Poor adherence to depression treatments (psychotherapy and pharmacotherapy) limits their effectiveness in community settings. Problems with adherence are especially pronounced in low-income settings. Innovative and cost-effective methods are needed to improve adherence to treatments and maximize mental health resources. Mobile phone based text messaging (or short messaging service: SMS) is a ubiquitous technology that has been used in various health applications across socioeconomic status. This technology has the potential to increase the fidelity of mental health treatments via increased adherence. The proposed research project will test whether adding an automated SMS adjunct to group cognitive behavioral therapy (CBT) for depression can increase adherence (homework adherence, attendance, medication adherence) and further reduce depression symptoms. The SMS adjunct will 1) prompt patients to monitor mood, thoughts and behaviors, 2) will provide medication and appointment reminders and 3) will send personalized CBT based tips. The information that patients provide will be used within the clinical setting to highlight interrelations between thoughts, behaviors and symptoms. The results of the research project will inform an R01 to do further testing of health information technology (HIT) applications in low-income settings. The experience gained through this award will complement previous training and prepare me for a successful clinical research career in the application of health information technologies to mental health services in low-income communities. This K23 (Mentored Patient-Oriented Career Development Award) application delineates a training and research plan seeking to improve depression treatment in low-income communities through the use of text messaging as an adjunct to psychotherapy. The applicant is seeking advanced training in 1) community based mental health services research, 2) health information technology and 3) mixed methods research via mentorship from Kurt C. Organista, Ricardo F. Mu?oz, and Patricia A. Arean. To achieve further expertise in these areas, various training experiences are proposed with a research trial serving as the core of the career development plan.

Public Health Relevance

This training proposal and research plan addresses NIMH strategic objective #3 to improve and personalize mental health treatment and the NIMH Road Ahead recommendation #3C to support research on the effective deployment of health information technology in underserved communities. Improving adherence to depression treatment with a low cost adjunct such as text messaging has the potential to reduce symptoms, sustain treatment gains and make treatments more efficient.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
Application #
Study Section
Mental Health Services in Non-Specialty Settings (SRNS)
Program Officer
Hill, Lauren D
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of California Berkeley
Schools of Social Work
United States
Zip Code
Aguilera, Adrian; Schueller, Stephen M; Leykin, Yan (2015) Daily mood ratings via text message as a proxy for clinic based depression assessment. J Affect Disord 175:471-4
Aguilera, Adrian; Berridge, Clara (2014) Qualitative feedback from a text messaging intervention for depression: benefits, drawbacks, and cultural differences. JMIR Mhealth Uhealth 2:e46
Campos, Belinda; Ullman, Jodie B; Aguilera, Adrian et al. (2014) Familism and psychological health: the intervening role of closeness and social support. Cultur Divers Ethnic Minor Psychol 20:191-201
Breitborde, Nicholas J K; López, Steven R; Aguilera, Adrian et al. (2013) Perceptions of efficacy, expressed emotion, and the course of schizophrenia: the case of emotional overinvolvement. J Nerv Ment Dis 201:833-40
Leykin, Yan; Aguilera, Adrian; Pérez-Stable, Eliseo J et al. (2013) Prompting Depression Treatment Seeking among Smokers: A Comparison of Participants from Six Countries in an Internet Stop Smoking RCT. J Technol Hum Serv 31:238-247
Morris, Margaret E; Aguilera, Adrian (2012) Mobile, Social, and Wearable Computing and the Evolution of Psychological Practice. Prof Psychol Res Pr 43:622-626
Aguilera, Adrian; Muench, Frederick (2012) There's an App for That: Information Technology Applications for Cognitive Behavioral Practitioners. Behav Ther (N Y N Y) 35:65-73
Aguilera, Adrian; Leykin, Yan; Adler, Nancy et al. (2012) Assessing the impact of relative social position and absolute community resources on depression and obesity among smokers. Am J Community Psychol 50:211-6
Leykin, Yan; Torres, Leandro D; Aguilera, Adrian et al. (2011) Factor structure of the CES-D in a sample of Spanish- and English-speaking smokers on the Internet. Psychiatry Res 185:269-74
Aguilera, Adrian; Muñoz, Ricardo F (2011) Text Messaging as an Adjunct to CBT in Low-Income Populations: A Usability and Feasibility Pilot Study. Prof Psychol Res Pr 42:472-478

Showing the most recent 10 out of 11 publications