Harnessing context sensing to develop a mobile intervention for depression.
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Date
2011-08-15
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Abstract
BACKGROUND Mobile phone sensors can be used to develop context aware systems that automatically detect when patients require assistance Mobile phones can also provide ecological momentary interventions that deliver tailored assistance during problematic situations However such approaches have not yet been used to treat major depressive disorder OBJECTIVE The purpose of this study was to investigate the technical feasibility functional reliability and patient satisfaction with Mobilyze a mobile phone and Internet based intervention including ecological momentary intervention and context sensing METHODS We developed a mobile phone application and supporting architecture in which machine learning models ie learners predicted patients mood emotions cognitive motivational states activities environmental context and social context based on at least 38 concurrent phone sensor values eg global positioning system ambient light recent calls The website included feedback graphs illustrating correlations between patients self reported states as well as didactics and tools teaching patients behavioral activation concepts Brief telephone calls and emails with a clinician were used to promote adherence We enrolled 8 adults with major depressive disorder in a single arm pilot study to receive Mobilyze and complete clinical assessments for 8 weeks RESULTS Promising accuracy rates 60 to 91 were achieved by learners predicting categorical contextual states eg location For states rated on scales eg mood predictive capability was poor Participants were satisfied with the phone application and improved significantly on self reported depressive symptoms beta week 82 P Under 001 per protocol Cohen d 3 43 and interview measures of depressive symptoms beta week 81 P Under 001 per protocol Cohen d 3 55 Participants also became less likely to meet criteria for major depressive disorder diagnosis b week 65 P 03 per protocol remission rate 85 71 Comorbid anxiety symptoms also decreased beta week 71 P Under 001 per protocol Cohen d 2 58 CONCLUSIONS Mobilyze is a scalable feasible intervention with preliminary evidence of efficacy To our knowledge it is the first ecological momentary intervention for unipolar depression as well as one of the first attempts to use context sensing to identify mental health related states Several lessons learned regarding technical functionality data mining and software development process are discussed TRIAL REGISTRATION Clinicaltrials gov NCT01107041 http clinicaltrials gov ct2 show NCT01107041 Archived by WebCite at http www webcitation org 60CVjPH0n
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At risk for a particular disease or infection, Client, Quality/unreliability of data, Access to information or data, Prototype, Functionality, Individual based, Mental health, Chronic care, Data collection and reporting, Internet, Text, Accelerometers / Motion sensors, GPS, Installed application