JMIR Publications

ABSTRACT

Background:

Technology-based mental health interventions are an increasingly attractive option for expanding access to mental health services within the primary care system. Older adults are among the groups that could potentially benefit from the growing ubiquity of technology-based mental health interventions, yet older adults are assumed to be averse to using technology and have reported barriers to use.

Objective:

The purpose of this paper is to present a case study of three participants from a clinical trial evaluating IntelliCare, an evidence-based mobile intervention for depression and anxiety, among adults recruited from primary care clinics. Our report of these three participants, who were aged 60 and older, focuses on their engagement with the IntelliCare service (i.e., app usage, coach communication) and clinical changes in depression symptoms over the 8-week intervention period.

Methods:

All study participants were offered IntelliCare. The intervention was comprised of five treatment intervention apps that support a variety of psychological skills, a Hub app that contained psychoeducational content and administered weekly PHQ-8 assessments, and coaching for encouragement, accountability, and technical assistance as needed. The case studies were selected to reflect the overall demographics of participants within the trial and because their interactions with IntelliCare provide a good illustration of varied experiences regarding engagement with the intervention.

Results:

The three participants’ unique experiences with the intervention are described. Despite potential barriers and experiencing some technical glitches, the participants showed proficient ability to use the apps, high levels of participation through frequent app use and coach interaction, and decreased depression scores through the intervention. At the end of the 8-week intervention, each of these participants expressed a high enthusiasm for the benefit of this program through feedback to their coach, and they each identified a number of ways they had seen improvements in themselves.

Conclusions:

These cases provide preliminary support that older individuals can effectively engage with and benefit from IntelliCare. Although results from these three cases may not generalize to others, they provide an important, informed perspective of the experiences that can contribute to our understanding of how older adults use and overcome barriers to mental health technologies. Findings also contribute toward the ultimate goal of ensuring the IntelliCare intervention is appropriate for individuals of all ages.