Self-guided digital intervention for depression in adolescents: feasibility and preliminary efficacy study
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Abstract
Background: Depression in adolescents is a large and growing problem; however, access to effective mental health care continues to be a challenge. Digitally based interventions may serve to bridge this access gap for adolescents in need of care. Digital interventions that deliver components of cognitive behavioral therapy (CBT) have been shown to reduce symptoms of depression, and virtual reality (VR) may be a promising adjunctive component. However, research on these types of treatments in adolescents and young adults is limited. Objective: This study aims to evaluate the feasibility, acceptability, and preliminary efficacy of Spark (v1.0), a 5-week, self-guided, CBT-based digital program using a mobile app and VR experiences to target symptoms of depression in adolescents. Methods: A single-arm, open-label study of the Spark program was conducted with a community sample of 30 adolescents and young adults aged 12 to 21 years with self-reported moderate to severe depression symptoms. Participants completed a weekly depression assessment (Patient Health Questionnaire-8) in the app during the 5-week intervention period as well as web-based baseline, postintervention, and 1-month follow-up self-report assessments. The participants also completed a qualitative postintervention interview. For participants aged <18 years, caregivers completed assessments at baseline and postintervention time points. Feasibility outcomes included recruitment rate (the proportion of participants who enrolled in the study divided by the total number of participants screened for eligibility) and retention rate (the proportion of participants who completed postintervention assessments divided by the total number of participants who received the intervention). Acceptability outcomes included engagement with the program and quantitative and qualitative feedback about the program. Preliminary efficacy was evaluated based on the Patient Health Questionnaire-8. Results: The study recruitment (31/66, 47%) and retention (29/30, 97%) rates were high. Participants provided higher ratings for the ease of use of the Spark program (8.76 out of 10) and their enjoyment of both the mobile app (7.00 out of 10) and VR components (7.48 out of 10) of the program, whereas they provided lower ratings for the program’s ability to improve mood (4.38 out of 10) or fit into their daily routines (5.69 out of 10). We observed a clinically and statistically significant reduction in depression scores at postintervention (mean difference 5.36; P<.001) and 1-month follow-up (mean difference 6.44; P<.001) time points. Conclusions: The Spark program was found to be a feasible and acceptable way to deliver a self-guided CBT-focused intervention to adolescents and young adults with symptoms of depression. Preliminary data also indicated that the Spark program reduced the symptoms of depression in adolescents and young adults. Future studies should evaluate the efficacy of this intervention in an adequately powered randomized controlled trial. Trial Registration: ClinicalTrials.gov NCT04165681; https://classic.clinicaltrials.gov/ct2/show/NCT04165681
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Ease of use and user-friendly interfaces significantly impact adolescents' willingness to adopt and continue using digital interventions.
“Studies show that ease of use and user-friendly interfaces significantly impact adolescents’ willingness to adopt and continue using digital interventions (82).”
From Recent developments in bibliotherapy for adolescent depression (2025) · cites this paper as [82]
The Discussion (Principal Findings; page unavailable) reports high ease-of-use ratings and calls ease of use critical for a self-guided program. The paper does not establish that ease of use or a user-friendly interface significantly affects adolescents’ willingness to adopt or continue using digital interventions. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe Spark program improved user participation through intuitive interfaces and engaging interactive elements.
“For example, the Spark program improved user participation through intuitive interfaces and engaging interactive elements (82).”
From Recent developments in bibliotherapy for adolescent depression (2025) · cites this paper as [82]
The Results (Postintervention Questionnaire Feedback; page not specified) report high ease-of-use ratings, and the Discussion (Principal Findings; page not specified) says participants enjoyed aspects of the app including interactivity. The paper does not establish that those features improved participation; interviewees also asked for more interactivity. (LLM, conf=0.86)
Experimental — accuracy not yet measured
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Research works printed but not linked: 1
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Digital Mental Health Interventions for Young People Aged 16-25 Years: Scoping Review
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- Authors
- Miller, I., Peake, E., Strauss, G., Vierra, E., Koepsell, X., Shalchi, B., Padmanabhan, A., & Lake, J.
- Affiliations
- Big Health Inc. (United States) (US)
- Corresponding author
- Lake, Jessica
- ORCID
- Venue
- JMIR Formative Research
- Publisher
- JMIR Publications Inc.
- Published
- 2023-11-22
- Volume
- 7
- Pages
- e43260
- ISSN
- 2561-326X (ISSN-L)
- PMC
- PMC10701656
- OpenAlex
- W4385254700
- Cited by
- 19
- References
- 96
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 2 · 2023: 1
- FWCI
- 4.90
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Formative Research (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
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- adolescent depression, cognitive behavioral therapy, virtual reality, mobile application, SPARK program, feasibility, acceptability, depressive symptoms, adolescents and young adults, access to mental health care, treatment retention, caregiver-reported outcomes, mood improvement, suicide prevention, suicide risk screening
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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.
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