title: Randomized Clinical Trial of a Primary Care Internet-based Intervention to Prevent Adolescent Depression: One-year Outcomes.
abstract: OBJECTIVE
  We developed a primary care/Internet-based intervention for adolescents at risk for depression (CATCH-IT, Competent Adulthood Transition with Cognitive-behavioral, Humanistic and Interpersonal Training). This phase II clinical trial compares two forms of primary care provider (PCP) engagement (motivational interview [MI] and brief advice [BA]) for adolescents using the Internet program.
  
  
  METHODS
  ADOLESCENTS SCREENING POSITIVE FOR DEPRESSION WERE RECRUITED FROM PRIMARY CARE PRACTICES AND RANDOMLY ASSIGNED TO A VERSION OF THE INTERVENTION: PCP MI + Internet program or PCP BA + Internet program. Between-group and within-group comparisons were conducted on depressive disorder outcome measures at baseline and one-year post-enrollment. Regression analyses examined factors predicting declines in depressed mood.
  
  
  RESULTS
  Both groups demonstrated significant within-group decreases in depressed mood, loneliness, and self-harm ideation. While no between-group differences were noted in depressed mood or depressive disorder measures at one-year, fewer participants in the MI group had experienced a depressive episode. Greater participant automatic negative thoughts and more favorable ratings of a component of the Internet-based training experience predicted declines in depressed mood at one-year.
  
  
  CONCLUSIONS
  A primary care/Internet-based intervention for depression prevention demonstrated sustained reductions in depressed mood, and, when coupled with motivational interviewing, reduction in the likelihood of being diagnosed with a depressive episode. This tool may help extend the services at the disposal of a primary care provider and can provide a bridge for adolescents at risk for depression prior to referral to mental health specialists.
authors.affiliation: Section of General Pediatrics, Adolescent Medicine and Education, Children's Hospital of the University of Illinois, College of Medicine, University of Illinois, Chicago, Illinois, USA.
authors.forename: Alexandria
authors.initials: A
authors.lastname: Saulsberry
authors.forename: Monika
authors.initials: M
authors.lastname: Marko-Holguin
authors.forename: Kelsey
authors.initials: K
authors.lastname: Blomeke
authors.forename: Clayton
authors.initials: C
authors.lastname: Hinkle
authors.forename: Joshua
authors.initials: J
authors.lastname: Fogel
authors.forename: Tracy
authors.initials: T
authors.lastname: Gladstone
authors.forename: Carl
authors.initials: C
authors.lastname: Bell
authors.forename: Mark
authors.initials: M
authors.lastname: Reinecke
authors.forename: Marya
authors.initials: M
authors.lastname: Corden
authors.forename: Benjamin W
authors.initials: BW
authors.lastname: Van Voorhees
keywords: Internet; adolescent depression; prevention and intervention; primary care