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iMedicalApps and JMIR Publications have partnered to help disseminate interesting and innovative digital health research being done worldwide. Each article in this series will feature summaries of interesting studies to help you keep up to date on the latest in digital health research. We invite you to share your thoughts on the study in the comments section.

MoodHacker Mobile-Web App with Email for Adults to Self-Manage Mild-to-Moderate Depression: Randomized Controlled Trial

1. What was the motivation behind your study?

ORCAS has worked for a number of years to deliver web-based interventions for depression, based on the Lewinsohn Coping with Depression model of cognitive-behavioral therapy (CBT). MoodHacker gave us the opportunity to create a mobile approach. Unlike many technology-based CBT interventions, MoodHacker directly activates not only daily tracking of mood, common among mobile depression apps, but also positive behavioral and cognitive strategies known to reduce depressive symptoms.

2. Describe your study.

The MoodHacker depression app was evaluated in a two-group randomized controlled trial involving 300 employed adults with mild-to-moderate depressive symptoms. Participants received either the six-week MoodHacker intervention (n=150) or a list of vetted depression-related websites (n=150). They were assessed for changes in depression symptoms, behavioral activation, negative thoughts, worksite outcomes, and depression-related knowledge at baseline, 6 weeks, and 10 weeks.

3. What were the results of the study?

At 6-week follow-up, the MoodHacker depression app yielded significant effects on depression (partial ?2 = .021), behavioral activation, negative thoughts, knowledge, work productivity, work absence, and workplace distress. Larger and highly significant effects on depression symptoms (partial ?2 = .093), work productivity, work absence, and workplace distress were found for participants who reported access to an employee assistance program, with the effect on work absence persisting at 10-week follow-up. There were no significant effects on these outcome measures for the subset of subjects without EAP access.

4. What is the main point that readers should take away from this study?

MoodHacker improved depression symptoms among employed adults compared to controls, with its strongest effects in those with access to an employee assistance program. MoodHacker also reduced work absence, which persisted four weeks after the intervention, and other work productivity measures.

5. What was the most surprising finding from your study?

We were pleased to find that the effect sizes for depression symptoms obtained with MoodHacker’s light-touch mobile approach are comparable to those reported in previous meta-analyses of more-traditional self-guided internet-based CBT programs. In this increasingly mobile society, proven mobile interventions will play an increasingly important role in both mental and physical health care.

6. What are the next steps? How do you envision this work ultimately translating into clinical practice or affecting R&D?

Our study suggests that light-touch mobile interventions like MoodHacker may be a valuable tool for use in employee assistance and similar behavioral health programs. It seems likely that MoodHacker could be implemented both as a self-directed intervention for adults unwilling to participate in counseling or as adjunct or follow-on care for those under the care of a counseling professional.

This Q&A was submitted by Amy Birney MPH, MCHES who is the Director of Research at ORCAS. ORCAS is a mobile health research and development company that applies extensive behavioral research to mobile self management interventions that help people manage their health and change their behavior in meaningful ways.