Evaluating a Mobile App for Students Seeking Care for Depression and Anxiety at Harvard University Health Services
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|ClinicalTrials.gov Identifier: NCT03552900|
Recruitment Status : Not yet recruiting
First Posted : June 12, 2018
Last Update Posted : September 13, 2019
There is a growing demand for mental health services on college campuses. At the same time there has been a dramatic surge in development of mobile mental health apps. Given the widespread popularity and utilization of mobile apps in the college-age population, there is an opportunity to leverage these tools to improve services. The study aims to evaluate the effects of a mobile app on reducing symptoms of depression and anxiety for students awaiting their first visit at Harvard Counseling and Mental Health Services (CAMHS), and on enhancing recovery after beginning treatment.
Students seeking an appointment at Harvard CAMHS who meet eligibility criteria will be randomized to receive one of two apps: an app offering direct online social support (7cups) or an app that provides information about mental health resources on campus (Bliss). Participants will complete a baseline assessment using the PHQ-9 and GAD-7 and a measure of perceived social support. They will be asked to use their assigned app while awaiting their intake appointment and during treatment. The primary endpoint will be at 2 weeks after enrollment and the secondary endpoints at 4, 8- and 12 weeks after enrollment. At all endpoints participants will complete a PHQ-9, GAD-7 and a survey assessing their experience with the app. At the 8-week endpoint they will also be asked about their overall satisfaction with their care and their perceived social support.
Feasibility and acceptability of the app will be evaluated by analyzing usage metrics of the 7cups app, self-report satisfaction questionnaire as well as trial adherence. Changes in PHQ-9 and GAD-7 scores between the two groups at baseline, primary and secondary endpoints will be analyzed as well as associations between PHQ-9, GAD-7 scores and patient socio-demographic and social support variables. Mediators of change in symptoms including frequency of use, activities used on app and perceived social support will also be analyzed.
|Condition or disease||Intervention/treatment||Phase|
|Depression, Anxiety||Behavioral: 7 Cups Mobile App Behavioral: Bliss Mobile App||Not Applicable|
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||250 participants|
|Intervention Model:||Parallel Assignment|
|Intervention Model Description:||Participants will be randomly assigned to one of two study groups and assigned to one of two different mobile apps|
|Masking Description:||Participants will not be masked to their mobile app however investigators conducting data analysis will be blinded to which participants were assigned to which app|
|Official Title:||Evaluating the Use of a Mobile App to Reduce Symptoms of Depression and Anxiety for Students Seeking Care at Harvard University Health Services|
|Estimated Study Start Date :||October 15, 2019|
|Estimated Primary Completion Date :||July 31, 2020|
|Estimated Study Completion Date :||December 31, 2020|
Active Comparator: App 1 Study group (7 Cups)
Participants assigned to this group will be assigned a behavioral intervention, the mobile app ("7 Cups") which allows participants access to direct online social support via the app.
Behavioral: 7 Cups Mobile App
Participants who receive the 7 Cups mobile app will get access to direct online social support by messaging with a listener, participating in group chats as well as evidence-based information and exercises to promote their mental health.
Active Comparator: App 2 Study Group (Bliss)
Participants assigned to this group will be assigned to a behavioral intervention, the mobile app ("Bliss") which provides participants an informational app about mental health resources at Harvard.
Behavioral: Bliss Mobile App
Participants who receive the Bliss mobile app will get access to an app that that provides information and offers a personal approach to navigate through mental health resources on Harvard's campus.
- Patient Health Questionnaire - 9 (PHQ-9) [ Time Frame: At two weeks after enrollment, participants will receive an email to complete the PHQ-9 and GAD-7, which will serve as the primary outcome measure of the study. ]
The PHQ-9 is a 9-question multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression.
The Patient Health Questionnaire (PHQ-9) Scoring:
Scoring: 0-3 Scale for each item; 0 Not at all; 3 Nearly every day
The nine item version of the Patient Health Questionnaire (PHQ-9) was designed to facilitate the recognition and diagnosis of depression in primary care patients. It can be used to monitor change in symptoms over time and provides a depression severity index score as follows:
0-4 None 5-9 Mild 10 - 14 Moderate 15 - 19 Moderately Severe 20 - 27 Severe
The recommended cut-off for the PHQ-9 severity index is a score of 9. Anyone who scores 10 or above can be considered to be suffering from clinically signicant symptoms of depression.
- Generalized Anxiety Disorder 7-item scale (GAD-7) [ Time Frame: At two weeks after enrollment, participants will receive an email to complete the PHQ-9 and GAD-7, which will serve as the primary outcome measure of the study. ]
The GAD-7 is a 7 item instrument for screening and severity measuring of generalized anxiety disorder (GAD).
Scoring: 0-3 Scale for each item; 0 Not at all; 3 Nearly every day
The index scores are as follows:
0-4 None 5-10 Mild Anxiety 11 - 15 Moderate Anxiety 15 - 21 Severe Anxiety
The recommended cut off for the GAD-7 severity index is a score of 7. Anyone who scores 8 or above can be considered to be suffering from clinically significant anxiety symptoms.
- Multidimensional Scale of Perceived Social Support [ Time Frame: Participants will receive this instrument at baseline, and at the 4 and 8-week endpoint. ]
Instrument to assess participant's perceived social support. Includes 12 questions where participants rate their responses on a scale of 1 to 7 ("1" Very Strongly Disagree, "2" Strongly Disagree, "3" Mildly Disagree, "4" Neutral, "5" Mildly Agree, "6" Strongly Agree "7" Very Strongly Agree).
The items can be divided into subgroups relating to the source of social support, namely family (Fam), friends (Fri) or significant other (SO).
Scoring Information: To calculate mean scores:
Significant Other Subscale: Sum across items 1, 2, 5, & 10, then divide by 4. Family Subscale: Sum across items 3, 4, 8, & 11, then divide by 4. Friends Subscale: Sum across items 6, 7, 9, & 12, then divide by 4. Total Scale: Sum across all 12 items, then divide by 12.
The 12-item MSPSS scale has a mean continuous score ranging from 1-84. Higher scores indicate greater perceived social support.
- Client Satisfaction Questionnaire (CSQ-8) [ Time Frame: Participants will receive a survey to complete this questionnaire at the 8 week endpoint ]
Questionnaire to assess patient satisfaction with care.
The CSQ-8 is a brief measure to assess patients' satisfaction the service they received from university health services. CSQ-8 is an 8-item scale with scores that range from 8 to 32, with higher values indicating higher satisfaction.
- Participant Experience Survey [ Time Frame: Participants will receive a survey to complete this questionnaire at the 2, 4, 8 and 12 week endpoint ]12-item questionnaire to measure participant's qualitative experiences with their assigned mobile app including overall utility, what activities were most used, help achieving goals, etc.
- Secondary Process Outcome Survey [ Time Frame: Participants will receive a survey to complete this questionnaire at the 4 and 8 week endpoint ]4 items to assess participants' use of other forms of care during the study including urgent mental health care, primary care and seeking help from others
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03552900
|Contact: Leslie Tarver, MD||617 email@example.com|
|Contact: Sheena Wood, BAfirstname.lastname@example.org|
|United States, Massachusetts|
|Harvard University Health Services|
|Cambridge, Massachusetts, United States, 02138|
|Contact: Paul Barreira, MD 617-495-5711|
|Contact: Leslie Tarver, MD 617 495-5711 email@example.com|
|Principal Investigator:||Leslie Tarver, MD||Harvard University|
|Study Director:||Paul Barreira, MD||Harvard University|