Immediate and Long-Term Effects of an 8-Week Digital Mental Health Intervention on Adults With Poorly Managed Type 2 Diabetes: Protocol for a Randomized Controlled Trial
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Abstract
Background Diabetes is a leading cause of years of life lost and accounts for approximately one-fourth of health care dollars spent in the United States. Many of these costs are related to poor medication adherence and lack of self-care behaviors and are thus preventable. Depression, which is more prevalent among people with diabetes than in the general population, predicts poorer management of one’s diabetes, whereas positive affect predicts engaging in more positive health behaviors. Consequently, interventions that improve depression and positive affect may also improve diabetes-related outcomes among people with diabetes. Although preliminary research on the impact of such interventions among people with diabetes is promising, these studies focused primarily on in-person interventions, have had small samples, and lack long-term follow-up. Objective This study aims to examine the short- and long-term effects of a digital therapeutic platform focused on mental health among adults with poorly managed type 2 diabetes and elevated levels of depression. Methods This is a randomized controlled trial in which adults with a type 2 diabetes diagnosis, elevated hemoglobin A1c (HbA1c) levels (≧7), and moderate to severe depressive symptoms will be randomly assigned to a positive emotion regulation skills intervention group or a sham digital intervention with only psychoeducational content. The study will take place over 14 months, including the 8-week intervention (or control) delivered via a digital therapeutic platform (Happify Health) and follow-up assessments at 3, 6, and 12 months postintervention. Throughout the intervention and for 1 week at each postintervention follow-up, participants will complete daily assessments of diabetes-related distress, diabetes regimen adherence, and mood. Our primary outcome, HbA1c, will be self-reported every 3 months throughout the study. Secondary and exploratory outcomes will be assessed at baseline; at 8 weeks; and at 3, 6, and 12 months postintervention. Results Recruitment is expected to begin in June 2020. Participants will begin the study as they are recruited and will finish in waves. The final wave of data collection from the 8-week intervention is expected for winter 2020, with the completion of the 12-month follow-up in winter 2021. Conclusions Although previous research suggests that in-person psychological interventions have promising effects on both psychological and physical outcomes among adults with diabetes, digital interventions can be advantageous because they are easily scalable and reduce many barriers that prevent people from seeking treatment. This trial will provide important information about the effects of a digital mental health intervention among adults with type 2 diabetes, assessing both short- and long-term effects of this intervention on HbA1c, depressive symptoms, and other diabetes-specific outcomes. If successful, this may introduce a scalable intervention that would help reduce some of the preventable costs associated with diabetes. Trial Registration ClinicalTrials.gov NCT04068805; https://clinicaltrials.gov/ct2/show/NCT04068805. International Registered Report Identifier (IRRID) PRR1-10.2196/18578
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In some sham controls, certain content and/or features were removed, mainly disease specific therapeutic content (e.g. CBT) or additional disease management features (community features).
“Finally, certain content and/or features were removed in the control condition, mainly disease specific therapeutic content (e.g. CBT (32, 56)) or additional disease management features (community features (33)).”
Sham controls either replaced core treatment activities with "fake, but plausible therapies" or delivered general, disease agnostic wellbeing tips.
“Sham controls either replaced core treatment activities with “fake, but plausible therapies” (33) or they delivered general, disease agnostic wellbeing tips (32, 56).”
A wellbeing program (The Health and Well-Being Program) included as a control condition for obsessive compulsive disorder was described as an "active intervention", while similar "general health and well-being educational content" was called a placebo control for a RCT for diabetes mellitus, type 2.
“For example, a wellbeing program (The Health and Well-Being Program) included as a control condition for obsessive compulsive disorder was described as an “active intervention” (61), while similar “general health and well-being educational content” was called a placebo control for a RCT for diabetes mellitus, type 2 (32).”
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Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910 · see citing works
Wild, S., Roglic, G., Green, A., Sicree, R., & King, H. (2004) · Diabetes Care · doi:10.2337/diacare.27.5.1047 · Cited by 15,297 · see citing works
IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040
Ogurtsova, K., Fernandes, J. D. D. R., Huang, Y., Linnenkamp, U., Guariguata, L., Cho, N. H., Cavan, D. A., Shaw, J. E., & Makaroff, L. (2017) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2017.03.024 · Cited by 6,977 · see citing works
Wang, H., Naghavi, M., Allen, C., Barber, R. M., Bhutta, Z. A., Carter, A., Casey, D. C., Charlson, F. J., Chen, A. Z., Coates, M. M., et al. (2016) · The Lancet · doi:10.1016/s0140-6736(16)31012-1 · Cited by 6,596 · see citing works
The Development and Validation of a Scale to Measure Self-Compassion
NEFF, K. D. (2003) · Self and Identity · doi:10.1080/15298860309027 · Cited by 6,436 · cited 1× · see citing works
“Conceivably, self-compassion may lead to improved diabetes outcomes because it promotes greater well-being and better mental health [27]; however, self-compassion may also lead to more adaptive responses to difficulties patients face with managing their condition and, in turn, promote better diabetes management, inclu…”
BackgroundPositive Psychology Progress: Empirical Validation of Interventions.
Seligman, M. E. P., Steen, T. A., Park, N., & Peterson, C. (2005) · American Psychologist · doi:10.1037/0003-066x.60.5.410 · Cited by 5,947 · see citing works
The PHQ-9: A New Depression Diagnostic and Severity Measure
Kroenke, K., & Spitzer, R. L. (2002) · Psychiatric Annals · doi:10.3928/0048-5713-20020901-06 · Cited by 5,898 · see citing works
Concurrent and Predictive Validity of a Self-reported Measure of Medication Adherence
Morisky, D. E., Green, L. W., & Levine, D. M. (1986) · Medical Care · doi:10.1097/00005650-198601000-00007 · Cited by 5,304 · see citing works
Cognitive Therapy of Depression
HOLLON, S. D., & BECK, A. T. (1979) · Cognitive-Behavioral Interventions · doi:10.1016/b978-0-12-404480-7.50012-5 · Cited by 4,685 · see citing works
Economic Costs of Diabetes in the U.S. in 2002
American Diabetes Association (2003) · Diabetes Care · doi:10.2337/diacare.26.3.917 · Cited by 4,147 · see citing works
IDF Diabetes Atlas: Global estimates of the prevalence of diabetes for 2011 and 2030
Whiting, D. R., Guariguata, L., Weil, C., & Shaw, J. E. (2011) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2011.10.029 · Cited by 3,994 · see citing works
Cella, D., Yount, S., Rothrock, N., Gershon, R., Cook, K., Reeve, B., Ader, D., Fries, J. F., Bruce, B., & Rose, M. (2007) · Medical Care · doi:10.1097/01.mlr.0000258615.42478.55 · Cited by 3,118 · see citing works
Defining empirically supported therapies.
Chambless, D. L., & Hollon, S. D. (1998) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.66.1.7 · Cited by 3,067 · see citing works
Sin, N. L., & Lyubomirsky, S. (2009) · Journal of Clinical Psychology · doi:10.1002/jclp.20593 · Cited by 2,955 · cited 1× · see citing works
“Unlike most other interventions tested in person or digitally, which draw on just one theoretical approach, Happify Health activities draw from each of the three major theoretical approaches: CBT [50], MBSR [51], and PP [52-54].”
BackgroundThe summary of diabetes self-care activities measure: results from 7 studies and a revised scale.
Toobert, D. J., Hampson, S. E., & Glasgow, R. E. (2000) · Diabetes Care · doi:10.2337/diacare.23.7.943 · Cited by 2,561 · see citing works
Goal striving, need satisfaction, and longitudinal well-being: The self-concordance model
Sheldon, K. M., & Elliot, A. J. (1999) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.76.3.482 · Cited by 2,541 · see citing works
Economic Costs of Diabetes in the U.S. in 2017
American Diabetes Association (2018) · Diabetes Care · doi:10.2337/dci18-0007 · Cited by 2,528 · see citing works
Eysenbach, G. (2005) · Journal of Medical Internet Research · doi:10.2196/jmir.7.1.e11 · Cited by 2,524 · see citing works
Diener, E., & Seligman, M. E. P. (2002) · Psychological Science · doi:10.1111/1467-9280.00415 · Cited by 2,508 · see citing works
Prevalence of and Trends in Diabetes Among Adults in the United States, 1988-2012
Menke, A., Casagrande, S., Geiss, L., & Cowie, C. C. (2015) · JAMA · doi:10.1001/jama.2015.10029 · Cited by 2,362 · see citing works
Positive psychology interventions: a meta-analysis of randomized controlled studies
Bolier, L., Haverman, M., Westerhof, G. J., Riper, H., Smit, F., & Bohlmeijer, E. (2013) · BMC Public Health · doi:10.1186/1471-2458-13-119 · Cited by 1,996 · cited 1× · see citing works
“Mindfulness and positive psychology (PP) interventions, which are effective in reducing depression and increasing well-being in the general population [29], have shown promise in improving depression, diabetes-related distress, and HbA1c levels among people with type 1 or 2 diabetes [30].”
BackgroundAssessing Psychosocial Distress in Diabetes
Polonsky, W. H., Fisher, L., Earles, J., Dudl, R. J., Lees, J., Mullan, J., & Jackson, R. A. (2005) · Diabetes Care · doi:10.2337/diacare.28.3.626 · Cited by 1,575 · see citing works
Depression and Diabetes: Impact of Depressive Symptoms on Adherence, Function, and Costs
Ciechanowski, P. S., Katon, W. J., & Russo, J. E. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.21.3278 · Cited by 1,465 · see citing works
Ali, S., Stone, M. A., Peters, J., Davies, M. J., & Khunti, K. K. (2006) · Diabetic Medicine · doi:10.1111/j.1464-5491.2006.01943.x · Cited by 1,281 · see citing works
A systematic review of adherence with medications for diabetes
Cramer, J. A. (2004) · Diabetes Care · doi:10.2337/diacare.27.5.1218 · Cited by 1,203 · see citing works
Advantages and limitations of Internet-based interventions for common mental disorders
Andersson, G., & Titov, N. (2014) · World Psychiatry · doi:10.1002/wps.20083 · Cited by 1,160 · see citing works
Global Economic Burden of Diabetes in Adults: Projections From 2015 to 2030
Bommer, C., Sagalova, V., Heesemann, E., Manne‐Goehler, J., Atun, R. A., Bärnighausen, T., Davies, J. I., & Vollmer, S. (2018) · Diabetes Care · doi:10.2337/dc17-1962 · Cited by 1,137 · see citing works
Ho, P. M., Rumsfeld, J. S., Masoudi, F. A., McClure, D. L., Plomondon, M. E., Steiner, J. F., & Magid, D. J. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.17.1836 · Cited by 1,135 · see citing works
Adherence in Internet Interventions for Anxiety and Depression
Christensen, H., Griffiths, K. M., & Farrer, L. (2009) · Journal of Medical Internet Research · doi:10.2196/jmir.1194 · Cited by 1,133 · see citing works
Barriers to mental health treatment: results from the National Comorbidity Survey Replication
Mojtabai, R., Olfson, M., Sampson, N. A., Jin, R., Druss, B., Wang, P. S., Wells, K. B., Pincus, H. A., & Kessler, R. C. (2011) · Psychological Medicine · doi:10.1017/s0033291710002291 · Cited by 951 · see citing works
6. Glycemic Targets: <i>Standards of Medical Care in Diabetes—2019</i>
American Diabetes Association (2019) · Diabetes Care · doi:10.2337/dc19-s006 · Cited by 655 · see citing works
County-level estimates of mental health professional shortage in the United States.
Thomas, K., Ellis, A. R., Konrad, T., Holzer, C., & Morrissey, J. (2009) · Psychiatric Services · doi:10.1176/ps.2009.60.10.1323 · Cited by 589 · see citing works
Mental health treatment seeking among older adults with depression: The impact of stigma and race
Conner, K. O., Copeland, V. C., Grote, N. K., Koeske, G., Rosen, D., Reynolds, C. F., & Brown, C. (2010) · The American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181cc0366 · Cited by 568 · cited 1× · see citing works
“However, there are numerous barriers to in-person treatment that prevent people from seeking treatment [37], including stigma [38] and a shortage of mental health professionals [39].”
BackgroundLustman, P. J., Griffith, L. S., Freedland, K. E., Kissel, S. S., & Clouse, R. E. (1998) · Annals of Internal Medicine · doi:10.7326/0003-4819-129-8-199810150-00005 · Cited by 562 · see citing works
Strine, T. W., Chapman, D. P., Balluz, L. S., Moriarty, D. G., & Mokdad, A. H. (2007) · Journal of Community Health · doi:10.1007/s10900-007-9066-4 · Cited by 496 · see citing works
Grant, N., Wardle, J., & Steptoe, A. (2009) · International Journal of Behavioral Medicine · doi:10.1007/s12529-009-9032-x · Cited by 486 · see citing works
Patients’ perceived barriers to active self-management of chronic conditions
Jerant, A. F., von Friederichs-Fitzwater, M. M., & Moore, M. (2004) · Patient Education and Counseling · doi:10.1016/j.pec.2004.08.004 · Cited by 472 · see citing works
Beratarrechea, A., Lee, A. G., Willner, J. M., Jahangir, E., Ciapponi, A., & Rubinstein, A. (2014) · Telemedicine and e-Health · doi:10.1089/tmj.2012.0328 · Cited by 403 · see citing works
Wang, Y., Xue, H., Huang, Y., Huang, L., & Zhang, D. (2017) · Advances in Nutrition · doi:10.3945/an.116.014100 · Cited by 310 · see citing works
Mehl, M. R., Vazire, S., Holleran, S. E., & Clark, C. S. (2010) · Psychological Science · doi:10.1177/0956797610362675 · Cited by 254 · see citing works
Mindfulness‐based stress reduction: A literature review and clinician’s guide
Praissman, S. (2008) · Journal of the American Academy of Nurse Practitioners · doi:10.1111/j.1745-7599.2008.00306.x · Cited by 250 · see citing works
Disseminating Self-Help: Positive Psychology Exercises in an Online Trial
Schueller, S. M., & Parks, A. C. (2012) · Journal of Medical Internet Research · doi:10.2196/jmir.1850 · Cited by 246 · cited 1× · see citing works
“Unlike most other interventions tested in person or digitally, which draw on just one theoretical approach, Happify Health activities draw from each of the three major theoretical approaches: CBT [50], MBSR [51], and PP [52-54].”
BackgroundSelf-citationSafren, S. A., Gonzalez, J. S., Wexler, D. J., Psaros, C., Delahanty, L. M., Blashill, A. J., Margolina, A. I., & Cagliero, E. (2013) · Diabetes Care · doi:10.2337/dc13-0816 · Cited by 233 · see citing works
Web-Based Depression Treatment for Type 1 and Type 2 Diabetic Patients
van Bastelaar, K. M. P., Pouwer, F., Cuijpers, P., Riper, H., & Snoek, F. J. (2011) · Diabetes Care · doi:10.2337/dc10-1248 · Cited by 209 · see citing works
Strandberg, R. B., Graue, M., Wentzel-Larsen, T., Peyrot, M., & Rokne, B. (2014) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2014.06.015 · Cited by 208 · see citing works
Positive affect uniquely predicts lower risk of mortality in people with diabetes.
Moskowitz, J. T., Epel, E. S., & Acree, M. (2008) · Health Psychology · doi:10.1037/0278-6133.27.1.s73 · Cited by 191 · see citing works
Self-citationThe cost of diabetes care-an elephant in the room
Riddle, M. C., & Herman, W. H. (2018) · Diabetes Care · doi:10.2337/dci18-0012 · Cited by 191 · see citing works
An online positive affect skills intervention reduces depression in adults with type 2 diabetes
Cohn, M. A., Pietrucha, M. E., Saslow, L. R., Hult, J. R., & Moskowitz, J. T. (2014) · The Journal of Positive Psychology · doi:10.1080/17439760.2014.920410 · Cited by 188 · see citing works
Self-citationFactors Associated With Adherence to Self-Monitoring of Blood Glucose Among Persons With Diabetes
Vincze, G., Barner, J. C., & Lopez, D. A. (2004) · The Science of Diabetes Self-Management and Care · doi:10.1177/014572170403000119 · Cited by 159 · see citing works
Warmerdam, L., Smit, F., van Straten, A., Riper, H., & Cuijpers, P. (2010) · Journal of Medical Internet Research · doi:10.2196/jmir.1436 · Cited by 158 · cited 1× · see citing works
“Internet-based interventions offer a cost-effective means of providing access to large populations [40], while also reducing some of the other barriers to seeking treatment by increasing convenience [41] and anonymity [42].”
BackgroundPiette, J. D., Richardson, C. R., & Valenstein, M. M. (2004) · PubMed · Cited by 146 · see citing works
Gerhards, S. A. H., Abma, T. A., Arntz, A., de Graaf, L. E., Evers, S. M. A. A., Huibers, M. J. H., & Widdershoven, G. A. M. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.09.012 · Cited by 141 · cited 1× · see citing works
“Internet-based interventions offer a cost-effective means of providing access to large populations [40], while also reducing some of the other barriers to seeking treatment by increasing convenience [41] and anonymity [42].”
BackgroundTemporal patterns of anxious and depressed mood in generalized anxiety disorder: a daily diary study
Starr, L. R., & Davila, J. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.11.005 · Cited by 134 · see citing works
Lloyd, C. E., Pambianco, G., & Orchard, T. J. (2010) · Diabetic Medicine · doi:10.1111/j.1464-5491.2009.02896.x · Cited by 112 · see citing works
Well-being interventions for individuals with diabetes: A systematic review
Massey, C. N., Feig, E. H., Duque-Serrano, L., Wexler, D., Moskowitz, J. T., & Huffman, J. C. (2019) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2018.11.014 · Cited by 96 · see citing works
Self-citationMurphy, M. E., Byrne, M., Galvin, R., Boland, F., Fahey, T., & Smith, S. M. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-015135 · Cited by 94 · see citing works
Li, C., Xu, D., Hu, M., Tan, Y., Zhang, P., Li, G., & Chen, L. (2017) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2017.02.006 · Cited by 90 · see citing works
Parks, A. C., Williams, A. L., Tugade, M. M., Hokes, K. E., Honomichl, R. D., & Zilca, R. D. (2018) · International Journal of Wellbeing · doi:10.5502/ijw.v8i2.745 · Cited by 87 · see citing works
Self-citationSnoek, F. J., van der Ven, N. C. W., Twisk, J. W. R., Hogenelst, M. H. E., Tromp‐Wever, A. M. E., van der Ploeg, H. M., & Heine, R. J. (2008) · Diabetic Medicine · doi:10.1111/j.1464-5491.2008.02595.x · Cited by 85 · see citing works
van Son, J., Nyklíček, I., Pop, V. J., Blonk, M. C., Erdtsieck, R. J., & Pouwer, F. (2014) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2014.03.013 · Cited by 82 · see citing works
Lewandowski, A. S., Palermo, T. M., Kirchner, H. L., & Drotar, D. (2009) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e3181965578 · Cited by 78 · see citing works
Ferrari, M., Cin, M. D., & Steele, M. C. (2017) · Diabetic Medicine · doi:10.1111/dme.13451 · Cited by 73 · see citing works
Positive Emotional Health and Diabetes Care: Concepts, Measurement, and Clinical Implications
Robertson, S. M., Stanley, M. A., Cully, J. A., & Naik, A. D. (2012) · Psychosomatics · doi:10.1016/j.psym.2011.09.008 · Cited by 69 · see citing works
Hadjiconstantinou, M., Byrne, J. L., Bodicoat, D. H., Robertson, N., Eborall, H., Khunti, K. K., & Davies, M. J. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5991 · Cited by 63 · see citing works
Carpenter, J. M., Crutchley, P., Zilca, R., Schwartz, H. A., Smith, L. K., Cobb, A. M., & Parks, A. C. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5725 · Cited by 58 · see citing works
Self-citationMai, Q., Holman, C. D. J., Sanfilippo, F. M., & Emery, J. D. (2011) · BMC Psychiatry · doi:10.1186/1471-244x-11-163 · Cited by 54 · see citing works
Ferwerda, M., van Beugen, S., van Burik, A., van Middendorp, H., de Jong, E. M. G. J., van de Kerkhof, P. C. M., van Riel, P. L. C. M., & Evers, A. W. M. (2013) · Clinical Rheumatology · doi:10.1007/s10067-013-2175-9 · Cited by 51 · see citing works
Summary of Diabetes Self-Care Activities Measure
Toobert, D. J., Hampson, S. E., & Glasgow, R. E. (2000) · PsycTESTS Dataset · doi:10.1037/t46178-000 · Cited by 50 · see citing works
Kopf, S., Oikonomou, D., Hartmann, M., Feier, F., Faude-Lang, V., Morcos, M., Häring, H.-U., Herzog, W., Bierhaus, A., Humpert, P., et al. (2014) · Experimental and Clinical Endocrinology & Diabetes · doi:10.1055/s-0034-1372583 · Cited by 48 · see citing works
Parks, A. C., Williams, A. L., Kackloudis, G. M., Stafford, J. L., Boucher, E. M., & Honomichl, R. D. (2019) · Journal of Medical Internet Research · doi:10.2196/16211 · Cited by 48 · see citing works
Self-citationvan Bastelaar, K. M. P., Cuijpers, P. J., Pouwer, F., Riper, H. M., & Snoek, F. J. (2010) · Patient Education and Counseling · doi:10.1016/j.pec.2010.06.013 · Cited by 41 · see citing works
Bogusch, L. M., & O'Brien, W. H. (2019) · Behavioral Medicine · doi:10.1080/08964289.2018.1432549 · Cited by 38 · cited 3× · see citing works
“Other research also suggested that mindfulness-based interventions have small to moderate effects on metabolic control [31].”
BackgroundLeyva, B., Zagarins, S., Allen, N. A., & Welch, G. W. (2011) · PubMed · Cited by 35 · see citing works
Shrestha, S. S., Zhang, P., HORA, I. A., Geiss, L. S., Luman, E. T., & Gregg, E. W. (2018) · Diabetes Care · doi:10.2337/dc18-1078 · Cited by 33 · see citing works
Guo, J., Wang, H., Luo, J., Guo, Y., Xie, Y., Lei, B., Wiley, J. A., & Whittemore, R. (2019) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2019-000757 · Cited by 27 · see citing works
Quinn, C. C., Swasey, K. K., Crabbe, J. C. F., Shardell, M. D., Terrin, M. L., Barr, E. A., & Gruber‐Baldini, A. L. (2017) · JMIR mhealth and uhealth · doi:10.2196/mhealth.8910 · Cited by 25 · see citing works
Trends in Diabetes-Related Preventable Hospitalizations in the U.S., 2005–2014
Rubens, M., Saxena, A., Ramamoorthy, V., Khera, R., Hong, J. C., Veledar, E., & Nasir, K. (2018) · Diabetes Care · doi:10.2337/dc17-1942 · Cited by 22 · see citing works
Carpenter, J. M., Crutchley, P., Zilca, R., Schwartz, H. A., Smith, L. K., Cobb, A. M., & Parks, A. C. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.8099 · Cited by 13 · see citing works
Self-citation(2003) · PsycEXTRA Dataset · doi:10.1037/e480062006-001 · Cited by 13 · see citing works
Clinical Psychological Science Editorial
Kazdin, A. E. (2013) · Clinical Psychological Science · doi:10.1177/2167702613514513 · Cited by 4 · see citing works
Polonsky, W. H., Fisher, L., Earles, J. E., Dudl, R. J., Lees, J. A., Mullan, J., & Jackson, R. A. (2005) · PsycTESTS Dataset · doi:10.1037/t01297-000 · Cited by 3 · see citing works
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Lutz, J., Offidani, E., Taraboanta, L., Lakhan, S. E., & Campellone, T. R. (2022) · Frontiers in Digital Health · doi:10.3389/fdgth.2022.823977 · Cited by 89 · see citing works
Wani, C., McCann, L., Lennon, M., & Radu, C. (2024) · Journal of Medical Internet Research · doi:10.2196/51376 · Cited by 75 · see citing works
The Nexus Between Diabetes and Depression: A Narrative Review
Habib, S., Sangaraju, S. L., Yepez, D., Grandes, X. A., & Manjunatha, R. T. (2022) · Cureus · doi:10.7759/cureus.25611 · Cited by 33 · see citing works
Romagnoli, A., Zovi, A., Sabbatucci, M., Ferrara, F., & Vitiello, A. (2023) · Journal of Interprofessional Education & Practice · doi:10.1016/j.xjep.2023.100656 · Cited by 7 · see citing works
Romagnoli, A., Valentino, F., Zovi, A., Caprodossi, A., Vitiello, A., & Ferrara, F. (2023) · Journal of Pharmaceutical Innovation · doi:10.1007/s12247-023-09767-w · Cited by 4 · see citing works
Digital Psychiatry for the Treatment of Comorbid Disorders
Orsolini, L., Fiorani, M., Longo, G., & Volpe, U. (2025) · Springer eBooks · doi:10.1007/978-3-031-81802-8_20
- Authors
- Boucher, E., Moskowitz, J. T., Kackloudis, G. M., Stafford, J. L., Kwok, I., & Parks, A. C.
- Affiliations
- Northwestern University (US)
- Corresponding author
- Boucher, Eliane
- Venue
- JMIR Research Protocols
- Publisher
- JMIR Publications Inc.
- Published
- 2020-08-04
- Volume
- 9
- Issue
- 8
- Pages
- e18578
- ISSN
- 1929-0748 (ISSN-L)
- PMC
- PMC7435623
- OpenAlex
- W3022979516
- Cited by
- 6
- References
- 82
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 2
- FWCI
- 0.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Research Protocols (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- digital mental health interventions, depression, positive emotion regulation, positive affect, HbA1c, glycemic control, medication adherence, diabetes self-care, diabetes distress, mood, long-term follow-up, smartphone-based intervention, psychoeducation, diabetes management, adults with diabetes
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.
What counts as a claim ›How we measure confidence ›How we check this ›
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