title: Randomized clinical trial of an Internet-based depression prevention program for adolescents (Project CATCH-IT) in primary care: 12-week outcomes.
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.
  
  
  METHODS
  Adolescent primary care patients in the United States, aged 14 to 21 years.
  
  
  METHODS
  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).
  
  
  METHODS
  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.
authors.affiliation: Section of General Internal Medicine, Department of Medicine, The University of Chicago, Chicago, IL 60637, USA.
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Van Voorhees
authors.forename: Joshua
authors.initials: J
authors.lastname: Fogel
authors.forename: Mark A
authors.initials: MA
authors.lastname: Reinecke
authors.forename: Tracy
authors.initials: T
authors.lastname: Gladstone
authors.forename: Scott
authors.initials: S
authors.lastname: Stuart
authors.forename: Jackie
authors.initials: J
authors.lastname: Gollan
authors.forename: Nathan
authors.initials: N
authors.lastname: Bradford
authors.forename: Rocco
authors.initials: R
authors.lastname: Domanico
authors.forename: Blake
authors.initials: B
authors.lastname: Fagan
authors.forename: Ruth
authors.initials: R
authors.lastname: Ross
authors.forename: Jon
authors.initials: J
authors.lastname: Larson
authors.forename: Natalie
authors.initials: N
authors.lastname: Watson
authors.forename: Dave
authors.initials: D
authors.lastname: Paunesku
authors.forename: Stephanie
authors.initials: S
authors.lastname: Melkonian
authors.forename: Sachiko
authors.initials: S
authors.lastname: Kuwabara
authors.forename: Tim
authors.initials: T
authors.lastname: Holper
authors.forename: Nicholas
authors.initials: N
authors.lastname: Shank
authors.forename: Donald
authors.initials: D
authors.lastname: Saner
authors.forename: Amy
authors.initials: A
authors.lastname: Butler
authors.forename: Amy
authors.initials: A
authors.lastname: Chandler
authors.forename: Tina
authors.initials: T
authors.lastname: Louie
authors.forename: Cynthia
authors.initials: C
authors.lastname: Weinstein
authors.forename: Shannon
authors.initials: S
authors.lastname: Collins
authors.forename: Melinda
authors.initials: M
authors.lastname: Baldwin
authors.forename: Abigail
authors.initials: A
authors.lastname: Wassel
authors.forename: Karin
authors.initials: K
authors.lastname: Vanderplough-Booth
authors.forename: Jennifer
authors.initials: J
authors.lastname: Humensky
authors.forename: Carl
authors.initials: C
authors.lastname: Bell
mesh_terms: D000293:Adolescent; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003376:Counseling / Q000379:methods; D003863:Depression / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy; D005260:Female; D006801:Humans; D020407:Internet; D007406:Interview, Psychological / Q000379:methods*; D008297:Male; D009042:Motivation; D011320:Primary Health Care / Q000379:methods; D011569:Psychiatric Status Rating Scales; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult