Randomized trial of a computer-tailored intervention for patients with depression
Open accessAbstract
PURPOSE. Examine the efficacy of a computer-tailored intervention (CTI) based on the transtheoretical model (TTM) for reducing depression, an increasingly important component of health promotion programs. DESIGN. Pretest-posttest randomized trial. Setting . Participants were recruited and treated at home after being identified in two primary care clinics in Eastern Massachusetts and Chicago, Illinois. SUBJECTS. A total of 350 adults experiencing at least mild symptoms of depression but not involved in or planning to seek treatment for depression. INTERVENTION. A print manual and three CTI reports tailored to stage of change for using effective methods to prevent or reduce depression, other TTM variables, level of depression, and behavior. . Pre-post changes and reliable and clinically significant change on the Beck Depression scale II and pre-post changes on the 20-item Medical Outcomes Study Short Form survey-based measure of physical functioning at 9 months' follow-up. ANALYSIS. t-tests and χ(2) tests. Complete-case analysis and two intention-to-treat analyses-assumption of no change and multiple imputation (MI)-are reported. Exploratory analyses examined whether the effects of the intervention on depression were moderated by five subject characteristics: baseline level of depression, baseline level of physical functioning, baseline stage of change for preventing or managing depression, age, and education. RESULTS. Complete-case and intention-to-treat analyses showed that the intervention group experienced significantly greater improvements in depression (d = .220-.355); results for physical functioning were weaker (d = .150-.309) and did not reach statistical significance in the MI analysis. The effects of the intervention on reliable and clinically significant change in depression were largest among participants who were experiencing moderate depression (d = .363-.519) or severe depression (d = .603-.718) or who were in the precontemplation or contemplation stage (d = .573-.856) at baseline.
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- Authors
- Levesque, D. A., Van Marter, D. F., Schneider, R. J., Bauer, M. R., Goldberg, D. N., Prochaska, J. O., & Prochaska, J. M.
- Affiliations
- Harvard University (US)
- Deborah A. Levesque, PhD; Deborah F. Van Marter, MPH; and Janice M. Prochaska, PhD, are with Pro-Change Behavior Systems Incorporated, West Kingston, Rhode Island. Robert J. Schneider, EdD, is with Harvard Vanguard Medical Associates, Braintree, Massachusetts. Mark R. Bauer, MD, is with Harvard Vanguard Medical Associates, Watertown, Massachusetts. David N. Goldberg, MD, is with John Stroger Hospital of Cook County, Chicago, Illinois. James O. Prochaska, PhD, is with the University of Rhode Island Cancer...
- Corresponding author
- Levesque, Deborah A.
- Venue
- American Journal of Health Promotion
- Publisher
- SAGE Publications
- Published
- 2011-11
- Volume
- 26
- Issue
- 2
- Pages
- 77-89
- ISSN
- 0890-1171 (ISSN-L)
- 2168-6602
- OpenAlex
- W2048213695
- Cited by
- 50
- References
- 77
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 6 · 2021: 6 · 2020: 5 · 2019: 4 · 2018: 3 · 2017: 2 · 2016: 6 · 2015: 3 · 2014: 1 · 2013: 5 · 2012: 1
- FWCI
- 3.06
- Type
- journal article
- Language
- en
- Open access
- Locations
- American Journal of Health Promotion (publishedVersion)
- PubMed (publishedVersion)
- Journal of Media Literacy Education (submittedVersion, cc-by)
- Funders
- National Institutes of Health (5r44mh060522-03)
- National Institute of Mental Health (R44MH60522)
- 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
- computer-tailored intervention, depression, transtheoretical model, stages of change, mild to moderate depression, primary care, physical function, health promotion, precontemplation, contemplation
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Depression, Diagnosis, Computer-Assisted, Female, Health Promotion, Health Surveys, Humans, Illinois, Male, Massachusetts, Middle Aged, Models, Psychological, Psychometrics, Surveys and Questionnaires, Time Factors, United States, Chi-Square Distribution, Decision Support Systems, Clinical, Social Marketing, Young Adult
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.
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