Digital Tools for Prevention and Treatment of Depression: Lessons from the Institute for International Internet Interventions for Health

Muñoz, Ricardo F.; Pineda, Blanca S.; Barrera, Alinne Z.; Bunge, Eduardo L.; Leykin, Yan

doi:10.5093/clysa2021a2

Cited by 15 publications

(10 citation statements)

References 14 publications

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“…DMHIs can include mental health mobile apps (MHAs) and computer-based interventions [8][9][10], which deliver on-demand support ranging from behavioral strategies (eg, self-monitoring) to more complex therapeutic approaches (eg, cognitive behavioral therapy) [8][9][10][11][12][13]. Clinician-delivered interventions, such as an hour of psychotherapy or a dose of medication, are costly and consumable (ie, once delivered to 1 client, they cannot be used to treat another), whereas DMHIs are nonconsumable, in that they can be delivered with high fidelity multiple times [14,15]. Human-supported DMHIs have the potential to offer a cost-effective, sustainable way of scaling access to high-quality interventions.…”

Section: Introductionmentioning

confidence: 99%

Providing Human Support for the Use of Digital Mental Health Interventions: Systematic Meta-review

Werntz¹,

Amado²,

Jasman³

et al. 2023

J Med Internet Res

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Background Digital mental health interventions (DMHIs) have been increasingly deployed to bridge gaps in mental health care, particularly given their promising efficacy. Nevertheless, attrition among DMHI users remains high. In response, human support has been studied as a means of improving retention to and outcomes of DMHIs. Although a growing number of studies and meta-analyses have investigated the effects of human support for DMHIs on mental health outcomes, systematic empirical evidence of its effectiveness across mental health domains remains scant. Objective We aimed to summarize the results of meta-analyses of human support versus no support for DMHI use across various outcome domains, participant samples, and support providers. Methods We conducted a systematic meta-review of meta-analyses, comparing the effects of human support with those of no support for DMHI use, with the goal of qualitatively summarizing data across various outcome domains, participant samples, and support providers. We used MEDLINE, PubMed, and PsycINFO electronic databases. Articles were included if the study had a quantitative meta-analysis study design; the intervention targeted mental health symptoms and was delivered via a technology platform (excluding person-delivered interventions mediated through telehealth, text messages, or social media); the outcome variables included mental health symptoms such as anxiety, depression, stress, posttraumatic stress disorder symptoms, or a number of these symptoms together; and the study included quantitative comparisons of outcomes in which human support versus those when no or minimal human support was provided. Results The results of 31 meta-analyses (505 unique primary studies) were analyzed. The meta-analyses reported 45 effect sizes; almost half (n=22, 48%) of them showed that human-supported DMHIs were significantly more effective than unsupported DMHIs. A total of 9% (4/45) of effect sizes showed that unsupported DMHIs were significantly more effective. No clear patterns of results emerged regarding the efficacy of human support for the outcomes assessed (including anxiety, depression, posttraumatic stress disorder, stress, and multiple outcomes). Human-supported DMHIs may be more effective than unsupported DMHIs for individuals with elevated mental health symptoms. There were no clear results regarding the type of training for those providing support. Conclusions Our findings highlight the potential of human support in improving the effects of DMHIs. Specifically, evidence emerged for stronger effects of human support for individuals with greater symptom severity. There was considerable heterogeneity across meta-analyses in the level of detail regarding the nature of the interventions, population served, and support delivered, making it difficult to draw strong conclusions regarding the circumstances under which human support is most effective. Future research should emphasize reporting detailed descriptions of sample and intervention characteristics and describe the mechanism through which they believe the coach will be most useful for the DMHI.

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Section: Introductionmentioning

confidence: 99%

Providing Human Support for the Use of Digital Mental Health Interventions: Systematic Meta-review

Werntz¹,

Amado²,

Jasman³

et al. 2023

J Med Internet Res

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show abstract

“…However, despite the many virtues of online interventions [ 60 ], they also have some limitations. Participation and retention can be difficult to sustain in an online intervention, leading to high drop-out rates and low adherence [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Healthy Moms and Babies Preventive Psychological Intervention Application: A Study Protocol

Ruiz‐Segovia

Rodríguez-Muñoz

Oivares

et al. 2021

IJERPH

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Depression is the most common psychological disorder during the perinatal period, and its negative effects extend to mothers, babies, their family and society. Scientific evidence points to the urgency of designing preventive interventions and concludes that the gestational period is the most appropriate time to implement these interventions. However, many pregnant women do not seek professional help due to a lack of knowledge about the importance of mental health, its impact, and the available intervention options, as well as a lack of time and financial resources. E-health interventions can be an efficient, cost-effective, and accessible resource for preventing postpartum depression that can circumvent the barriers that pregnant women face. This randomized clinical trial will examine the efficacy of Healthy Moms and Babies, an app aimed at preventing postpartum depressive symptomatology. The second objective of this study is to analyze the effectiveness of the tool in preventing anxious symptomatology. The primary outcome measure is the difference in the mean score between the intervention and control groups on the Patient Health Questionnaire-9 (PHQ-9) at the end of the intervention and at 3 and 6 months postpartum. The secondary outcome will be determined by using the Generalized Anxiety Disorder Screener (GAD-7) at the same time points. The research findings can be used to determine pregnant women’s use of the e-health application for the prevention of postpartum depression, whether the Healthy Moms and Babies intervention app is an effective and useful resource, and what modifications will need to be made to the tool in future updates.

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“…Our data could show that general concerns are present at the beginning of pregnancy and that these concerns may become more pregnancy-specific and should be evaluated. Antenatal depression can be prevented with appropriate interventions and by increasing knowledge of the factors involved [ 81 ], which is particularly important in women with ART. A deeper understanding of the protective and risk factors for depression during gestation will ensure a more humane pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Early Association Factors for Depression Symptoms in Pregnancy: A Comparison between Spanish Women Spontaneously Gestation and with Assisted Reproduction Techniques

Ramiro-Cortijo

Soto-Balbuena

Rodríguez-Muñoz

2021

JCM

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Women with assisted reproduction techniques (ART) have a different psychological profile than women with a spontaneous pregnancy. These differences may put the former group at higher risk for depressive symptomatology. Our aim was to determine what sociodemographic factors and psychological variables interact with early depressive symptoms in pregnant women with ART. This is a cross-sectional, non-interventional, and observational study where a total of 324 women were analyzed in the first trimester of pregnancy at the Hospital Universitario Central de Asturias (Spain). Women completed a sociodemographic questionnaire, the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder 7-item Scale, the Resilience inventory, the General concerns (ad hoc scale), the Stressful life events, and the prenatal version of Postpartum Depression Predictors Inventory-Revised (PDPI-R), including socioeconomic status, pregnancy intendedness, self-esteem, partner support, family support, friends support, marital satisfaction, and life stress. According to our models, women undergoing ART had significantly increased the PHQ-9 scores (β = 6.75 ± 0.74; p-value < 0.001). Being single also increased the PHQ-9 score. Related to the psychological variables, anxiety (β = 0.43 ± 0.06; p-value < 0.001) and stressful life events (β = 0.17 ± 0.06; p-value = 0.003) increased PHQ-9 scores. In contrast, resilience (β = −0.05 ± 0.02; p-value = 0.004), self-esteem (β = −1.21 ± 0.61; p-value = 0.048), and partner support (β = −1.50 ± 0.60; p-value = 0.013) decreased PHQ-9 scores. We concluded that women undergoing ART need interventions to reduce anxiety and stressful life events, and to improve resilience, self-esteem, and emotional partner support to prevent depressive symptomatology during this important phase in their lives.

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Digital Tools for Prevention and Treatment of Depression: Lessons from the Institute for International Internet Interventions for Health

Cited by 15 publications

References 14 publications

Providing Human Support for the Use of Digital Mental Health Interventions: Systematic Meta-review

Providing Human Support for the Use of Digital Mental Health Interventions: Systematic Meta-review

Healthy Moms and Babies Preventive Psychological Intervention Application: A Study Protocol

Early Association Factors for Depression Symptoms in Pregnancy: A Comparison between Spanish Women Spontaneously Gestation and with Assisted Reproduction Techniques

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