title: Adherence to the MoodGYM program: outcomes and predictors for an adolescent school-based population.
abstract: BACKGROUND
  Program adherence has been associated with improved intervention outcomes for mental and physical conditions. The aim of the current study is to investigate adolescent adherence to an Internet-based depression prevention program in schools to identify the effect of adherence on outcomes and to ascertain the predictors of program adherence.
  
  
  METHODS
  Data for the current study (N=1477) was drawn from the YouthMood Project, which was conducted to test the effectiveness of the MoodGYM program in reducing and preventing symptoms of anxiety and depression in an adolescent school-based population. The current study compares intervention effects across three sub-groups: high adherers, low adherers and the wait-list control condition.
  
  
  RESULTS
  When compared to the control condition, participants in the high adherence intervention group reported stronger intervention effects at post-intervention and 6-month follow-up than participants in the low adherence group for anxiety (d=0.34-0.39 vs. 0.11-0.22), and male (d=0.43-0.59 vs. 0.26-0.35) and female depression (d=0.13-0.20 vs. 0.02-0.04). No significant intervention effects were identified between the high and low adherence groups. Being in Year 9, living in a rural location and having higher pre-intervention levels of depressive symptoms or self-esteem were predictive of greater adherence to the MoodGYM program.
  
  
  CONCLUSIONS
  The program trialled is Internet-based and therefore the predictors of adherence identified may not generalise to face-to-face interventions.
  
  
  CONCLUSIONS
  The current study provides preliminary support for the positive relationship between program adherence and outcomes in a school environment. The identification of significant predictors of adherence will assist in identifying the type of user who will engage most with an online depression prevention program.
authors.affiliation: Centre for Mental Health Research, The Australian National University, Acton ACT 0200, Australia. Alison.Calear@anu.edu.au
authors.forename: Alison L
authors.initials: AL
authors.lastname: Calear
authors.forename: Helen
authors.initials: H
authors.lastname: Christensen
authors.forename: Andrew
authors.initials: A
authors.lastname: Mackinnon
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Griffiths
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000517:prevention & control* / Q000628:therapy; D001315:Australia; D002648:Child; D003863:Depression / Q000517:prevention & control* / Q000628:therapy; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D010349:Patient Compliance; D012572:School Health Services