mHealth Research Digest with Tim Bredrup

Preventing depression during adolescence may reduce health problems in adulthood.  Mobile phones make it possible to deliver prevention programs scalable to a variety of large populations.  Researchers at the University of Auckland in New Zealand used these concepts to develop and test an intervention for adolescents focused on preventing depression.

The intervention was designed around 15 key messages derived from cognitive behavior therapy.  These positive and encouraging messages were delivered automatically via mobile phones twice daily for 9 weeks by means of text, video, cartoons, and mobile website.  Two types of controls were used, including a control program with the same number and types of messages on varying topics and a randomized controlled trial performed in surrounding high schools of the Auckland, New Zealand area.

In the study, a total of 1,348 students (13–17 years of age) volunteered to participate at group sessions in schools, and 855 were eventually randomly assigned to groups.

Of these, the study results reveal

“97.7% self-completed follow-up questionnaires at post-program interviews on satisfaction, perceived usefulness, and adherence to the intervention. Over 75% of participants viewed at least half of the messages and 90.7% reported they would refer the program to a friend. 66.7% of participants said the intervention helped them to be more positive and 50.2% said it helped to get rid of negative thoughts—significantly higher than proportions in the control group.”

The study concluded that key messages from cognitive behavioral therapy can indeed be effectively delivered by mobile phone, and young people reported that they found this to be helpful. However, the researchers have more work to do.  The effectiveness of the intervention will be proven by the change in clinician-related depression symptom scores from baseline to 12 months, however those have yet to be completed.  But according to the researchers, “If proven effective, this form of delivery may be useful in many countries lacking widespread mental health services but with extensive mobile phone coverage.”

Authors: Robyn Whittaker, MBChB, MPH, PhD; Sally Merry, MBChB, MD; Karolina Stasiak, PhD; Heather McDowell, PhD; Iain Doherty, PhD; Matthew Shepherd, BA(Hons); Enid Dorey, MSc; Varsha Parag, MSc; Shanthi Ameratunga, MBChB, MPH, PhD; Anthony Rodgers, MBChB, PhD

Institution: University of Auckland, New Zealand

Original Abstract: Journal of Medical Internet Research