title: MEMO--a mobile phone depression prevention intervention for adolescents: development process and postprogram findings on acceptability from a randomized controlled trial.
abstract: BACKGROUND
  Prevention of the onset of depression in adolescence may prevent social dysfunction, teenage pregnancy, substance abuse, suicide, and mental health conditions in adulthood. New technologies allow delivery of prevention programs scalable to large and disparate populations.
  
  
  OBJECTIVE
  To develop and test the novel mobile phone delivery of a depression prevention intervention for adolescents. We describe the development of the intervention and the results of participants' self-reported satisfaction with the intervention.
  
  
  METHODS
  The intervention was developed from 15 key messages derived from cognitive behavioral therapy (CBT). The program was fully automated and delivered in 2 mobile phone messages/day for 9 weeks, with a mixture of text, video, and cartoon messages and a mobile website. Delivery modalities were guided by social cognitive theory and marketing principles. The intervention was compared with an attention control program of the same number and types of messages on different topics. A double-blind randomized controlled trial was undertaken in high schools in Auckland, New Zealand, from June 2009 to April 2011.
  
  
  RESULTS
  A total of 1348 students (13-17 years of age) volunteered to participate at group sessions in schools, and 855 were eventually randomly assigned to groups. Of these, 835 (97.7%) self-completed follow-up questionnaires at postprogram interviews on satisfaction, perceived usefulness, and adherence to the intervention. Over three-quarters of participants viewed at least half of the messages and 90.7% (379/418) in the intervention group reported they would refer the program to a friend. Intervention group participants said the intervention helped them to be more positive (279/418, 66.7%) and to get rid of negative thoughts (210/418, 50.2%)--significantly higher than proportions in the control group.
  
  
  CONCLUSIONS
  Key messages from CBT can be delivered by mobile phone, and young people report that these are helpful. Change in clinician-rated depression symptom scores from baseline to 12 months, yet to be completed, will provide evidence on the effectiveness of the intervention. If proven effective, this form of delivery may be useful in many countries lacking widespread mental health services but with extensive mobile phone coverage. CLINICALTRIAL: Australia New Zealand Clinical Trials Registry (ACTRN): 12609000405213; http://www.anzctr.org.au/trial_view.aspx?ID=83667 (Archived by WebCite at http://www.webcitation.org/64aueRqOb).
authors.affiliation: Clinical Trials Research Unit, University of Auckland, Auckland, New Zealand. r.whittaker@ctru.auckland.ac.nz
authors.forename: Robyn
authors.initials: R
authors.lastname: Whittaker
authors.forename: Sally
authors.initials: S
authors.lastname: Merry
authors.forename: Karolina
authors.initials: K
authors.lastname: Stasiak
authors.forename: Heather
authors.initials: H
authors.lastname: McDowell
authors.forename: Iain
authors.initials: I
authors.lastname: Doherty
authors.forename: Matthew
authors.initials: M
authors.lastname: Shepherd
authors.forename: Enid
authors.initials: E
authors.lastname: Dorey
authors.forename: Varsha
authors.initials: V
authors.lastname: Parag
authors.forename: Shanthi
authors.initials: S
authors.lastname: Ameratunga
authors.forename: Anthony
authors.initials: A
authors.lastname: Rodgers
mesh_terms: D000293:Adolescent; D040421:Cell Phone; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000517:prevention & control*; D004311:Double-Blind Method; D006801:Humans; D009520:New Zealand; D010342:Patient Acceptance of Health Care; D016730:Program Development; D015397:Program Evaluation