J. Med. Internet Res. - MEMO--a mobile phone depression prevention intervention for adolescents: development process and postprogram findings on acceptability from a randomized controlled trial.


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CKGROUND: Prevention of the onset of depression in adolescence may prevent social dysfunction, teenage pregnancy, substance abuse, suicide, and mental health conditions in adulthood. New technologies allow delivery of prevention programs scalable to large and disparate populations.OBJECTIVE: To develop and test the novel mobile phone delivery of a depression prevention intervention for adolescents. We describe the development of the intervention and the results of participants' self-reported satisfaction with the intervention.METHODS: The intervention was developed from 15 key messages derived from cognitive behavioral therapy (CBT). The program was fully automated and delivered in 2 mobile phone messages/day for 9 weeks, with a mixture of text, video, and cartoon messages and a mobile website. Delivery modalities were guided by social cognitive theory and marketing principles. The intervention was compared with an attention control program of the same number and types of messages on different topics. A double-blind randomized controlled trial was undertaken in high schools in Auckland, New Zealand, from June 2009 to April 2011.RESULTS: A total of 1348 students (13-17 years of age) volunteered to participate at group sessions in schools, and 855 were eventually randomly assigned to groups. Of these, 835 (97.7%) self-completed follow-up questionnaires at postprogram interviews on satisfaction, perceived usefulness, and adherence to the intervention. Over three-quarters of participants viewed at least half of the messages and 90.7% (379/418) in the intervention group reported they would refer the program to a friend. Intervention group participants said the intervention helped them to be more positive (279/418, 66.7%) and to get rid of negative thoughts (210/418, 50.2%)--significantly higher than proportions in the control group.CONCLUSIONS: Key messages from CBT can be delivered by mobile phone, and young people report that these are helpful. Change in clinician-rated depression symptom scores from baseline to 12 months, yet to be completed, will provide evidence on the effectiveness of the intervention. If proven effective, this form of delivery may be useful in many countries lacking widespread mental health services but with extensive mobile phone coverage. CLINICALTRIAL: Australia New Zealand Clinical Trials Registry (ACTRN): 12609000405213; http://www.anzctr.org.au/trial_view.aspx?ID=83667 (Archived by WebCite at http://www.webcitation.org/64aueRqOb).

Resumo Limpo

ckground prevent onset depress adolesc may prevent social dysfunct teenag pregnanc substanc abus suicid mental health condit adulthood new technolog allow deliveri prevent program scalabl larg dispar populationsobject develop test novel mobil phone deliveri depress prevent intervent adolesc describ develop intervent result particip selfreport satisfact interventionmethod intervent develop key messag deriv cognit behavior therapi cbt program fulli autom deliv mobil phone messagesday week mixtur text video cartoon messag mobil websit deliveri modal guid social cognit theori market principl intervent compar attent control program number type messag differ topic doubleblind random control trial undertaken high school auckland new zealand june april result total student year age volunt particip group session school eventu random assign group selfcomplet followup questionnair postprogram interview satisfact perceiv use adher intervent threequart particip view least half messag intervent group report refer program friend intervent group particip said intervent help posit get rid negat thought signific higher proport control groupconclus key messag cbt can deliv mobil phone young peopl report help chang clinicianr depress symptom score baselin month yet complet will provid evid effect intervent proven effect form deliveri may use mani countri lack widespread mental health servic extens mobil phone coverag clinicaltri australia new zealand clinic trial registri actrn httpwwwanzctrorgautrialviewaspxid archiv webcit httpwwwwebcitationorgauerqob

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