A personal sensing technology enabled service versus a digital psychoeducation control for primary care patients with depression and anxiety: a pilot randomized controlled trial.

Autor: Stiles-Shields C; Institute for Juvenile Research, Department of Psychiatry, University of Illinois Chicago, 1747 W. Roosevelt Road, Chicago, IL, 60608, USA. ecss@uic.edu.; AI.Health4All Center, College of Medicine, University of Illinois Chicago, Chicago, IL, USA. ecss@uic.edu., Reyes KM; Department of Psychiatry & Behavioral Sciences, RUSH University Medical Center, Chicago, IL, USA., Lakhtakia T; Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, USA., Smith SR; Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, USA., Barnas OE; Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, USA., Gray EL; Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA., Krause CJ; Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, USA., Kruzan KP; Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, USA., Kwasny MJ; Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA., Mir Z; Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, USA., Panjwani S; Department of Family and Preventive Medicine, RUSH University Medical Center, Chicago, IL, USA., Rothschild SK; Department of Family and Preventive Medicine, RUSH University Medical Center, Chicago, IL, USA., Sánchez-Johnsen L; Institute of Health and Equity, Department of Psychiatry & Behavioral Medicine, Surgery, and Family Medicine, Milwaukee, WI, USA.; MCW Cancer Center, Medical College of Wisconsin (MCW), Milwaukee, WI, USA., Winquist NW; Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, USA., Lattie EG; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA., Allen NB; Department of Psychology, University of Oregon, Ksana Health Inc., Eugene, OR, USA., Reddy M; Department of Informatics, University of California, Irvine, CA, USA., Mohr DC; Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, USA.
Jazyk: angličtina
Zdroj: BMC psychiatry [BMC Psychiatry] 2024 Nov 19; Vol. 24 (1), pp. 828. Date of Electronic Publication: 2024 Nov 19.
DOI: 10.1186/s12888-024-06284-z
Abstrakt: Background: Technology-enabled services (TES; clinical services that include both technology-driven [e.g., personal sensing technologies] and person-powered support elements) may address gaps in depression and anxiety treatments in healthcare settings. The current study: (1) developed a TES tailored for Primary Care patients with depression and/or anxiety, and (2) conducted a pilot randomized controlled trial to assess the efficacy of the TES compared to a digital psychoeducation control app.
Methods: Participants were randomized to either: (1) TES: the "Vira" smartphone app (Ksana Health Inc.), informed by behavioral activation and using passive sensing technology to provide behavioral "insights" and target behaviors associated with mental health symptoms, alongside lay-provider coaching, or (2) Control: the Mood Education mobile app (ME), containing static psychoeducational resources designed to target mental health symptoms. Both apps collected usage data. Participants completed assessments on depression (PHQ-9), anxiety (GAD-7), health-related quality of life (PedsQL), and engagement (TWEETs) at baseline, mid-treatment (week 4), end-of-treatment (week 8), and post-treatment (week 12).
Results: Participants (N = 130) were randomized to receive either the TES (Vira; M age = 30) or ME (M age = 33). Linear mixed-effects models determined significant improvements in PHQ-9 and GAD-7 scores for participants across both conditions (ps < 0.001). There was no interactive effect of intervention and time for the PHQ-9 (p = .90) nor the GAD-7 (p = .49). Adjusting for baseline differences and randomization strata, TES participants reported a greater change in a quality of life rating of Physical Functioning (PedsQL) across time (p = .018). TES participants also reported higher levels of engagement and demonstrated higher app usage. However, adjusting for baseline symptom severity, neither app usage nor coach interaction frequency moderated outcomes (ps ≥ 0.2).
Conclusions: While the TES demonstrated superior engagement, improvements in depressive and anxious symptoms for both conditions speak to the potential benefit of both TES and low-intensity psychoeducation treatments in care settings. Future research is needed to better understand which patients might differentially benefit from TESs and broader personal sensing technologies over low-intensity treatments.
Trial Registration: ClinicalTrials.gov NCT05406791.
Competing Interests: Declarations Ethics approval and consent to participate This research was conducted in accordance with the Declaration of Helsinki. All procedures were approved by the Northwestern University Institutional Review Board (IRB; STU# 00211887) and via a relying protocol approved by the IRB at Rush University Medical Center (“RUSH”; ORA# 18050901). Participants completed electronic informed consent, and teen participants completed electronic assent and parent/guardian permission. The trial was preregistered on ClinicalTrials.gov (NCT05406791). Consent for publication Not applicable. Competing interests The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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