Use of a Fully Automated Internet-Based Cognitive Behavior Therapy Intervention in a Community Population of Adults With Depression Symptoms: Randomized Controlled Trial

Schure, Mark B; Lindow, Janet C; Greist, John H; Nakonezny, Paul A; Bailey, Sandra J; Bryan, William L; Byerly, Matthew J

Name:

pdf.pdf

Size:

167.6Kb

Format:

PDF

Description:

Final Published Version

Download

Author

Schure, Mark B
Lindow, Janet C
Greist, John H
Nakonezny, Paul A
Bailey, Sandra J
Bryan, William L
Byerly, Matthew J

Affiliation

Univ Arizona, Coll Med, Dept Psychiat

Issue Date

2019-11-16

Citation

Schure MB, Lindow JC, Greist JH, Nakonezny PA, Bailey SJ, Bryan WL, Byerly MJ Use of a Fully Automated Internet-Based Cognitive Behavior Therapy Intervention in a Community Population of Adults With Depression Symptoms: Randomized Controlled Trial J Med Internet Res 2019;21(11):e14754 URL: http://www.jmir.org/2019/11/e14754/ doi: 10.2196/14754

Journal

JOURNAL OF MEDICAL INTERNET RESEARCH

Rights

©Mark B Schure, Janet C Lindow, John H Greist, Paul A Nakonezny, Sandra J Bailey, William L Bryan, Matthew J Byerly. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 17.11.2019. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

Collection Information

This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.

Abstract

Background: Although internet-based cognitive behavior therapy (iCBT) interventions can reduce depression symptoms, large differences in their effectiveness exist. Objective: The aim of this study was to evaluate the effectiveness of an iCBT intervention called Thrive, which was designed to enhance engagement when delivered as a fully automated, stand-alone intervention to a rural community population of adults with depression symptoms. Methods: Using no diagnostic or treatment exclusions, 343 adults with depression symptoms were recruited from communities using an open-access website and randomized 1:1 to the Thrive intervention group or the control group. Using self-reports, participants were evaluated at baseline and 4 and 8 weeks for the primary outcome of depression symptom severity and secondary outcome measures of anxiety symptoms, work and social adjustment, psychological resilience, and suicidal ideation. Results: Over the 8-week follow-up period, the intervention group (n=181) had significantly lower depression symptom severity than the control group (n=162; P<.001), with a moderate treatment effect size (d=0.63). Moderate to near-moderate effect sizes favoring the intervention group were observed for anxiety symptoms (P<.001; d=0.47), work/social functioning (P<.001; d=0.39), and resilience (P<.001; d=0.55). Although not significant, the intervention group was 45% less likely than the control group to experience increased suicidal ideation (odds ratio 0.55). Conclusions: These findings suggest that the Thrive intervention was effective in reducing depression and anxiety symptom severity and improving functioning and resilience among a mostly rural community population of US adults. The effect sizes associated with Thrive were generally larger than those of other iCBT interventions delivered as a fully automated, stand-alone intervention.

Note

Open access journal

ISSN

1438-8871

PubMed ID

31738173

DOI

10.2196/14754

Version

Final published version

Collections

UA Faculty Publications