A Randomized Controlled Trial Evaluating a Manualized TeleCoaching Protocol for Improving Adherence to a Web-Based Intervention for the Treatment of Depression
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{"title"=>"A Randomized Controlled Trial Evaluating a Manualized TeleCoaching Protocol for Improving Adherence to a Web-Based Intervention for the Treatment of Depression", "type"=>"journal", "authors"=>[{"first_name"=>"David C.", "last_name"=>"Mohr", "scopus_author_id"=>"55614489700"}, {"first_name"=>"Jenna", "last_name"=>"Duffecy", "scopus_author_id"=>"25228229300"}, {"first_name"=>"Joyce", "last_name"=>"Ho", "scopus_author_id"=>"23090934600"}, {"first_name"=>"Mary", "last_name"=>"Kwasny", "scopus_author_id"=>"14519611300"}, {"first_name"=>"Xuan", "last_name"=>"Cai", "scopus_author_id"=>"55830551400"}, {"first_name"=>"Michelle Nicole", "last_name"=>"Burns", "scopus_author_id"=>"26031955600"}, {"first_name"=>"Mark", "last_name"=>"Begale", "scopus_author_id"=>"36766824700"}], "year"=>2013, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"369619779", "sgr"=>"84882672840", "issn"=>"19326203", "pmid"=>"23990896", "scopus"=>"2-s2.0-84882672840", "doi"=>"10.1371/journal.pone.0070086", "isbn"=>"1932-6203"}, "id"=>"5bfa7238-bab7-3745-a862-1417148dc3a1", "abstract"=>"BACKGROUND: Web-based interventions for depression that are supported by coaching have generally produced larger effect-sizes, relative to standalone web-based interventions. This is likely due to the effect of coaching on adherence. We evaluated the efficacy of a manualized telephone coaching intervention (TeleCoach) aimed at improving adherence to a web-based intervention (moodManager), as well as the relationship between adherence and depressive symptom outcomes.\\n\\nMETHODS: 101 patients with MDD, recruited from primary care, were randomized to 12 weeks moodManager+TeleCoach, 12 weeks of self-directed moodManager, or 6 weeks of a waitlist control (WLC). Depressive symptom severity was measured using the PHQ-9.\\n\\nRESULTS: TeleCoach+moodManager, compared to self-directed moodManager, resulted in significantly greater numbers of login days (p = 0.01), greater time until last use (p = 0.007), greater use of lessons (p = 0.03), greater variety of interactive tools used (p = 0.02), but total instances of tool use did not reach statistical significance. (p = 0.07). TeleCoach+moodManager produced significantly lower PHQ-9 scores relative to WLC at week 6 (p = 0.04), but there were no other significant differences in PHQ-9 scores at weeks 6 or 12 (ps>0.20) across treatment arms. Baseline PHQ-9 scores were no significantly related to adherence to moodManager.\\n\\nCONCLUSIONS: TeleCoach produced significantly greater adherence to moodManager, relative to self-directed moodManager. TeleCoached moodManager produced greater reductions in depressive symptoms relative to WLC, however, there were no statistically significant differences relative to self-directed moodManager. While greater use was associated with better outcomes, most users in both TeleCoach and self-directed moodManager had dropped out of treatment by week 12. Even with telephone coaching, adherence to web-based interventions for depression remains a challenge. Methods of improving coaching models are discussed.\\n\\nTRIAL REGISTRATION: Clinicaltrials.gov NCT00719979.", "link"=>"http://www.mendeley.com/research/randomized-controlled-trial-evaluating-manualized-telecoaching-protocol-improving-adherence-webbased-1", "reader_count"=>80, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Professor > Associate Professor"=>1, "Researcher"=>16, "Student > Doctoral Student"=>5, "Student > Ph. D. Student"=>13, "Student > Postgraduate"=>2, "Other"=>6, "Student > Master"=>20, "Student > Bachelor"=>9, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>2, "Professor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Professor > Associate Professor"=>1, "Researcher"=>16, "Student > Doctoral Student"=>5, "Student > Ph. D. Student"=>13, "Student > Postgraduate"=>2, "Other"=>6, "Student > Master"=>20, "Student > Bachelor"=>9, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>2, "Professor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>7, "Engineering"=>1, "Nursing and Health Professions"=>3, "Medicine and Dentistry"=>13, "Agricultural and Biological Sciences"=>3, "Neuroscience"=>1, "Psychology"=>40, "Social Sciences"=>7, "Computer Science"=>4, "Linguistics"=>1}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>13}, "Neuroscience"=>{"Neuroscience"=>1}, "Social Sciences"=>{"Social Sciences"=>7}, "Psychology"=>{"Psychology"=>40}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Computer Science"=>{"Computer Science"=>4}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}, "Linguistics"=>{"Linguistics"=>1}, "Unspecified"=>{"Unspecified"=>7}}, "reader_count_by_country"=>{"Norway"=>1, "United States"=>1, "Ireland"=>1, "United Kingdom"=>2, "Italy"=>1}, "group_count"=>15}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1178362"], "description"=>"*<p>Ethnicity had 4 cases not replied.</p>**<p>Race had 1 case not replied.</p>***<p>Employment had 8 cases not replied.</p>****<p>Marital status had 2 cases not replied.</p>", "links"=>[], "tags"=>["Mental health", "psychiatry", "Mood disorders", "psychology", "behavior", "emotions", "Clinical psychology", "therapies"], "article_id"=>779285, "categories"=>["Medicine", "Sociology"], "users"=>["David C. Mohr", "Jenna Duffecy", "Joyce Ho", "Mary Kwasny", "Xuan Cai", "Michelle Nicole Burns", "Mark Begale"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0070086.t001", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Baseline_Participant_Characteristics_/779285", "title"=>"Baseline Participant Characteristics.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-08-21 02:09:46"}
  • {"files"=>["https://ndownloader.figshare.com/files/1178363", "https://ndownloader.figshare.com/files/1178364"], "description"=>"<div><p>Background</p><p>Web-based interventions for depression that are supported by coaching have generally produced larger effect-sizes, relative to standalone web-based interventions. This is likely due to the effect of coaching on adherence. We evaluated the efficacy of a manualized telephone coaching intervention (TeleCoach) aimed at improving adherence to a web-based intervention (moodManager), as well as the relationship between adherence and depressive symptom outcomes.</p><p>Methods</p><p>101 patients with MDD, recruited from primary care, were randomized to 12 weeks moodManager+TeleCoach, 12 weeks of self-directed moodManager, or 6 weeks of a waitlist control (WLC). Depressive symptom severity was measured using the PHQ-9.</p><p>Results</p><p>TeleCoach+moodManager, compared to self-directed moodManager, resulted in significantly greater numbers of login days (<i>p</i> = 0.01), greater time until last use (<i>p</i> = 0.007), greater use of lessons (<i>p</i> = 0.03), greater variety of interactive tools used (<i>p</i> = 0.02), but total instances of tool use did not reach statistical significance. (<i>p</i> = 0.07). TeleCoach+moodManager produced significantly lower PHQ-9 scores relative to WLC at week 6 (<i>p</i> = 0.04), but there were no other significant differences in PHQ-9 scores at weeks 6 or 12 (<i>p</i>s>0.20) across treatment arms. Baseline PHQ-9 scores were no significantly related to adherence to moodManager.</p><p>Conclusions</p><p>TeleCoach produced significantly greater adherence to moodManager, relative to self-directed moodManager. TeleCoached moodManager produced greater reductions in depressive symptoms relative to WLC, however, there were no statistically significant differences relative to self-directed moodManager. While greater use was associated with better outcomes, most users in both TeleCoach and self-directed moodManager had dropped out of treatment by week 12. Even with telephone coaching, adherence to web-based interventions for depression remains a challenge. Methods of improving coaching models are discussed.</p><p>Trial Registration</p><p>Clinicaltrials.gov <a href=\"http://clinicaltrials.gov/ct2/show/NCT00719979?term=NCT00719979&rank=1\" target=\"_blank\">NCT00719979</a></p></div>", "links"=>[], "tags"=>["Mental health", "psychiatry", "Mood disorders", "psychology", "behavior", "emotions", "Clinical psychology", "therapies", "randomized", "controlled", "evaluating", "manualized", "telecoaching", "improving", "adherence", "web-based"], "article_id"=>779286, "categories"=>["Medicine", "Sociology"], "users"=>["David C. Mohr", "Jenna Duffecy", "Joyce Ho", "Mary Kwasny", "Xuan Cai", "Michelle Nicole Burns", "Mark Begale"], "doi"=>["https://dx.doi.org/10.1371/journal.pone.0070086.s001", "https://dx.doi.org/10.1371/journal.pone.0070086.s002"], "stats"=>{"downloads"=>2, "page_views"=>16, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_A_Randomized_Controlled_Trial_Evaluating_a_Manualized_TeleCoaching_Protocol_for_Improving_Adherence_to_a_Web_Based_Intervention_for_the_Treatment_of_Depression_/779286", "title"=>"A Randomized Controlled Trial Evaluating a Manualized TeleCoaching Protocol for Improving Adherence to a Web-Based Intervention for the Treatment of Depression", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2013-08-21 02:09:46"}
  • {"files"=>["https://ndownloader.figshare.com/files/1178360"], "description"=>"<p>Least square means and standard errors for PHQ-9 depression symptom severity scores.</p>", "links"=>[], "tags"=>["Mental health", "psychiatry", "Mood disorders", "psychology", "behavior", "emotions", "Clinical psychology", "therapies", "means", "errors", "phq-9", "severity"], "article_id"=>779283, "categories"=>["Medicine", "Sociology"], "users"=>["David C. Mohr", "Jenna Duffecy", "Joyce Ho", "Mary Kwasny", "Xuan Cai", "Michelle Nicole Burns", "Mark Begale"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0070086.t003", "stats"=>{"downloads"=>0, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Least_square_means_and_standard_errors_for_PHQ_9_depression_symptom_severity_scores_/779283", "title"=>"Least square means and standard errors for PHQ-9 depression symptom severity scores.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-08-21 02:09:46"}
  • {"files"=>["https://ndownloader.figshare.com/files/1178361"], "description"=>"<p>Intervention Adherence.</p>", "links"=>[], "tags"=>["Mental health", "psychiatry", "Mood disorders", "psychology", "behavior", "emotions", "Clinical psychology", "therapies"], "article_id"=>779284, "categories"=>["Medicine", "Sociology"], "users"=>["David C. Mohr", "Jenna Duffecy", "Joyce Ho", "Mary Kwasny", "Xuan Cai", "Michelle Nicole Burns", "Mark Begale"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0070086.t002", "stats"=>{"downloads"=>1, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Intervention_Adherence_/779284", "title"=>"Intervention Adherence.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2013-08-21 02:09:46"}
  • {"files"=>["https://ndownloader.figshare.com/files/1178359"], "description"=>"<p>Flow of study participants through the trial.</p>", "links"=>[], "tags"=>["Mental health", "psychiatry", "Mood disorders", "psychology", "behavior", "emotions", "Clinical psychology", "therapies"], "article_id"=>779282, "categories"=>["Medicine", "Sociology"], "users"=>["David C. Mohr", "Jenna Duffecy", "Joyce Ho", "Mary Kwasny", "Xuan Cai", "Michelle Nicole Burns", "Mark Begale"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0070086.g001", "stats"=>{"downloads"=>0, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flow_of_study_participants_through_the_trial_/779282", "title"=>"Flow of study participants through the trial.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-08-21 02:09:46"}

PMC Usage Stats | Further Information

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Relative Metric

{"start_date"=>"2013-01-01T00:00:00Z", "end_date"=>"2013-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Engineering and technology", "average_usage"=>[254, 440, 558, 675, 785, 883, 972, 1061, 1154, 1248, 1336, 1414, 1489]}, {"subject_area"=>"/Engineering and technology/Telecommunications", "average_usage"=>[254, 376, 524, 661, 765, 841, 926, 1024, 1120, 1183, 1249, 1301, 1350, 1421]}, {"subject_area"=>"/Medicine and health sciences/Health care", "average_usage"=>[278, 463, 587, 692, 804, 897, 984, 1068, 1165, 1254, 1339, 1429, 1490]}, {"subject_area"=>"/Medicine and health sciences/Mental health and psychiatry", "average_usage"=>[282, 468, 596, 706, 804, 895, 1000, 1081, 1175, 1272, 1356, 1445, 1531]}]}
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