The feasibility, acceptability, and outcomes of PRIME-D: A novel mobile intervention treatment for depression

Abstract

Background Despite decades of research and development, depression has risen from the 5th to the leading cause of disability in the U.S. Barriers to progress in the field are 1) Poor access to high quality care; 2) Limited mental health workforce; and 3) Few providers trained in the delivery of evidence-based treatments (EBTs). While mobile platforms are being developed to give consumers greater access to high quality care, too often these tools do not have empirical support for their effectiveness. In this study, we evaluated PRIME-D, a mobile app intervention that uses social networking, goal setting, and a mental health coach to deliver text-based, EBT’s to treat mood symptoms and functioning in adults with depression. Methods Thirty-six adults with depression remotely participated in PRIME-D over an 8-week period with a 4-week follow up, with 83% retained over the 12-week course of the study. Results On average, participants logged into the app 5 days/week. Depression scores (PHQ-9) significantly improved over time (over 50% reduction), with coach interactions enhancing these effects. Mood-related disability (SDS) also significantly decreased over time with participants no longer being impaired by their mood symptoms. Overall use of PRIME-D predicted greater gains in functioning. Improvements in mood and functioning were sustained over the 4-week follow-up. Conclusions Results suggest that PRIME-D is a feasible, acceptable, and effective intervention for adults with depression and that a mobile service delivery model may address the serious public health problem of poor access to high quality mental health care.

Self-Directed Engagement with a Mobile App (Sinasprite) and Its Effects on Confidence in Coping Skills, Depression, and Anxiety: Retrospective Longitudinal Study

“…Summary data provided by the Sinasprite development team reported that 74% (25/34) of users included in the analysis continued to use the app after 6 weeks of use. This is consistent with previously reported retention rates, ranging from 10% to 70%, for internet and mobile app interventions [ 16 ]. However, it is important to note, among the entire sample, only 38.9% (175/450) of users actually presented with usage data.…”

“…The results from this study are similar to previously published studies that detailed the positive effects of different mobile app interventions on depression severity [ 14 - 16 , 18 , 35 - 37 ]. It is important to note that several of these studies included access to additional resources or health care practitioners [ 14 , 15 , 35 , 36 ].…”

“…The unassisted platform of the survey may have resulted in incorrect input by users. Use of the mobile app was not supplemented by administrative or clinical assistance, which may have resulted in lower engagement [ 16 , 41 , 42 ]. The significant dropout rate in this study is concerning; however, it is important to note that the mobile app assessed is in a beta phase and is still being optimized to improve the user experience.…”

“…The Get Happy Program based on the principles of CBT resulted in improved self-reported Patient Health Questionnaire 9 (PHQ-9) scores up to 3 months after program completion [ 15 ]. Another study found a mobile app that incorporated CBT, behavioral activation, mindfulness, and psychoeducation in conjunction with coaching, significantly improved self-reported depression severity among users [ 16 ]. Cognitive bias modification interventions for attention via a mobile app were beneficial in the management of anxiety among patients [ 17 ].…”

One-year outcomes of a therapist-supported, smartphone-based intervention for elevated symptoms of depression and anxiety

“…Our analysis revealed a larger effect size for the reduction in depression symptoms 12-months postintervention (g = 1.14) than was reported by a recent meta-analysis comparing smartphone-based interventions for depression to inactive control groups 35 (g = 0.56). However, the present study was uncontrolled, and the large effect reported here is consistent with other within-group (uncontrolled) effect sizes for app-and online-based depression interventions [56][57][58] . The observed reduction in depression symptoms remained significant when making the conservative assumption that participants with missing data did not experience any long-term benefit from the intervention.…”