Jennifer Dahne1, Anahi Collado2, C W Lejuez3, Cristina M Risco4, Vanessa A Diaz5, Lisa Coles6, Jacob Kustanowitz7, Michael J Zvolensky8, Matthew J Carpenter9. 1. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States; Hollings Cancer Center, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, United States. Electronic address: dahne@musc.edu. 2. Alvord, Baker, and Associates, LLC, 3200 Tower Oaks Blvd, Suite 200, Rockville, MD 20852, United States; Department of Psychology and Cofrin Logan Center for Addiction Research and Treatment, The University of Kansas, 1000 Sunnyside Ave, Lawrence, KS 66045, United States. 3. Department of Psychology and Cofrin Logan Center for Addiction Research and Treatment, The University of Kansas, 1000 Sunnyside Ave, Lawrence, KS 66045, United States. 4. Department of Psychology and Office of the Senior Vice President and Provost, University of Maryland, College Park, 2131 Biology-Psychology Building, College Park, MD 20742, United States. 5. Department of Family Medicine, Medical University of South Carolina, 5 Charleston Center, Suite 263, Charleston SC 29425, United States. 6. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States. 7. MountainPass Technology, 2 Wisconsin Circle, Suite 700, Chevy Chase, MD 20815, United States. 8. Department of Psychology, University of Houston, Fred J. Heyne Building, Suite 104, Houston, Texas 77204, United States; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Houston, Texas 77030, United States. 9. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States; Hollings Cancer Center, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, United States.
Abstract
BACKGROUND: To address the need for disseminable, evidence-based depression treatment options for Latinx adults with limited English proficiency (LEP), our team developed ¡Aptívate!, a Spanish-language Behavioral Activation self-help mobile application. Primary aims of this study were to: 1) examine feasibility and uptake of ¡Aptívate! among depressed Latinx adults with LEP and 2) preliminarily examine ¡Aptívate! efficacy for depression treatment. METHODS:Participants (N = 42) with elevated depressive symptoms were randomized 2:1:1 to: 1) ¡Aptívate! (n = 22), 2) an active control Spanish-language app ("iCouch CBT"; n = 9), or 3) Treatment As Usual (i.e., no app; n = 11). Feasibility was assessed via self-reported app utilization and app analytics data. Depressive symptoms were assessed weekly for eight weeks via self report. RESULTS: All ¡Aptívate! participants used the app at least once, 81.8% of participants used the app ≥8 times, and 36.4% of participants used the app ≥56 times. Weekly retention was strong: 72.7% and 50% of participants continued to use the app at one- and two-months post-enrollment, respectively. Generalized Estimating Equation models indicated a significant interaction between time and treatment, such that ¡Aptívate! participants reported significantly lower depressive symptoms over time than TAU. Depressive symptoms did not differ on average across time between the iCouch and TAU conditions, nor between iCouch and ¡Aptívate!. LIMITATIONS: Limitations include small sample size, limited follow-up, and lack of analytics data for the active control condition. CONCLUSIONS: With further research, ¡Aptívate! may offer a feasible, efficacious approach to extend the reach of evidence-based depression treatment for Latinx adults with LEP.
RCT Entities:
BACKGROUND: To address the need for disseminable, evidence-based depression treatment options for Latinx adults with limited English proficiency (LEP), our team developed ¡Aptívate!, a Spanish-language Behavioral Activation self-help mobile application. Primary aims of this study were to: 1) examine feasibility and uptake of ¡Aptívate! among depressed Latinx adults with LEP and 2) preliminarily examine ¡Aptívate! efficacy for depression treatment. METHODS:Participants (N = 42) with elevated depressive symptoms were randomized 2:1:1 to: 1) ¡Aptívate! (n = 22), 2) an active control Spanish-language app ("iCouch CBT"; n = 9), or 3) Treatment As Usual (i.e., no app; n = 11). Feasibility was assessed via self-reported app utilization and app analytics data. Depressive symptoms were assessed weekly for eight weeks via self report. RESULTS: All ¡Aptívate! participants used the app at least once, 81.8% of participants used the app ≥8 times, and 36.4% of participants used the app ≥56 times. Weekly retention was strong: 72.7% and 50% of participants continued to use the app at one- and two-months post-enrollment, respectively. Generalized Estimating Equation models indicated a significant interaction between time and treatment, such that ¡Aptívate! participants reported significantly lower depressive symptoms over time than TAU. Depressive symptoms did not differ on average across time between the iCouch and TAU conditions, nor between iCouch and ¡Aptívate!. LIMITATIONS: Limitations include small sample size, limited follow-up, and lack of analytics data for the active control condition. CONCLUSIONS: With further research, ¡Aptívate! may offer a feasible, efficacious approach to extend the reach of evidence-based depression treatment for Latinx adults with LEP.
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