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Randomized Clinical Trial of an Internet-Based Depression Prevention Program for Adolescents (Project CATCH-IT) in Primary Care: 12-Week Outcomes
Open accessAbstract
OBJECTIVE: The authors sought to evaluate 2 approaches with varying time and complexity in engaging adolescents with an Internet-based preventive intervention for depression in primary care. The authors conducted a randomized controlled trial comparing primary care physician motivational interview (MI, 5-10 minutes) + Internet program versus brief advice (BA, 1-2 minutes) + Internet program. SETTING: Adolescent primary care patients in the United States, aged 14 to 21 years. PARTICIPANTS: Eighty-four individuals (40% non-white) at increased risk for depressive disorders (subthreshold depressed mood >3-4 weeks) were randomly assigned to either the MI group (n = 43) or the BA group (n = 40). MAIN OUTCOME MEASURES: Patient Health Questionnaire-Adolescent and Center for Epidemiologic Studies Depression Scale (CES-D). RESULTS: Both groups substantially engaged the Internet site (MI, 90.7% vs BA 77.5%). For both groups, CES-D-10 scores declined (MI, 24.0 to 17.0, p < .001; BA, 25.2 to 15.5, p < .001). The percentage of those with clinically significant depression symptoms based on CES-D-10 scores declined in both groups from baseline to 12 weeks, (MI, 52% to 12%, p < .001; BA, 50% to 15%, p < .001). The MI group demonstrated declines in self-harm thoughts and hopelessness and was significantly less likely than the BA group to experience a depressive episode (4.65% vs 22.5%, p = .023) or to report hopelessness (MI group of 2% vs 15% for the BA group, p = .044) by 12 weeks. CONCLUSIONS: An Internet-based prevention program in primary care is associated with declines in depressed mood and the likelihood of having clinical depression symptom levels in both groups. Motivational interviewing in combination with an Internet behavior change program may reduce the likelihood of experiencing a depressive episode and hopelessness.
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“the remaining studies (83%) described moderate or mixed adherence [56,63-65] and usage [60]”
From eMental Healthcare Technologies for Anxiety and Depression in Childhood and Adolescence: Systematic Review of Studies Reporting Implementation Outcomes (2018) · cites this paper as [64]
In the citing paper
“Four studies examining fidelity reported mixed results [62-65], particularly healthcare provider adherence to the program.”
From eMental Healthcare Technologies for Anxiety and Depression in Childhood and Adolescence: Systematic Review of Studies Reporting Implementation Outcomes (2018) · cites this paper as [64]
In the citing paper
“but to a surprising degree, many adolescents and parents appeared to shift from passive to pro-active problem solving with evident benefit.53,54”
From Adolescent and parent experiences with a primary care/Internet-based depression prevention intervention (CATCH-IT) (2011) · cites this paper as [53]
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Internet-Based Depression Prevention over the Life Course: A Call for Behavioral Vaccines
Voorhees, B. W. V., Mahoney, N., Mazo, R., Barrera, A. Z., Siemer, C. P., Gladstone, T. R. G., & Muñoz, R. F. (2011) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2010.11.002 · Cited by 44
“Increased monitoring was another method used, including “checking up” on their participants via email, phone, or direct contact to discuss progress and/or concerns.(31,34,35,39,45,49) However, most articles either did not assess selfharm risk and/or did not report additional safety precautions.”
InfluentialSelf-citationGladstone, T. R. G., Marko-Holguin, M., Rothberg, P. C., Nidetz, J., Diehl, A., DeFrino, D. T., Harris, M., Ching, E., Eder, M., Canel, J., et al. (2015) · Trials · doi:10.1186/s13063-015-0705-2 · Cited by 41
Self-citationGlascoe, F. P., & Trimm, F. (2014) · PEDIATRICS · doi:10.1542/peds.2013-1859 · Cited by 41
Saulsberry, A., Corden, M. E., Taylor-Crawford, K., Crawford, T. J., Johnson, M., Froemel, J., Walls, A., Fogel, J., Marko-Holguin, M., & Voorhees, B. W. V. (2012) · Journal of Child and Family Studies · doi:10.1007/s10826-012-9627-8 · Cited by 41
Self-citationmHealth Interventions for Self-Harm: Scoping Review
Cliffe, B., Tingley, J., Greenhalgh, I., & Stallard, P. N. (2021) · Journal of Medical Internet Research · doi:10.2196/25140 · Cited by 44
“[56] 1 (3) Acceptance and commitment therapy”
BackgroundInfluentialMyers, K., & Comer, J. S. (2016) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2015.0055 · Cited by 40
“…‘‘Mood Gymn’’ has demonstrated variable success in reducing depressive symptoms in high school students with low levels of depressive symptoms (O’Kearney et al. 2009), whereas Project CATCH-IT has shown potential to prevent depression in youth treated in primary care (Van Voorhees et al. 2009).”
Gladstone, T. R. G., DeFrino, D. T., Paulson, A., Nidetz, J., Canel, J., Ching, E., Berry, A. D., Cantorna, J., Fogel, J., Eder, M., et al. (2018) · JAMA Network Open · doi:10.1001/jamanetworkopen.2018.4278 · Cited by 34
Self-citationHo, J., Corden, M. E., Caccamo, L., Tomasino, K. N., Duffecy, J., Begale, M. J., & Mohr, D. C. (2016) · Internet Interventions · doi:10.1016/j.invent.2016.09.005 · Cited by 33
Prado, G. J., Estrada, Y. A., Rojas, L. M., Bahamón, M., Pantin, H. M., Nagarsheth, M., Gwynn, L. A., Ofir, A. Y., Forster, L., Torres, N. S., et al. (2018) · Contemporary Clinical Trials · doi:10.1016/j.cct.2018.11.005 · Cited by 34
Bringing psychotherapy to primary care: Innovations and challenges.
Alexander, C. L., Arnkoff, D. B., & Glass, C. R. (2010) · Clinical Psychology Science and Practice · doi:10.1111/j.1468-2850.2010.01211.x · Cited by 32
“At a 12-week follow-up, the percentage of participants with depressive symptoms had declined from baseline in both groups; depressive episodes were significantly less likely in the motivational interviewing group than in the brief advice group (Van Voorhees et al., 2009).”
BackgroundGladstone, T., Buchholz, K. R., Fitzgibbon, M., Schiffer, L., Lee, M., & Voorhees, B. W. V. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17217736 · Cited by 32
“Additionally, adolescents were excluded if they were in current treatment for MDD, had a significant developmental disability or reading impairment, were assessed to be at imminent risk of suicide, or were being treated for serious medical conditions [13,44].”
InfluentialSelf-citationEffectiveness of an eating disorder preventative intervention in primary care medical settings
Linville, D. C., Cobb, E. L., Lenee-Bluhm, T., López‐Zerón, G., Gau, J. M., & Stice, E. M. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.10.004 · Cited by 32
Lattie, E. G., Ho, J., Sargent, E., Tomasino, K. N., Smith, J. D., Brown, C. H., & Mohr, D. C. (2017) · Internet Interventions · doi:10.1016/j.invent.2017.02.003 · Cited by 31
“While some internet-based mental health interventions have been deployed through primary care (Van Voorhees et al., 2009) or based on referral from mental health clinicians (Rice et al., 2016), most studies of internet-based mental health interventions focused on prevention with adolescents have…”
BackgroundResultInfluentialKulikov, V. N., Crosthwaite, P. C., Hall, S. A., Flannery, J., Strauss, G., Vierra, E., Koepsell, X., Lake, J. I., & Padmanabhan, A. (2023) · Frontiers in Digital Health · doi:10.3389/fdgth.2023.1062471 · Cited by 35
Oddo, L. E., Felton, J. W., Meinzer, M. C., Mazursky-Horowitz, H., Lejuez, C. W., & Chronis-Tuscano, A. M. (2019) · Journal of Attention Disorders · doi:10.1177/1087054719864660 · Cited by 31
“Given prior research suggesting important variations in depressive symptoms based on age, race/ethnicity, and sex (Ge, Conger, & Elder, 2001; Van Voorhees, Paunesku, Fogel, & Bell, 2009), mothers were asked to report their child’s demographic information at study visits.”
BackgroundAdvances in Prevention Science: A Developmental Psychopathology Perspective
Toth, S. L., Petrenko, C. L. M., Gravener, J. A., & Handley, E. D. (2016) · Wiley eBooks · doi:10.1002/9781119125556.devpsy416 · Cited by 30
Rojas, L. M., Bahamón, M., Wagstaff, R. G., Ferré, I. M., Perrino, T., Estrada, Y. A., George, S. M. S., Pantin, H. M., & Prado, G. J. (2019) · Preventive Medicine · doi:10.1016/j.ypmed.2018.12.009 · Cited by 36
Mood management effects of brief unsupported internet interventions
Bunge, E. L., Williamson, R. E., Cano, M. T., Leykin, Y., & Muñoz, R. F. (2016) · Internet Interventions · doi:10.1016/j.invent.2016.06.001 · Cited by 28
“Other studies have shown that Internet programs are effective in preventing depressive episodes in adults (Holländare et al., 2011; Buntrock et al., 2016) and in adolescents (Calear and Christensen, 2010; Calear et al., 2009; Van Voorhees et al., 2009).”
BackgroundUnderstanding Adolescent Response to a Technology-Based Depression Prevention Program
Gladstone, T., Marko-Holguin, M., Henry, J., Fogel, J., Diehl, A., & Van Voorhees, B. W. (2014) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2013.850697 · Cited by 26
Self-citationStruthers, A., Charette, C., Bapuji, S. B., Winters, S., Ye, X., Metge, C., Kreindler, S., Raynard, M., Lemaire, J., Synyshyn, M., et al. (2015) · Canadian Journal of Community Mental Health · doi:10.7870/cjcmh-2015-006 · Cited by 27
Eisen, J. C., Marko-Holguin, M., Fogel, J., Cardenas, A., Bahn, M., Bradford, N., Fagan, B., Wiedmann, P., & Van Voorhees, B. W. (2013) · The Primary Care Companion For CNS Disorders · doi:10.4088/pcc.10m01065 · Cited by 26
Self-citationHe, R., Wei, J., Huang, K., Yang, H., Chen, Y., Liu, Z., Ma, L., Jia, Y., & Chen, L. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114897 · Cited by 29
Dickter, B., Bunge, E. L., Brown, L. M., Leykin, Y., Soares, E. E., Voorhees, B. W. V., Marko-Holguin, M., & Gladstone, T. R. G. (2019) · mHealth · doi:10.21037/mhealth.2019.04.01 · Cited by 29
“Previous analyses of the CATCHIT sample found a significant effect of these variables on participant depression (35), indicating that increased participation in the study can lead to greater clinical effects.”
BackgroundMethodInfluentialSelf-citationCOACH consortium, Reinauer, C., Viermann, R., Förtsch, K., Linderskamp, H., Warschburger, P., Holl, R. W., Staab, D., Minden, K., Muche, R., et al. (2018) · Trials · doi:10.1186/s13063-018-2997-5 · Cited by 23
Cairns, K., Yap, M. B. H., Reavley, N. J., & Jorm, A. F. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.05.019 · Cited by 30
Voorhees, B. W. V., Gladstone, T. R. G., Cordel, S. L., Marko-Holguin, M., Beardslee, W. R., Kuwabara, S. A., Kaplan, M. A., Fogel, J., Diehl, A., Hansen, C., et al. (2015) · Internet Interventions · doi:10.1016/j.invent.2015.07.004 · Cited by 22
“nurse/medical assistant staff members complete the screening process, and study staff collect the screening forms and then conduct eligibility assessments by phone (Van Voorhees et al., 2009a).”
BackgroundSelf-citationSobowale, K., Zhou, A., Voorhees, B. W. V., Stewart, S. M., Tsang, A. M.-C., Ip, P., Fabrizio, C., Wong, K. L., & Chim, D. (2013) · International Journal of Adolescent Medicine and Health · doi:10.1515/ijamh-2013-0020 · Cited by 23
Behavioral activation for major depression in adolescents: Results from a pilot study.
Ritschel, L. A., Ramirez, C. L., Cooley, J. L., & Craighead, W. E. (2016) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12140 · Cited by 23
“Van Voorhees et al. (2009) adapted BA for delivery via the Internet; however, their program was intended for the prevention rather than the treatment of depression.”
MethodInternetbasierte psychologische Behandlung bei Depressionen
Klein, J. P., & Berger, T. (2013) · Verhaltenstherapie · doi:10.1159/000354046 · Cited by 23
Metadata
- Authors
- Van Voorhees, B. W., Fogel, J., Reinecke, M. A., Gladstone, T., Stuart, S., Gollan, J., Bradford, N., Domanico, R., Fagan, B., Ross, R., Larson, J., Watson, N., Paunesku, D., Melkonian, S., Kuwabara, S., Holper, T., Shank, N., Saner, D., Butler, A., Chandler, A., Louie, T., Weinstein, C., Collins, S., Baldwin, M., Wassel, A., Vanderplough-Booth, K., Humensky, J., & Bell, C.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Northwestern University (US)
- Illinois Institute of Technology (US)
- University of Iowa (US)
- University of Chicago (US)
- John H. Stroger, Jr. Hospital of Cook County (US)
- Corresponding author
- Stuart, Scott
- Watson, Natalie
- Melkonian, Stephanie
- Kuwabara, Sachiko
- Butler, Amy
- Chandler, Amy
- Louie, Tina
- Weinstein, Cynthia
- Collins, Shannon
- Baldwin, Melinda
- Wassel, Abigail
- ORCID
- Venue
- Journal of Developmental & Behavioral Pediatrics
- Published
- 2009-02
- Volume
- 30
- Issue
- 1
- Pages
- 23-37
- ISSN
- 0196-206X (ISSN-L)
- PMC
- PMC6290998
- OpenAlex
- W2055937548
- Cited by
- 197
- References
- 52
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 6 · 2023: 6 · 2022: 7 · 2021: 13 · 2020: 7 · 2019: 14 · 2018: 12 · 2017: 16 · 2016: 18 · 2015: 17 · 2014: 15 · 2013: 17 · 2012: 8
- FWCI
- 14.91
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of Developmental & Behavioral Pediatrics (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Alliance for Research on Schizophrenia and Depression
- National Institute of Mental Health (R01MH090035, K08MH072918)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- adolescent depression, depression prevention, online intervention, motivational interviewing, brief advice, primary care, subthreshold depression, hopelessness, self-harm thoughts, depressive episodes, behavior change
- MeSH terms
- Adolescent, Combined Modality Therapy, Counseling, Depression, Female, Humans, Interview, Psychological, Male, Motivation, Primary Health Care, Psychiatric Status Rating Scales, Time Factors, Cognitive Behavioral Therapy, Treatment Outcome, Internet, Young Adult
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