Abstract
BackgroundDigital mental health interventions may help middle-aged and older adults with depression overcome barriers to accessing traditional care, but few studies have investigated their use in this population.ObjectiveThis pilot study examines the feasibility, acceptability, and potential efficacy of the Meru Health Program, an 8-week mobile app–delivered intervention.MethodsA total of 20 community-dwelling middle-aged and older adults (age: mean 61.7 years, SD 11.3) with elevated depressive symptoms participated in a single-arm pilot study investigating the Meru Health Program, an app-delivered intervention supported by remote therapists. The program primarily uses mindfulness and cognitive behavioral skills to target depressive symptoms. A semistructured interview was completed at the baseline to establish current psychiatric diagnoses. Depressive symptoms were measured using the Patient Health Questionnaire and Patient-Reported Outcomes Measurement Information System (PROMIS) depression measures. Anxiety symptoms were measured using the Generalized Anxiety Disorder Scale and the PROMIS Anxiety measure. User experience and acceptability were examined through surveys and qualitative interviews.ResultsIn total, 90% (18/20) of the participants completed the program, with 75% (15/20) completing at least 7 of the 8 introductory weekly lessons. On average, participants completed 60 minutes of practice and exchanged 5 messages with their therapists every week. The app was rated as helpful by 89% (17/19) participants. Significant decreases in depressive (P=.03) and anxiety symptom measures (P=.01) were found; 45% (9/20) of participants showed clinically significant improvement in either depressive symptoms or anxiety symptoms.ConclusionsThe findings suggest that the commercially available Meru Health Program may be feasible, acceptable, and potentially beneficial to middle-aged and older adults. Although larger controlled trials are needed to demonstrate efficacy, these findings suggest that digital health interventions may benefit adults of all ages.
Highlights
BackgroundMajor depressive disorder (MDD) is among the foremost causes of disability worldwide among older adults [1,2,3]
Cognitive behavioral therapy (CBT) and mindfulness-based interventions have been efficacious in reducing late-life depressive symptoms [5,6,7]
This study investigates the use of an 8-week mobile app–based intervention with remote therapist support called the Meru Health Program, a commercially available digital health program
Summary
Major depressive disorder (MDD) is among the foremost causes of disability worldwide among older adults [1,2,3]. One group tested an adapted app-based intervention to promote the self-management of chronic conditions alongside peer coaching among middle-aged and older adults with serious mental illness and found it to be feasible, acceptable, and potentially helpful in improving outcomes among the 8 study completers [17]. Another small study examining an app targeting mental wellness in a group-based treatment setting yielded positive feedback about the app from older users, but the findings were limited by substantial attrition [18]. Given the barriers to care faced by older adults, there is a need to examine app-based interventions that do not include extensive in-person support
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