IntelliCare: An Eclectic, Skills-Based App Suite for the Treatment of Depression and Anxiety

Mohr, David C.; Tomasino, Kathryn Noth; Lattie, Emily G.; Palac, Hannah; Kwasny, Mary; Weingardt, Kenneth R.; Karr, Chris; Kaiser, Susan M.; Rossom, Rebecca C.; Bardsley, Leland R; Caccamo, Lauren; Stiles‐Shields, Colleen; Schueller, Stephen M.

doi:10.2196/jmir.6645

Cited by 278 publications

(274 citation statements)

References 42 publications

(49 reference statements)

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“…Details on the methods are reported in the primary paper [18]. Briefly, participants were recruited from a variety of sources, including online, a healthcare system, community advertising, and research registries.…”

Section: Participantsmentioning

confidence: 99%

“…A detailed description of the participants and primary outcomes have been published elsewhere [18]. Briefly, 99 participants were enrolled and began the 8-week field trial.…”

Section: Participantsmentioning

confidence: 99%

“…Briefly, 99 participants were enrolled and began the 8-week field trial. A flow diagram is available in the main outcome paper [18], however only 3 participants were lost to follow-up, leaving 96 participants with at least two outcome assessments, who are the focus of this secondary analysis. At the start of the field trial, the depression criterion of PHQ-9 ≥10 was met by 78 (81%) participants, the anxiety criterion of GAD-7 ≥8 was met by 77 (80%) participants, and 59 (61%) met criteria for both depression and anxiety.…”

Section: Participantsmentioning

confidence: 99%

“…Thus, each app is elemental, allowing the user to select which strategies are the most useful to them, consistent with the US Institute of Medicine (IOM) report recommending that app-based treatments combine therapeutic elements as well as consider how people tend to use apps. Each app is simple to use, most requiring less than a minute per engagement [18]. Most of the apps focus on supporting learning or implementing a skill, and not on psychoeducation, thus helping people with an immediate problem.…”

Section: Introduction 3 Backgroundmentioning

confidence: 99%

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Exploring the Use of Multiple Mental Health Apps Within a Platform: Secondary Analysis of the IntelliCare Field Trial (Preprint)

Kwasny¹,

Schueller²,

Lattie³

et al. 2018

Preprint

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Background: People using apps for mental health and wellbeing are likely to try multiple apps over time. In general, people use apps to meet immediate needs, and often use a variety of apps to meet larger goals (for example people may have multiple apps to manage various transportation needs). IntelliCare is a mental health app platform that was designed with these principles in mind: the apps are elemental in that each app targets a different change strategy; they are simple and brief to use; and they are eclectic, allowing the user to select which strategies are useful to them. While this may improve engagement, it creates the same challenges faced by users of app stores. Thus, mental health app platforms will require navigation aids, such as recommender systems that can quickly get a person to an app that is useful. Objective: As a first step towards developing navigation and recommender tools, this study explored app use patterns across the IntelliCare platform, and their relationship to depression and anxiety outcomes. Method: This secondary analysis of the IntelliCare Field Trial recruited people with depression and/or anxiety. Participants received 8 weeks of coaching, primarily by text, and weekly recommendations for apps. App use metrics included frequency of use and lifetime use were defined. Depression and anxiety, measured using the PHQ-9 and GAD-7, were assessed at baseline and end of treatment. Ordinal logistic regression models, log-rank tests and cluster analysis were utilized to determine patterns of use, and if these use metrics alone, or in combination, predicted improvement or remission(I/R) in depression or anxiety. Results: The analysis included 96 people with depression and/or anxiety. Peole generally followed recommendations to download and try new apps each week. Apps clustered into 5 groups: Thinking (apps that targeted or relied on thinking), Calming (relaxation and insomnia), Checklists (apps that used checklists), Activity (behavioral activation and activity), and Other. Both overall frequency of use and lifetime use were predictive in response for depression and anxiety. The Thinking, Calming, and Checklist clusters were associated with improvement in depression and anxiety, and the Activity cluster was associated with improvement in Anxiety only. However, the use of clusters was not more strongly associated with improvement than individual app use. Conclusion: Participants in a field trial remained engaged with a suite of apps for the full eight weeks of the trial. App use patterns did fall into clusters, suggesting knowing something about use of one app may be useful in helping select another app that the person is more likely to use. Trial Registration: Clinicaltrials.gov NCT02176226

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Section: Participantsmentioning

confidence: 99%

“…A detailed description of the participants and primary outcomes have been published elsewhere [18]. Briefly, 99 participants were enrolled and began the 8-week field trial.…”

Section: Participantsmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Introduction 3 Backgroundmentioning

confidence: 99%

See 2 more Smart Citations

Exploring the Use of Multiple Mental Health Apps Within a Platform: Secondary Analysis of the IntelliCare Field Trial (Preprint)

Kwasny¹,

Schueller²,

Lattie³

et al. 2018

Preprint

Self Cite

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“…IntelliCare is a collection of apps that utilize an elemental, skills based approach to improving mental health [9].…”

Section: Introductionmentioning

confidence: 99%

Use of Mental Health Apps by Breast Cancer Patients and Their Caregivers in the United States: Protocol for a Pilot Pre-Post Study (Preprint)

Chow¹,

Showalter²,

Gerber³

et al. 2018

Preprint

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Background: Over a third of cancer patients experience clinically significant mental distress, and distress in caregivers can exceed that of the cancer patients for whom they care. There is an urgent need to identify scalable and cost-efficient ways of delivering mental health interventions to cancer patients and their loved ones. Objective: This study describes the protocol to pilot a mobile app-based mental health intervention for breast cancer patients and caregivers. Methods: The IntelliCare mental health apps are grounded in evidence-based research in psychology. They have not been examined in cancer populations. This pilot study will adopt a within subject, pre-post study design, to inform a potential phase III randomizedcontrolled trial. A target sample of 50 individuals (with roughly equal numbers of patients and caregivers) at least 18 years of age and fluent in English will be recruited at a U.S. NCIdesignated Clinical Cancer Center. Consent will be obtained in writing and smartphones will be provided if needed. Self-report surveys assessing mental health outcomes will be administered at a baseline session and after 7 week intervention. Before using the apps, participants will receive a 30-minute coaching call to explain their purpose and function. A 10-minute coaching call 3 weeks later will check on user progress and address questions or barriers to use. Self-report and semi-structured interviews with participants at the end of the study period will focus on user experience and suggestions for improving the apps and coaching in future studies. Results: This project is ongoing and data collection will be completed by the end of 2018. Conclusions: Results from this study will inform how scalable smartphone-delivered programs can be used to support breast cancer patients and their loved ones.

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Coached Mobile App Platform for the Treatment of Depression and Anxiety Among Primary Care Patients

et al. 2020

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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.

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IntelliCare: An Eclectic, Skills-Based App Suite for the Treatment of Depression and Anxiety

Cited by 278 publications

References 42 publications

Exploring the Use of Multiple Mental Health Apps Within a Platform: Secondary Analysis of the IntelliCare Field Trial (Preprint)

Exploring the Use of Multiple Mental Health Apps Within a Platform: Secondary Analysis of the IntelliCare Field Trial (Preprint)

Use of Mental Health Apps by Breast Cancer Patients and Their Caregivers in the United States: Protocol for a Pilot Pre-Post Study (Preprint)

Coached Mobile App Platform for the Treatment of Depression and Anxiety Among Primary Care Patients

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