Adherence to the MoodGYM program: outcomes and predictors for an adolescent school-based population
Abstract
Background Program adherence has been associated with improved intervention outcomes for mental and physical conditions. The aim of the current study is to investigate adolescent adherence to an Internet-based depression prevention program in schools to identify the effect of adherence on outcomes and to ascertain the predictors of program adherence.Methods Data for the current study (N=1477) was drawn from the YouthMood Project, which was conducted to test the effectiveness of the MoodGYM program in reducing and preventing symptoms of anxiety and depression in an adolescent school-based population. The current study compares intervention effects across three sub-groups: high adherers, low adherers and the wait-list control condition.Results When compared to the control condition, participants in the high adherence intervention group reported stronger intervention effects at post-intervention and 6-month follow-up than participants in the low adherence group for anxiety (d=0.34-0.39 vs. 0.11-0.22), and male (d=0.43-0.59 vs. 0.26-0.35) and female depression (d=0.13-0.20 vs. 0.02-0.04). No significant intervention effects were identified between the high and low adherence groups. Being in Year 9, living in a rural location and having higher pre-intervention levels of depressive symptoms or self-esteem were predictive of greater adherence to the MoodGYM program.Limitations The program trialled is Internet-based and therefore the predictors of adherence identified may not generalise to face-to-face interventions.Conclusions The current study provides preliminary support for the positive relationship between program adherence and outcomes in a school environment. The identification of significant predictors of adherence will assist in identifying the type of user who will engage most with an online depression prevention program.
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Treatment adherence has a direct impact on treatment dosage, thereby influencing psychological outcomes.
“As such, treatment adherence has a direct impact on the treatment dosage, thereby influencing psychological outcomes (Calear et al., 2013).”
From Involving patients' perspective in the development of an internet- and mobile-based CBT intervention for adolescents with chronic medical conditions: Findings from a qualitative study (2021) · cites this paper as Calear et al., 2013
Eight papers regarding six different trials measured rural location as a predictor of outcomes, adherence, or acceptability.
“Eight papers regarding six different trials measured rural location as a predictor of outcomes, adherence, or acceptability [38-45].”
From Computerized cognitive behavior therapy for anxiety and depression in rural areas:a systematic review (2015) · cites this paper as [38]
Lack of availability of alternative services, greater motivation of supervising staff members, or a preference for health self-management in rural participants are potential explanations for the mixed adherence findings.
“Lack of availability of alternative services, greater motivation of supervising staff members, or a preference for health self-management in rural participants are potential explanations for this [38,43,48].”
From Computerized cognitive behavior therapy for anxiety and depression in rural areas:a systematic review (2015) · cites this paper as [38]
Across the RCTs included in this review, the risk of bias was rated as low for two studies, and moderate for two studies.
“Across the RCTs included in this review, the risk of bias was rated as low for two studies [38,40], and moderate for two studies [41,47].”
From Computerized cognitive behavior therapy for anxiety and depression in rural areas:a systematic review (2015) · cites this paper as [38]
One school-based study found that rurality predicted high adherence to CCBT among adolescents, and that higher adherence led to greater reductions in depression and anxiety.
“One school-based study found that rurality predicted high adherence to CCBT among adolescents, and that higher adherence led to greater reductions in depression and anxiety [38].”
From Computerized cognitive behavior therapy for anxiety and depression in rural areas:a systematic review (2015) · cites this paper as [38]
The two studies with adolescents that compared adherence outcomes by location both found that rural residence predicted significantly greater adherence to the MoodGYM program.
“The two studies with adolescents that compared adherence outcomes by location both found that rural residence predicted significantly greater adherence to the MoodGYM program [38,43].”
From Computerized cognitive behavior therapy for anxiety and depression in rural areas:a systematic review (2015) · cites this paper as [38]
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- Authors
- Calear, A. L., Christensen, H., Mackinnon, A., & Griffiths, K. M.
- Affiliations
- Australian National University (AU)
- Black Dog Institute (AU)
- The University of Melbourne (AU)
- Corresponding author
- Calear, Alison L.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2013-05
- Volume
- 147
- Issue
- 1-3
- Pages
- 338-344
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2147451901
- Cited by
- 105
- References
- 25
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 5 · 2023: 6 · 2022: 8 · 2021: 15 · 2020: 8 · 2019: 11 · 2018: 7 · 2017: 12 · 2016: 8 · 2015: 7 · 2014: 8 · 2013: 1
- FWCI
- 7.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- Funders
- National Health and Medical Research Council (NHMRC) (1013199)
- NHMRC (525411, 425413)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- program adherence, MoodGYM, adolescent depression, adolescent anxiety, school-based mental health programs, predictors of adherence, self-esteem, rural adolescents
- MeSH terms
- Adolescent, Anxiety, Australia, Child, Depression, Female, Humans, Male, Patient Compliance, School Health Services, Internet
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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