Abstract
The developmental period of adolescence can pose a risk for the onset of depressive disorders, but is also a time when potentially modifiable factors and behaviors related to depressive episode onset can develop. An online health intervention can provide an opportunity to reach at-risk adolescents in between primary care visits and could impact these modifiable factors and behaviors to support healthy development. We explore the Competent Adulthood Transition with Cognitive-Behavioral, Humanistic, and Interpersonal Therapy (CATCH-IT), a self-directed online cognitive behavioral therapy prevention intervention, and its impact on modifiable factors and behaviors related to: (1) program completion, (2) normative adolescent development, (3) coping, (4) family relations, (5) general health behaviors, and (6) externalizing behaviors, in a primary care sample of adolescents at intermediate to high risk of developing depression. Adolescents were enrolled into either CATCH-IT or Health Education (HE) control group and followed for 24 months. CATCH-IT improved some factors related to program completion (e.g., motivation, recommendation to peers for depression prevention, and physician positive relationship), coping (e.g., perceived behavior change), and family relations (e.g., parental psychological control, sibling relative status) as compared to HE. HE improved normative adolescent development (e.g., health and loss life events) as compared to CATCH-IT. CATCH-IT utilized in primary care may benefit some at-risk adolescents in selective factors and behaviors.
Highlights
During adolescence, many long-term lifestyle habits develop, and risk factors and health behaviors related to many chronic diseases are established (Lynch and Smith 2005; Birmaher et al 1996a)
(1) Modifiable factors related to program completion were the Trans-Theoretical Model (TTM) Scale, the Theory of Planned Behavior (TPB) Scale, the Physician Relationship Scale, depressed peer recommendation, satisfaction, and usefulness items
There was no difference between groups in depressive episodes at 24 months, and the sample had a low incidence of depressive episodes at two years of follow-up (4.6% per year for CATCH-IT (Van Voorhees et al 2020), and 5.8% per year for Health Education (HE) (Van Voorhees et al 2020), versus 9.2% for the general population (Rushton et al 2002)
Summary
Many long-term lifestyle habits develop, and risk factors and health behaviors related to many chronic diseases are established (Lynch and Smith 2005; Birmaher et al 1996a). Community based depression prevention interventions research by our group and others has identified and assessed instruments to measure a wide range of potentially modifiable factors and behaviors across six domains, including those impacting: (1) program completion (motivation, physician relationship, attitudes toward the intervention), (2) normative adolescent development (quality of life, social adjustment, life events), (3) coping (perceived benefits of behavioral principles, hopelessness), (4) family relations (family relationships, parental mood), (5) general health behaviors (internet use, physical and social activity, body mass index (BMI)), and (6) externalizing behaviors (substance use, oppositional defiant activities) (Lewinsohn et al 1994, 1995, 1997; Liu 2002; Hollon et al 1990; Booth et al 2008; Van Voorhees et al 2008a, 2008b, 2008c; Paunesku et al 2008; Gladstone and Kaslow 1995; Gottlieb et al 2016)
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