Web-Based Cognitive Behavioral Therapy for Depression Among Homebound Older Adults: Development and Usability Study

Area of Science:

• Gerontology
• Digital Health
• Mental Health Interventions

Background:

• Homebound older adults are a vulnerable population at high risk for depression.
• Barriers to accessing traditional mental health services are prevalent in this demographic.
• Existing digital interventions often lack specific tailoring for older adults with depression.

Purpose of the Study:

• To describe the development of Empower@Home, a web-delivered cognitive behavioral therapy intervention for homebound older adults with depression.
• To report on the usability and user experience of the Empower@Home intervention.

Main Methods:

• User-centered design principles guided development, incorporating community stakeholder and older adult input.
• Needs assessment involved data analysis and interviews with community partners.
• Comparative usability testing (N=10) and field testing (n=4) evaluated the intervention's ease of use and user acceptance.

Main Results:

• Empower@Home, featuring 9 sessions with psychoeducation and CBT skills, was developed with significant community partner input.
• Comparative usability testing yielded a high System Usability Scale score (78), with 80% of participants preferring Empower@Home over comparators.
• Field testing indicated positive user experience, confidence in task completion, and a downward trend in depression scores.

Conclusions:

• Collaborative design with community stakeholders is crucial for developing usable and engaging digital mental health tools.
• Addressing implementation challenges during design enhances the potential effectiveness of digital interventions for older adults.