Adolescent Behavior, Adolescent - Emotional Problem, Cardiology, Depression, Depressive Disorder, Depressive Episode, Depressive Symptoms, Gastrointestinal Diseases, Major Depressive Disorder
Conditions
Keywords
Depression, Mental Health, Adolescent Depression
Brief summary
The primary aim of this pilot study is to assess the feasibility, acceptability, and preliminary evidence of efficacy of a self-guided, cognitive behavioral therapy (CBT)-based mobile app intervention (SparkRx) for symptoms of depression among adolescents being treated in specialty medical care settings at Children's Hospital of Los Angeles (CHLA).
Detailed description
Self-report assessments will be collected at pre, post and 1-month follow up time points. Weekly PHQ-8 assessments will also be collected during the 5-week intervention as well as at pre, post and 1- month follow up time points. Study aims involve evaluating: * Feasibility of recruiting and enrolling adolescents with elevated symptoms of depression from the Cardiology and Gastroenterology programs at CHLA. * Retention, program adherence, completion, and withdrawal rates. * Safety of the intervention, including reported adverse and serious adverse events * Perceived utility, usability, and enjoyment of the SparkRx app by adolescents * Clinically significant changes in pre- to -post treatment depressive symptoms and persistence of such gains at 1 month follow up.
Interventions
DEVICESparkRx Mobile App
The SparkRx app will be fully self-guided and completed by participants at home. It is designed to be completed over 5 weeks but users may progress through the app at their own pace. The app progresses linearly, i.e., a task must be completed before a participant can progress to the next task. Content for a given week is not expected to take more than 60 minutes to complete.
Sponsors
Children's Hospital Los Angeles
Limbix Health, Inc.
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
13 Years to 22 Years
Healthy volunteers
No
Inclusion criteria
* 13-22 years of age at time of enrollment * Moderate-severe self-reported symptoms of depression at baseline (PHQ-8 \>=5) * Under the care of a US-based healthcare provider and willing and able to provide the name and contact information of the provider during consent * English fluency or proficiency and literacy of adolescent and consenting legal guardian, if required * Access to an eligible mobile device (capable of installing the app) and regular internet access * Willing to provide informed e-consent/assent and have legal guardian willing to provide informed e consent (if required)
Exclusion criteria
* Change in concurrent treatment (medication, and/or psychotherapy) for depression 30 days prior to study enrollment * Suicide attempt within the past year * Active suicide ideation with intent * Previously participated in user testing or clinical testing of the Spark app * Any condition, comorbidity, or event that, in the opinion of the investigator, will prevent the participant from adhering to the protocol or benefitting from the treatment (e.g., unable to perform informed assent or consent, treatment resistance as determined by investigator) or will prevent investigators from being able to ensure safety (e.g., will be leaving the country during study time period)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility of intervention - Adherence | 5 weeks | Adherence to program: percent of enrolled participants completing all modules by post-treatment |
| Feasibility of intervention - Participant willingness | Screening | Percent of eligible participants willing to participate |
| Participant satisfaction with the SparkRx app | 5 weeks | Acceptability of intervention. Measured by the User Experience (UXR) questionnaire. Includes questions from the UMUX-Lite; a two-item questionnaire that assesses the usability of the mobile application. Questions have seven response options from Strongly agree to Strongly disagree. Includes questions from the HaTs questionnaire; an open-ended questionnaire that assesses respondents' experiences with the product and provides options for feedback. |
| Feasibility of intervention - Eligibility | Screening | Percent of potential participants eligible to participate |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in participant-rated anxiety symptoms | Change from screening to post-intervention (5 weeks) | Measured by the Generalized Anxiety Disorder scale (GAD-7).The GAD-7 is a brief 7-item assessment for generalized anxiety disorder with satisfactory sensitivity and specificity. Score range of 0 to 21 with a higher score indicating worse outcome. |
| Average treatment related usability rating | 5 weeks | Measured by the System Usability Scale (SUS). The SUS consists of a 10 item questionnaire with five response options for respondents; from Strongly agree to Strongly disagree. Score range of 0 to 100 with a higher score indicating a better outcome. |
| Average treatment related engagement rating | 5 weeks | Measured by the User Engagement Scale (UES-SF).A statistically reliable measure of self-reported user engagement. The form has 12 items and uses a 5 point Likert scale. Score range of 1-5 with a higher score indicating a better outcome. |
| Average treatment related program adherence | 5 weeks | Measured by mobile app analytics |
| Average treatment related program engagement | 5 weeks | Measured by mobile app analytics |
| Change in legal guardian-reported depressive symptoms | Change from screening to post-intervention (5 weeks) | Measured by the Patient Health Questionnaire (PHQ-8). Score range of 0 to 24 with higher scores indicating worse outcome. * Clinically significant improvement: reduction in assessment score \>= 5 * Treatment response: 50% reduction in symptoms from pre to post-intervention * Remission is defined as a score \< 5 |
| Change in depressive symptoms | Change from screening to post-intervention (5 weeks) | Measured by the Patient Health Questionnaire (PHQ-8). Score range of 0 to 24 with higher scores indicating worse outcome. * Clinically significant improvement: reduction in assessment score \>= 5 * Treatment response: 50% reduction in symptoms from pre to post-intervention * Remission is defined as a score \< 5 |
| Change in participant-reported health-related quality of life | Change from screening to post-intervention (5 weeks) | Measured by the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q).A 15-item self-administered questionnaire that captures life satisfaction over the past week. Score range of 14 to 84 with a higher score indicating better outcome. |
| Change in legal-guardian reported health-related quality of life | Change from screening to post-intervention (5 weeks) | Measured by the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q).A 15-item self-administered questionnaire that captures life satisfaction over the past week. Score range of 14 to 84 with a higher score indicating better outcome. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Health care utilization | 5 weeks | Measured by the Healthcare Utilization Questionnaire. A two-item questionnaire that asks whether participants' have used healthcare resources in the past week. |
| Caregiver burden | 5 weeks | Measured by the work absenteeism questionnaire, containing qualitative and quantitative questions about caregiving responsibilities and related impacts on employment. Higher scores are equal to more time missed from work. |
| Treatment related perceptions of participants' experiences in general with SparkRx | 5 weeks | Measured by the User Experience (UXR) questionnaire. Includes questions from the Usability Metric for User Experience-Lite; a two-item questionnaire that assesses the usability of the mobile application. Questions have seven response options from Strongly agree to Strongly disagree. Includes questions from the Happiness Tracking Surveys; an open-ended questionnaire that assesses respondents' experiences with the product and provides options for feedback. |
| Treatment related changes by physical symptom severity | 5 weeks | Measured by the Functional Disability Inventory a fifteen-item questionnaire that measures functional disability and evaluates the impact of illness on the respondents' physical and psychosocial functioning in everyday social roles. Each question is rated on a 5-point scale from 0(No Trouble) to 4 (Impossible). Score range is 0 to 60 with higher scores indicating a worse outcome. |
Countries
United States
Outcome results
None listed