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Article Title

Mobile Assessment of Depression Treatment Response: Recruitment Challenges and Possible Solutions

Publication Date

8-15-2016

Keywords

depression, mobile assessments

Abstract

Background/Aims: Effective treatments to depression exist, but treatment response is variable. Persons likely to respond to antidepressants often show early change in emotional processing and attentional bias. Methods to assess these constructs passively and at low burden/cost are now available via smartphone apps, with potential for broad dissemination.

Methods: This Mental Health Research Network-supported study is testing the feasibility, acceptability and utility of assessing behavior and neuropsychological performance for prediction of depression treatment response using smartphone behavioral apps. Kaiser Permanente Northwest (N = 75) and Georgia members (N = 75) starting new antidepressant treatment are recruited via secure online messaging through their www.kp.org personal health record. Participants complete assessments at baseline, 4, 8 and 12 weeks. App data is shared with their provider.

Results: We have experienced several challenges related to study enrollment. First, read rates of the recruitment message are at ~60%. Second, of those who read the message, only 12% visit the study website. Third, among those who visit the study website, only ~3% consent and enroll in the study. Finally, among enrolled participants, approximately 33% successfully download and use the apps. We have implemented several strategies aimed at increasing enrollment: 1) revising recruitment messaging to highlight the unique features of the apps and emphasize that results may help improve their treatment, 2) sending additional recruitment messages via email/text, 3) initiating recruitment calls using Kaiser Permanente’s automated telephone system, 4) providing follow-up phone calls to offer technical assistance for those experiencing difficulties with downloading/using the apps, and 5) introducing tiered incentives to motivate completion of each phase of the study. These efforts appear to be improving our recruitment efforts. Additional interviews will be conducted with participants, and thus additional data about barriers to/facilitators of recruitment and retention will be available prior to the conference.

Conclusion: The use of mobile technologies to predict depression treatment response may have significant implications for effective and timely depression care. Understanding the barriers/facilitators of successful enrollment and retention is critical to the implementation of this intervention. Lessons learned from the present study may aid others in similar efforts and in different settings.

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