JMIR Publications

ABSTRACT

Background:

Adolescent depression is a large and growing problem, yet access to effective mental healthcare continues to be a challenge. Digitally-based interventions may serve to bridge this access gap for adolescents in need of care.

Objective:

To evaluate the feasibility, acceptability, and preliminary efficacy of Spark (v1.0) , a 5-week, self-guided, cognitive-behavioral therapy (CBT)-based digital program employing mobile app and virtual reality (VR) experiences to target symptoms of depression in adolescents.

Methods:

A single-arm, open-label study of the Spark program with a community sample of thirty adolescents (ages 12-21) with self-reported moderate to severe depression symptoms was conducted. Participants completed a weekly depression assessment (8-item Patient Health Questionnaire, PHQ-8) in the app during the intervention period as well as web-based baseline, post-intervention, and 1-month follow-up self-report assessments. Participants also completed a post-intervention qualitative interview. Caregivers of participants under 18 completed baseline and post-intervention assessments. Feasibility outcomes included recruitment and retention rates. Acceptability outcomes included engagement with the program and quantitative and qualitative feedback about the program. Efficacy was evaluated based on the PHQ-8.

Results:

Study recruitment (47%) and retention (97%) rates were high. Participants highly rated 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, while providing more moderate ratings of 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 post-intervention (mean difference = 5.36, p <.001) and 1-month follow-up (mean difference = 6.44, p <.001).

Conclusions:

Preliminary data indicated that Spark reduced symptoms of depression in adolescents. The Spark program was also found to be a feasible and acceptable way to deliver a self-guided CBT-focused intervention to adolescents with symptoms of depression. Clinical Trial: This study was registered on clinicaltrials.gov (NCT04165681).