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Clinical Trial
. 2009 Feb;30(1):23-37.
doi: 10.1097/DBP.0b013e3181966c2a.

Randomized clinical trial of an Internet-based depression prevention program for adolescents (Project CATCH-IT) in primary care: 12-week outcomes

Benjamin W Van Voorhees  1 , Joshua Fogel, Mark A Reinecke, Tracy Gladstone, Scott Stuart, Jackie Gollan, Nathan Bradford, Rocco Domanico, Blake Fagan, Ruth Ross, Jon Larson, Natalie Watson, Dave Paunesku, Stephanie Melkonian, Sachiko Kuwabara, Tim Holper, Nicholas Shank, Donald Saner, Amy Butler, Amy Chandler, Tina Louie, Cynthia Weinstein, Shannon Collins, Melinda Baldwin, Abigail Wassel, Karin Vanderplough-Booth, Jennifer Humensky, Carl Bell
Affiliations
Clinical Trial

Randomized clinical trial of an Internet-based depression prevention program for adolescents (Project CATCH-IT) in primary care: 12-week outcomes

Benjamin W Van Voorhees et al. J Dev Behav Pediatr. 2009 Feb.

Abstract

Objective: The authors sought to evaluate 2 approaches with varying time and complexity in engaging adolescents with an Internet-based preventive intervention for depression in primary care. The authors conducted a randomized controlled trial comparing primary care physician motivational interview (MI, 5-10 minutes) + Internet program versus brief advice (BA, 1-2 minutes) + Internet program.

Setting: Adolescent primary care patients in the United States, aged 14 to 21 years.

Participants: Eighty-four individuals (40% non-white) at increased risk for depressive disorders (subthreshold depressed mood >3-4 weeks) were randomly assigned to either the MI group (n = 43) or the BA group (n = 40).

Main outcome measures: Patient Health Questionnaire-Adolescent and Center for Epidemiologic Studies Depression Scale (CES-D).

Results: Both groups substantially engaged the Internet site (MI, 90.7% vs BA 77.5%). For both groups, CES-D-10 scores declined (MI, 24.0 to 17.0, p < .001; BA, 25.2 to 15.5, p < .001). The percentage of those with clinically significant depression symptoms based on CES-D-10 scores declined in both groups from baseline to 12 weeks, (MI, 52% to 12%, p < .001; BA, 50% to 15%, p < .001). The MI group demonstrated declines in self-harm thoughts and hopelessness and was significantly less likely than the BA group to experience a depressive episode (4.65% vs 22.5%, p = .023) or to report hopelessness (MI group of 2% vs 15% for the BA group, p = .044) by 12 weeks.

Conclusions: An Internet-based prevention program in primary care is associated with declines in depressed mood and the likelihood of having clinical depression symptom levels in both groups. Motivational interviewing in combination with an Internet behavior change program may reduce the likelihood of experiencing a depressive episode and hopelessness.

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Figures

Figure 1:
Figure 1:
Intervention Model, where the physician utilizes brief advice or motivational interview techniques to initiate teen engagement with the Internet-based (CATCH-IT) component of the intervention
Figure 2:
Figure 2:
CONSORT Study Diagram, displaying the progress of all participants through the pilot trial
Figure 3:
Figure 3:
Depressed Mood (CES-D Scale) by Intention to Treat over
Figure 4:
Figure 4:
Cumulative Incidents of clinically significant depressive disorder
See this image and copyright information in PMC

References

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