Depression is a major public health problem. Even slight elevations in depressive symptoms are associated with significant deficits in daily functioning. Only 50% of Americans with depression receive adequate treatment, and one-third of those receiving treatment do not benefit. There is now evidence that internet-based depression interventions can effectively reach large numbers of people at low cost, but they commonly have problems with high attrition and low adherence. We propose an intervention to reduce depressive symptoms by adapting our existing internet- based positive affect skills intervention for individuals with depression. We will develop and test innovative features for increasing adherence including exercises for use on mobile devices in real-life situations; very brief contact with a study facilitator; peer support via a private, moderated internet forum; and optional goals and challenges that provide users with reinforcement and feedback. The materials and delivery method will undergo multiple cycles of user testing and comparative evaluation, followed by a randomized test comparing several different versions of the intervention.
We aim to 1) Maximize acceptability and relevance of intervention content for people with elevated depressive symptoms or clinical depression; (2) Develop methods for boosting retention and adherence, and (3) collect preliminary data regarding proximal mediators of efficacy of the program for reducing levels of depressive symptoms. The proposed study will extend the literature and inform clinical practice by gathering evidence regarding efficacy of positive psychological interventions; optimizing an online intervention for depression that has the potential for widespread reach and dissemination; and maximizing retention and adherence, two key components of successful psychological interventions.

Public Health Relevance

There is now evidence that internet-based depression interventions can reach large numbers of people at low cost, but they commonly have problems with high attrition and low adherence. We have developed an online intervention that focuses on positive affect skills to reduce stress and its associated negative emotions. We propose to adapt and tailor the intervention for delivery to people living with depression with the goal of disseminating an effective online depression program that people like and will want to do. Ultimately the proposed work will lead to significant improvements in the quality of life of people living with, or at risk for, clinical depression.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Planning Grant (R34)
Project #
5R34MH101265-02
Application #
8903998
Study Section
Interventions Committee for Adult Disorders (ITVA)
Program Officer
Sherrill, Joel
Project Start
2014-08-08
Project End
2017-07-31
Budget Start
2015-08-01
Budget End
2016-07-31
Support Year
2
Fiscal Year
2015
Total Cost
$217,759
Indirect Cost
$33,585
Name
Northwestern University at Chicago
Department
Public Health & Prev Medicine
Type
Schools of Medicine
DUNS #
005436803
City
Chicago
State
IL
Country
United States
Zip Code
60611