title: IntelliCare: An Eclectic, Skills-Based App Suite for the Treatment of Depression and Anxiety.
abstract: Digital mental health tools have tended to use psychoeducational strategies based on treatment orientations developed and validated outside of digital health. These features do not map well to the brief but frequent ways that people use mobile phones and mobile phone apps today. To address these challenges, we developed a suite of apps for depression and anxiety called IntelliCare, each developed with a focused goal and interactional style. IntelliCare apps prioritize interactive skills training over education and are designed for frequent but short interactions.
  
  
  
  The overall objective of this study was to pilot a coach-assisted version of IntelliCare and evaluate its use and efficacy at reducing symptoms of depression and anxiety.
  
  
  
  Participants, recruited through a health care system, Web-based and community advertising, and clinical research registries, were included in this single-arm trial if they had elevated symptoms of depression or anxiety. Participants had access to the 14 IntelliCare apps from Google Play and received 8 weeks of coaching on the use of IntelliCare. Coaching included an initial phone call plus 2 or more texts per week over the 8 weeks, with some participants receiving an additional brief phone call. Primary outcomes included the Patient Health Questionnaire-9 (PHQ-9) for depression and the Generalized Anxiety Disorder-7 (GAD-7) for anxiety. Participants were compensated up to US $90 for completing all assessments; compensation was not for app use or treatment engagement.
  
  
  
  Of the 99 participants who initiated treatment, 90.1% (90/99) completed 8 weeks. Participants showed substantial reductions in the PHQ-9 and GAD-7 (P<.001). Participants used the apps an average of 195.4 (SD 141) times over the 8 weeks. The average length of use was 1.1 (SD 2.1) minutes, and 95% of participants downloaded 5 or more of the IntelliCare apps.
  
  
  
  This study supports the IntelliCare framework of providing a suite of skills-focused apps that can be used frequently and briefly to reduce symptoms of depression and anxiety. The IntelliCare system is elemental, allowing individual apps to be used or not used based on their effectiveness and utility, and it is eclectic, viewing treatment strategies as elements that can be applied as needed rather than adhering to a singular, overarching, theoretical model.
  
  
  
  Clinicaltrials.gov NCT02176226; http://clinicaltrials.gov/ct2/show/NCT02176226 (Archived by WebCite at http://www.webcitation/6mQZuBGk1).
authors.affiliation: Center for Behavioral Intervention Technologies (CBITs), Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
authors.forename: David C
authors.identifier: 0000-0002-3184-6338
authors.initials: DC
authors.lastname: Mohr
authors.affiliation: Center for Behavioral Intervention Technologies (CBITs), Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
authors.forename: Kathryn Noth
authors.identifier: 0000-0002-4905-8807
authors.initials: KN
authors.lastname: Tomasino
authors.affiliation: Center for Behavioral Intervention Technologies (CBITs), Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
authors.forename: Emily G
authors.identifier: 0000-0002-3069-5996
authors.initials: EG
authors.lastname: Lattie
authors.affiliation: Center for Behavioral Intervention Technologies (CBITs), Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
authors.forename: Hannah L
authors.identifier: 0000-0003-1314-3329
authors.initials: HL
authors.lastname: Palac
authors.affiliation: Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
authors.forename: Mary J
authors.identifier: 0000-0003-3287-1903
authors.initials: MJ
authors.lastname: Kwasny
authors.affiliation: Center for Behavioral Intervention Technologies (CBITs), Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
authors.forename: Kenneth
authors.identifier: 0000-0002-9026-4995
authors.initials: K
authors.lastname: Weingardt
authors.affiliation: Audacious Software, Chicago, IL, United States.
authors.forename: Chris J
authors.identifier: 0000-0003-1828-4497
authors.initials: CJ
authors.lastname: Karr
authors.affiliation: Center for Behavioral Intervention Technologies (CBITs), Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
authors.forename: Susan M
authors.identifier: 0000-0002-5749-2072
authors.initials: SM
authors.lastname: Kaiser
authors.affiliation: HealthPartners Institute, Minneapolis, MN, United States.
authors.forename: Rebecca C
authors.identifier: 0000-0002-9531-914X
authors.initials: RC
authors.lastname: Rossom
authors.affiliation: Center for Behavioral Intervention Technologies (CBITs), Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
authors.forename: Leland R
authors.identifier: 0000-0002-7560-1666
authors.initials: LR
authors.lastname: Bardsley
authors.affiliation: Center for Behavioral Intervention Technologies (CBITs), Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
authors.forename: Lauren
authors.identifier: 0000-0003-2052-5843
authors.initials: L
authors.lastname: Caccamo
authors.affiliation: Center for Behavioral Intervention Technologies (CBITs), Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
authors.forename: Colleen
authors.identifier: 0000-0002-6759-8380
authors.initials: C
authors.lastname: Stiles-Shields
authors.affiliation: Center for Behavioral Intervention Technologies (CBITs), Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
authors.forename: Stephen M
authors.identifier: 0000-0002-1003-0399
authors.initials: SM
authors.lastname: Schueller
mesh_terms: D000328:Adult; D001007:Anxiety / Q000628:therapy*; D040421:Cell Phone; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D017216:Telemedicine
keywords: anxiety; depression; eHealth; mHealth; mobile health