of two adolescent health promotion interventions: a well-care visit (WCV) with a risk assessment interview and counseling and self-monitoring with a smartphone cognitive behavioral therapy (CBT) app. Our hypothesis was that participants who had received both WCV and the CBT app would have better outcomes than those who had received only WCV or those who had not received any intervention. We conducted a prospective multi-institutional randomized controlled trial. MethodsParticipants were 217 adolescents aged 13-18 years. They were randomly divided into two intervention groups (WCV group and WCV with CBT app group) and a nonintervention group. WCV comprised a standardized physical examination along with a structured interview and counseling for youth risk assessment, which was designed with reference to the Guideline for Health Supervision of Adolescents of Bright Futures. A smartphone-based CBT program was developed based on the CBT approach. The CBT app comprised a 1-week psychoeducation component and a 1-week self-monitoring component. During the CBT program, participants created several self-monitoring sheets based on the CBT model with five window panels: event, thoughts, feelings, body response, and actions. The primary outcome was the change in scores for depressive symptoms. Secondary outcomes included changes in scores for self-esteem, quality of life, self-monitoring, and an adolescent health promotion scale. These outcomes were evaluated at baseline and at 1, 2, and 4 months after baseline. The exploratory outcome was the presence of suicidal ideation during the observation period. Intervention effects were estimated using mixed effect models. ResultsIn total, 94% (204/217) of the participants completed the 4-month evaluation. Both intervention groups showed a significant effect in the form of reduced scores for depressive symptoms at 1 month in high school students; however, these effects were not observed at 2 and 4 months. The intervention effect was significantly more predominant in those scoring above cutoff for depressive symptoms. There was significantly less suicidal ideation in the intervention groups. As for secondary outcomes, there was significant increase in health promotion scale scores at the 4-month follow-up among junior high school students in the WCV group. Moreover, the CBT app was significantly effective in terms of obtaining self-monitoring skills and reducing depressive symptoms. ConclusionsAlthough adolescent health promotion interventions may have short-term benefits, the frequency of WCV and further revision of the CBT app should be considered to evaluate long-term effectiveness. Trial RegistrationUniversity Hospital Medical Information Network Clinical Trials Registry UMIN 000036343; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000041246https://mhealth.jmir.org/2022/5/e34154 |
| spellingShingle | Shinichiro Nagamitsu Ayako Kanie Kazumi Sakashita Ryoichi Sakuta Ayumi Okada Kencho Matsuura Masaya Ito Akiko Katayanagi Takashi Katayama Ryoko Otani Tasuku Kitajima Naoki Matsubara Takeshi Inoue Chie Tanaka Chikako Fujii Yoshie Shigeyasu Ryuta Ishii Sayaka Sakai Michiko Matsuoka Tatsuyuki Kakuma Yushiro Yamashita Masaru Horikoshi Adolescent Health Promotion Interventions Using Well-Care Visits and a Smartphone Cognitive Behavioral Therapy App: Randomized Controlled Trial JMIR mHealth and uHealth |
| title | Adolescent Health Promotion Interventions Using Well-Care Visits and a Smartphone Cognitive Behavioral Therapy App: Randomized Controlled Trial |
| title_full | Adolescent Health Promotion Interventions Using Well-Care Visits and a Smartphone Cognitive Behavioral Therapy App: Randomized Controlled Trial |
| title_fullStr | Adolescent Health Promotion Interventions Using Well-Care Visits and a Smartphone Cognitive Behavioral Therapy App: Randomized Controlled Trial |
| title_full_unstemmed | Adolescent Health Promotion Interventions Using Well-Care Visits and a Smartphone Cognitive Behavioral Therapy App: Randomized Controlled Trial |
| title_short | Adolescent Health Promotion Interventions Using Well-Care Visits and a Smartphone Cognitive Behavioral Therapy App: Randomized Controlled Trial |
| title_sort | adolescent health promotion interventions using well care visits and a smartphone cognitive behavioral therapy app randomized controlled trial |
| url | https://mhealth.jmir.org/2022/5/e34154 |
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