title: Mobile Phone and Web-based Cognitive Behavior Therapy for Depressive Symptoms and Mental Health Comorbidities in People Living With Diabetes: Results of a Feasibility Study.
abstract: BACKGROUND
  Depression is often comorbid with diabetes; however, undertreatment of depressive symptoms in people affected is common.
  
  
  OBJECTIVE
  We studied preliminary acceptability and effectiveness of a fully automated, mobile phone, and web-based public health intervention, myCompass, for reducing depressive symptoms and improving mental health comorbidities in people with diabetes.
  
  
  METHODS
  In this single-group feasibility study, 89 volunteers with type 1 (n=34) or type 2 (n=55) diabetes and at least mild depressive symptoms used myCompass for 7 weeks. Web-based measures of depressive and anxious symptoms, functional impairment, diabetes-specific variables, and user satisfaction were completed at baseline, postintervention, and 3-month follow-up.
  
  
  RESULTS
  Retention rates were 54% (n=48) at postintervention and 36% (n=32) at follow-up. Depressive symptoms were significantly improved at postintervention (P<.001; within-group effect size d=1.05), with gains persisting at follow-up. Mental health comorbidities, including anxiety (P<.001), functioning (P<.001), and diabetes-specific distress (P<.001), also showed significant and sustained improvement. Satisfaction with myCompass was high, with convenience and ease of program use, and relevance of program content rated positively by participants.
  
  
  CONCLUSIONS
  The myCompass program shows promise as an acceptable and effective treatment for depression and comorbid mental health problems in people with diabetes. The program is broadly available, free to use, and may benefit patients with diabetes who do not access services and/or wish to manage their mental health themselves. Replication of these findings in a controlled study is warranted.
authors.affiliation: Black Dog Institute, Randwick, Australia. janine.clarke@unsw.edu.au.
authors.forename: Janine
authors.identifier: http://orcid.org/0000-0002-2652-5273
authors.initials: J
authors.lastname: Clarke
authors.forename: Judith
authors.identifier: http://orcid.org/0000-0002-3872-9871
authors.initials: J
authors.lastname: Proudfoot
authors.forename: Howard
authors.identifier: http://orcid.org/0000-0003-4726-9552
authors.initials: H
authors.lastname: Ma
keywords: CBT; Internet interventions; depression; diabetes; eHealth