Significant reduction in depressive symptoms among patients with at least moderately severe depressive symptoms after participation in a therapist-supported, evidence-based program delivered via a smartphone app

2020 ◽  
Author(s):  
Valerie Forman-Hoffman ◽  
Kristian Ranta ◽  
Albert Nazander ◽  
Outi Hilgert ◽  
Joao de Quevedo
Keyword(s):  
Depressive Symptoms ◽  
Health Program ◽  
Digital Health ◽  
Program Assessment ◽  
Smartphone App ◽  
Evidence Based ◽  
Symptoms Of Depression ◽  
End Of Treatment ◽  
Intent To Treat ◽  
Treat Analysis

Depression is a debilitating disorder associated with many poor health outcomes, including increased comorbidity and early mortality. Despite the advent of new digital health interventions, few have been tested among patients with more severe forms of depression. As such, we examined whether 150 patients with at least moderately severe depressive symptoms (PHQ-9>=15) experienced significant reductions in depressive symptoms after participation in a therapist-supported, evidence-based program delivered via smartphone app. An-intent-to-treat analysis showed that patients with at least moderately severe depressive symptoms at pre-program assessment experienced significant decreases in depressive symptoms at end-of treatment (mean PHQ-9 reduction=7.3, Hedges’ g = 1.7]) that were maintained at 1-, 3-, 6-, and 12-months post-program. Also, 40% of patients with at least moderately severe depressive symptoms at baseline and 32% of patients with severe depressive symptoms (PHQ-9>=20) at baseline responded to the intervention at end-of-treatment, defined as experiencing >= 50% reduction in PHQ-9 score and a post-program PHQ-9 score lower than 10. Future randomized trials are warranted to test the Meru Health Program as a scalable solution for patients with more severe symptoms of depression.

Examining the Temporal Dynamics of Anxiety and Depressive Symptoms During a Therapist-Supported, Smartphone-Based Intervention for Major Depression (Preprint)

2020 ◽  
Author(s):  
Santiago Allende ◽  
Valerie Forman-Hoffman ◽  
Philippe Goldin
Keyword(s):  
Depressive Symptoms ◽  
Temporal Relationship ◽  
Temporal Dynamics ◽  
Digital Health ◽  
Quadratic Function ◽  
Depression Symptoms ◽  
Symptoms Of Depression ◽  
Effect Model ◽  
End Of Treatment ◽  
Highly Correlated

UNSTRUCTURED Background: Anxiety and depression symptoms are highly correlated in adults with depression; however, little is known about their interaction and temporal dynamics of change during treatment. Thus, the primary aim of this study was to examine the temporal dynamics of anxiety and depressive symptoms during a 12-week therapist-supported, smartphone-delivered digital health intervention for symptoms of depression and anxiety, the Meru Health Program (MHP). Method: A total of 290 participants from the MHP were included in the present analyses (age Mean = 39.64, SD = 10.25 years; 79% female; 54% self-reported psychotropic medication use). A variance components model was used to examine whether (1) reporting greater anxiety during the current week relative to anxiety reported in other weeks would be associated with greater reporting of depressive symptoms during the current week, while a time-varying effect model was used to examine whether, (2) consistent with findings reported by Wright et al. (2014), the temporal relationship between anxiety and depressive symptoms during the intervention would be expressed as a quadratic function marked by a weak association at baseline, followed by an increase to a peak before demonstrating a negligible decrease until the end of treatment. Results: In support of hypothesis 1, we found that reporting greater anxiety symptoms during the current week relative to other weeks was associated with greater depressive symptoms during the current week. Contrary to hypothesis 2, the temporal relationship between anxiety and depressive symptoms evidenced a recurring pattern, with the association increasing during the initial weeks, decreasing during mid-treatment and sharply increasing toward the end of treatment. Conclusions: The present findings demonstrate that anxiety and depressive symptoms overlap and fluctuate in concert during a smartphone-based intervention for anxiety and depressive symptoms. The present findings may warrant more refined intervention strategies specifically tailored to co-occurring patterns of change in symptoms.

scholarly journals Evaluation of the Effectiveness and Implementation of an Adapted Evidence-Based Mammography Intervention for African American Women

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Linda Highfield ◽  
Marieke A. Hartman ◽  
L. Kay Bartholomew ◽  
Philomene Balihe ◽  
Valerie A. Ausborn
Keyword(s):  
African American ◽  
African American Women ◽  
Contextual Information ◽  
Breast Cancer Mortality ◽  
Intervention Group ◽  
Evidence Based ◽  
Implementation Barriers ◽  
American Women ◽  
Intent To Treat ◽  
Treat Analysis

Breast cancer mortality disparities continue, particularly for uninsured and minority women. A number of effective evidence-based interventions (EBIs) exist for addressing barriers to mammography screening; however, their uptake and use in community has been limited. Few cancer-specific studies have evaluated adapted EBIs in new contexts, and fewer still have considered implementation. This study sought to (1) evaluate the effectiveness of an adapted mammography EBI in improving appointment keeping in African American women and (2) describe processes of implementation in a new practice setting. We used the type 1 hybrid design to test effectiveness and implementation using a quasi-experimental design. Logistic regression and intent-to-treat analysis were used to evaluate mammography appointment attendance. The no-show rate was 44% (comparison) versus 19% (intervention). The adjusted odds of a woman in the intervention group attending her appointment were 3.88p<0.001. The adjusted odds of a woman attending her appointment in the intent-to-treat analysis were 2.31p<0.05. Adapted EBI effectiveness was 3.88 (adjusted OR) versus 2.10 (OR) for the original program, indicating enhanced program effect. A number of implementation barriers and facilitators were identified. Our findings support previous studies noting that sequentially measuring EBI efficacy and effectiveness, followed by implementation, may be missing important contextual information.

scholarly journals Smartphone-delivered, therapist-supported digital health intervention for physicians with burnout

2019 ◽  
Author(s):  
Valerie Hoffman ◽  
Anu Raevuori ◽  
philippe goldin ◽  
Erin Gillung ◽  
Susan Connolly ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Effect Size ◽  
Mindfulness Meditation ◽  
Behavioral Therapy ◽  
Digital Health ◽  
Smartphone Application ◽  
Health Intervention ◽  
Evidence Based ◽  
Work Related ◽  
Related Stress

Objective: The aim was to examine change in burnout and depressive symptoms among physicians enrolled in an evidence-based digital health intervention, the Meru Health Program (MHP). Methods: We recruited 27 physicians with evidence of work-related stress as reported from a single-item burnout measure from the Palo Alto Foundation Medical Group and enrolled them into an 8-week, smartphone-delivered and therapist-supported program that combines several evidence-based depression treatments such as cognitive behavioral therapy and mindfulness meditation. Results: We observed a decrease in burnout (p = 0.049, effect size r = 0.71) and depressive symptoms (p = 0.001, effect size d = -0.9) at post-treatment. Engagement metrics were not significantly associated with outcomes. Conclusion: The MHP, a digital therapist-supported intervention delivered via smartphone application, was found to be a promising intervention for physicians suffering from burnout.

Smartphone App Support of Evidence-Based Trauma Treatment: A Prolonged Exposure Coach

2012 ◽  
Author(s):  
Greg M. Reger ◽  
Julia E. Hoffman ◽  
Josef I. Ruzek ◽  
David S. Riggs ◽  
Barbara O. Rothbaum ◽  
...  
Keyword(s):  
Prolonged Exposure ◽  
Trauma Treatment ◽  
Smartphone App ◽  
Evidence Based

日本における抑うつ症状に対する心理学的介入を目的とした スマートフォン用アプリケーション・プログラムのレビュー

2020 ◽  
Author(s):  
Hikari Takashina ◽  
Kengo Yokomitsu
Keyword(s):  
Depressive Symptoms ◽  
Daily Life ◽  
Behavioral Therapy ◽  
Mobile Apps ◽  
Evaluation Model ◽  
Ease Of Use ◽  
Background Information ◽  
Evidence Based ◽  
Privacy And Security ◽  
Current State

There are thousands of mobile apps delivering information and offering support and intervention in situations of daily life. The aim of this study was to identify the current state of apps for depressive symptoms or prevention of depression within the official Android and iOS app stores in Japan. The 47 apps for depression available for download from the app stores were evaluated by the App Evaluation Model regarding background information, risk/ privacy and security, evidence, ease of use, and interoperability. Also, we evaluated their primary purpose, technology components, and cognitive-behavioral therapy components. The results suggest that in general few apps have been developed that are evidence-based, secure, and provide the services that users expect. In the future, it will be necessary to develop a framework for developing and disseminating more effective apps. This study is the first review of apps for depression available in Japan and seeks to help create a framework for such apps.

Digital Home Health Care: Culture-Specific Observations in Saudi Arabia (Preprint)

2020 ◽  
Author(s):  
Abdulaziz A Alodhayani ◽  
Marwah Mazen Hassounah ◽  
Fatima R Qadri ◽  
Noura A Abouammoh ◽  
Zakiuddin Ahmed ◽  
...  
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Home Health Care ◽  
Health Program ◽  
Digital Health ◽  
Local Population ◽  
Family Members ◽  
Cultural Factors ◽  
Home Health ◽  
Design And Implementation

BACKGROUND There is growing evidence of the need to consider cultural factors in the design and implementation of digital health interventions. However, there is still inadequate knowledge pertaining to what aspects of the Saudi Arabian culture need to be considered in the design and implementation of digital health programs, especially in the context of home health care services for chronically and terminally ill patients. OBJECTIVE This study aims to explore the specific cultural factors relating to patients and their caregivers from the perspective of physicians, nurses, and trainers that have influenced the pilot implementation of Remotely Accessible Healthcare At Home (RAHAH); a connected health program in the Home Health Care Department at King Saud University Medical City, Riyadh, Saudi Arabia. METHODS A qualitative study design was adopted to conduct a focus group discussion (FGD) in July 2019 using a semi-structured interview guide with 3 female and 4 male participants working as nurses, family physicians, and information technologists. Qualitative data obtained were analyzed using a thematic framework analysis. RESULTS Two categories emerged from the FGD that influenced the experiences of digital health program intervention: (1) culture-related factors including language and communication, cultural views on using cameras during consultation, non-adherence to online consultations, and family role and commitment (2) caregiver characteristics in telemedicine that includes their skills and education and electronic literacy. Participants of this study revealed that indirect contact with the patients and their family members may work as a barrier to proper communication through RAHAH. CONCLUSIONS We recommend exploring the use of interpreters in digital health, creating awareness among the local population regarding privacy in digital health, and actively involving the direct family members with the healthcare providers.

scholarly journals Evidence-Based Digital Tools for Weight Loss Maintenance: The NoHoW Project

Obesity Facts ◽  
2021 ◽  
pp. 1-14
Author(s):  
R. James Stubbs ◽  
Cristiana Duarte ◽  
António L. Palmeira ◽  
Falko F. Sniehotta ◽  
Graham Horgan ◽  
...  
Keyword(s):  
Weight Loss ◽  
Behaviour Change ◽  
Digital Health ◽  
Self Regulation ◽  
Self Management ◽  
Behaviour Change Techniques ◽  
Evidence Based ◽  
Behavioural Science ◽  
Digital Architecture

<b><i>Background:</i></b> Effective interventions and commercial programmes for weight loss (WL) are widely available, but most people regain weight. Few effective WL maintenance (WLM) solutions exist. The most promising evidence-based behaviour change techniques for WLM are self-monitoring, goal setting, action planning and control, building self-efficacy, and techniques that promote autonomous motivation (e.g., provide choice). Stress management and emotion regulation techniques show potential for prevention of relapse and weight regain. Digital technologies (including networked-wireless tracking technologies, online tools and smartphone apps, multimedia resources, and internet-based support) offer attractive tools for teaching and supporting long-term behaviour change techniques. However, many digital offerings for weight management tend not to include evidence-based content and the evidence base is still limited. <b><i>The Project:</i></b> First, the project examined why, when, and how many European citizens make WL and WLM attempts and how successful they are. Second, the project employed the most up-to-date behavioural science research to develop a digital toolkit for WLM based on 2 key conditions, i.e., self-management (self-regulation and motivation) of behaviour and self-management of emotional responses for WLM. Then, the NoHoW trial tested the efficacy of this digital toolkit in adults who achieved clinically significant (≥5%) WL in the previous 12 months (initial BMI ≥25). The primary outcome was change in weight (kg) at 12 months from baseline. Secondary outcomes included biological, psychological, and behavioural moderators and mediators of long-term energy balance (EB) behaviours, and user experience, acceptability, and cost-effectiveness. <b><i>Impact:</i></b> The project will directly feed results from studies on European consumer behaviour, design and evaluation of digital toolkits self-management of EB behaviours into development of new products and services for WLM and digital health. The project has developed a framework and digital architecture for interventions in the context of EB tracking and will generate results that will help inform the next generation of personalised interventions for effective self-management of weight and health.

scholarly journals Systematic review: Symptoms of parental depression and anxiety and offspring overweight

2020 ◽  
Vol 54 ◽  
pp. 49
Author(s):  
Paula Lobo Marco ◽  
Inaê Dutra Valério ◽  
Christian Loret de Mola Zanatti ◽  
Helen Gonçalves
Keyword(s):  
Depressive Symptoms ◽  
Childhood Obesity ◽  
Mental Disorder ◽  
Common Mental Disorder ◽  
Positive Association ◽  
Depression And Anxiety ◽  
Recurrent Depression ◽  
Child Feeding ◽  
Middle Income ◽  
Symptoms Of Depression

OBJECTIVE: To evaluate the existing literature on the association between parents’ depression and anxiety and their influence on their children’s weight during childhood, identifying possible mechanisms involved in this association. METHODS: A systematic search of the literature was conducted in the PubMed, PsycINFO and SciELO databases, using the following descriptors: (maternal OR mother* OR parent* OR paternal OR father) AND (“common mental disorder” OR “mental health” OR “mental disorder” OR “depressive disorder” OR depress* OR anxiety OR “anxiety disorder”) AND (child* OR pediatric OR offspring) AND (overweight OR obes* OR “body mass index” OR BMI). A total of 1,187 articles were found after peer selection. RESULTS: In total, 16 articles that met the inclusion criteria were selected for the review. Most of them investigated depressive symptoms and only three, symptoms of maternal anxiety. The evaluated studies suggested a positive association between symptoms of maternal depression and higher risk of childhood obesity. The results diverged according to the chronicity of depressive symptoms (episodic or recurrent depression) and income of the investigated country (high or middle income). Mechanisms were identified passing by quality of parenthood, affecting behaviors related to physical activity and child-feeding, as mediators of the association. CONCLUSIONS: We conclude there is evidence of a positive relationship between the occurrence of maternal symptoms of depression and anxiety and childhood obesity. It is emphasized the need for a better understanding on the effect of depressive symptoms and the contextual factors involved in this relationship so that effective intervention strategies can be implemented.

scholarly journals Effectiveness of exercise at workplace in physical fitness: uncontrolled randomized study

2014 ◽  
Vol 12 (1) ◽  
pp. 55-60 ◽  
Author(s):  
Antônio José Grande ◽  
Valter Silva ◽  
Sérgio Alencar Parra
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Randomized Study ◽  
Exercise Program ◽  
Employee Health ◽  
Fat Percentage ◽  
Academic Organizations ◽  
Health Related ◽  
Intent To Treat ◽  
Treat Analysis

Objective : To investigate the effectiveness of workplace exercise for employee health by means of health-related physical activity components. Methods : A randomized uncontrolled study with 20 workers was carried out during three months to evaluate a workplace exercise program. The selected outcomes were flexibility, body mass, fat percentage, lean mass, blood pressure, and heart rate. For statistical analysis, the paired t test and the intent-to-treat analysis were used. Results : There was a significant increase in weight, fat percentage, blood pressure, and heart rate. However the clinical significance was 10% in the size of the effect. Conclusion : The changes verified in the outcomes analyzed were not significant; the variables are within normality ranges proposed by academic organizations

Sign in / Sign up

Export Citation Format

Share Document