A Digital Depression Treatment Program for Adults Treated in Primary Care: A Randomized Clinical Trial

Area of Science:

• Digital health interventions
• Behavioral activation therapy
• Primary care mental health

Background:

• Over two-thirds of US adults with depression symptoms in primary care do not receive treatment.
• There is a need for scalable, evidence-based interventions for depression in primary care settings.

Purpose of the Study:

• To evaluate the effectiveness of Moodivate, a self-directed digital intervention, for treating depression symptoms in primary care patients.
• To compare Moodivate with and without EHR integration against usual care.

Main Methods:

• A 3-group, decentralized randomized clinical trial involving adult primary care patients with moderate depression symptoms (PHQ-9 score ≥10).
• Interventions included Moodivate (digital behavioral activation), Moodivate with EHR access for providers, and usual care.
• The primary outcome was the change in depression symptoms measured by the Beck Depression Inventory-II (BDI-II) over 12 weeks.

Main Results:

• Participants in both Moodivate groups showed significantly greater improvement in depression symptoms compared to usual care.
• Moodivate groups had 2.5 to 3.0 times higher odds of clinically significant improvement and 2.3 to 2.6 times higher odds of depression remission.
• High engagement was observed, with 33% of patients continuing Moodivate use after 12 weeks.

Conclusions:

• A digital behavioral activation intervention (Moodivate) is effective for treating adults with moderate depression symptoms in primary care.
• This digital approach offers a scalable and evidence-based solution for improving mental health outcomes in primary care settings.