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Depression is common in primary care settings, but barriers prevent many primary care patients from initiating treatment. Smartphone apps stand as a possible means to overcome such barriers. However, there is limited evidence to understand the use and efficacy of these apps. The purpose of the current study was to pilot an evaluation of the usage and efficacy of apps for depression based upon behavioral or cognitive intervention skills, compared to a wait-list control. Thirty adults with depression were randomized to the use of either a behavioral app (Boost Me) or a cognitive app (Thought Challenger) or to a wait-list control. Boost Me and Thought Challenger participants received 6 weeks of the respective intervention along with weekly coaching sessions, with a 4-week follow-up period; wait-list control participants received no interventions for 10 weeks. A repeated-measures analysis of variance was conducted to examine depression over time and across treatment groups; t tests compared app usage across groups. Depression scores changed significantly over time (p < .001), with group differences occurring between Thought Challenger and wait-list control participants (p = .03). Boost Me was used significantly more than was Thought Challenger (p = .02); however, there was no evidence to suggest correlations between usage and changes in depression (ps > .05). The present study provides initial support that intervention strategies for depression delivered via apps with human support can impact symptoms and may promote continued use over 6 weeks. This pilot also demonstrates the feasibility of future research regarding the delivery of behavioral and cognitive intervention strategies via apps.

Although counts of tweets citing academic papers are used as an informal indicator of interest, little is known about who tweets academic papers and who uses Twitter to find scholarly information. Without knowing this, it is difficult to draw useful conclusions from a publication being frequently tweeted. This study surveyed 1,912 users that have tweeted journal articles to ask about their scholarly-related Twitter uses. Almost half of the respondents (45%) did not work in academia, despite the sample probably being biased towards academics. Twitter was used most by people with a social science or humanities background. People tend to leverage social ties on Twitter to find information rather than searching for relevant tweets. Twitter is used in academia to acquire and share real-time information and to develop connections with others. Motivations for using Twitter vary by discipline, occupation, and employment sector, but not much by gender. These factors also influence the sharing of different types of academic information. This study provides evidence that Twitter plays a significant role in the discovery of scholarly information and cross-disciplinary knowledge spreading. Most importantly, the large numbers of non-academic users support the claims of those using tweet counts as evidence for the non-academic impacts of scholarly research.

IMPORTANCE Depression and anxiety are common and disabling. Primary care is the de facto site for treating these mental health problems but is typically underresourced to meet the burden of these demands.OBJECTIVE To evaluate the efficacy of a mobile intervention platform, IntelliCare, for addressing depression and anxiety among primary care patients.DESIGN, SETTING, AND PARTICIPANTS Two-arm randomized clinical trial at internal medicine clinics at the University of Arkansas for Medical Sciences. Adult primary care patients (N = 146) who screened positive for depression on the Patient Health Questionnaire-8 (PHQ; score Ն 10) or anxiety on the Generalized Anxiety Disorder-7 (GAD-7; score Ն 8) were recruited between July 17, 2018, and December 14, 2018. INTERVENTIONSThe coach-supported platform composed of a suite of apps, was delivered over 8 weeks. Wait list control participants received treatment as usual for 8 weeks, then the mobile platform.MAIN OUTCOMES AND MEASURES Primary outcomes were changes in depression (PHQ-9) and anxiety (GAD-7) during the intervention period. Secondary outcomes were differences in the proportion of patients who achieved recovery (PHQ-9/GAD-7 <5 or 50% improvement from baseline), sustainment of intervention effects during 2-month follow-up, and app use during the intervention period.RESULTS One hundred forty-six patients were included (119 of 146 were women [81.5%]; mean [SD] age, 42.3 [13.8] years). Of the 146 patients, 122 (83.6%) were diagnosed as having depression and 131 (89.7%) were diagnosed as having anxiety. A greater proportion of intervention vs wait list control participants achieved recovery from depression (n = 38 of 64 [59%] vs n = 18 of 58 [31%]; odds ratio, 3.25; 95% CI, 1.54-6.86) and anxiety (n = 37 of 65 [57%] vs n = 25 of 66 [38%]; odds ratio, 2.17; 95% CI, 1.08-4.36). Sustained effects were observed for depression (slope, 0.01; 95% CI, -0.09 to 0.10; P = .92) and anxiety scores (slope, 0.02; 95% CI, -0.08 to 0.12; P = .67) during follow-up. App use was high, with a median of 93 and 98 sessions among participants with depression and anxiety, respectively. CONCLUSIONS AND RELEVANCEIn this trial, a mobile intervention app was effective for depression and anxiety among primary care patients. Findings also support designing digital mental health interventions as platforms containing simple, brief apps that can be bundled by users to meet their needs.TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03500536.