Reviewing tailoring mechanisms of apps for depression
Depression is the leading cause for years lived with disability. While prevalence is rising worldwide, resources for treating depression are limited and most individuals in need still do not receive care. Mobile applications (apps) may have the potential to address the rising prevalence and insufficient resources available for the treatment of depression. A promising approach to increase the effectiveness of these apps addressing depression while simultaneously reducing the burden of the individual is to tailor the content and timing of the apps along with measurements uniquely available from a smartphone. By using the JITAI framework support can be offered when an individual is in need (vulnerable) and able to process and use the support (receptive).
In this systematic review of apps for depression available from the Apple App Store and Google Play Store Gisbert W. Teepe, Dr. Tobias Kowatsch, and Prof Elgar Fleisch from ETH Zurich and Dr. Alicia Salamanca Sanabria, and Dr. Lorainne Tudor Car from FHT reviewed what is measured by which measurements and to what degree apps tailor their content to the situation and individual. In their work, they also examined whether studies investigating an increase in effectiveness or efficacy were reported in peer-reviewed studies investigating the reviewed apps.
The results show that while a range of digital markers to measure symptoms of depression have been found in recent related studies the apps almost exclusively rely on measuring changes by self-reports. These self-reported outcomes were used to describe changes in depressive symptoms but not tailor the content or timing. Furthermore, the reviewed apps did not measure or use any outcomes that could be used to tailor to the receptivity of an individual. Studies comparing the effectiveness of tailoring the content to not tailoring the content could also not be found for the reviewed apps.
The study concludes that the reviewed apps addressing depression do not tailor their content or timing and, therefore, do not leverage the full and unique potential of apps to reach individuals in times of need. Due to the limited studies found comparing the effectiveness with a focus on tailoring further research is also necessary to understand the effects of these tailoring methods, especially in the real world.
For further details, please watch the main author’s video abstract below and refer to the full research article.
Teepe GW, Da Fonseca A, Kleim B, Jacobson NC, Salamanca Sanabria A, Tudor Car L, Fleisch E, Kowatsch T Just-in-Time Adaptive Mechanisms of Popular Mobile Apps for Individuals With Depression: Systematic App Search and Literature Review J Med Internet Res 2021;23(9):e29412 doi: 10.2196/29412