Kandoo App for Depression

(Kandoo Trial)

Overseen By Lindsay Alexander

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Child Mind Institute

Disqualifiers: Eating disorder, Manic episode, Psychotic disorder, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 9

Duration: 8 weeks

200 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the Kandoo treatment for depression?

Research shows that mobile health apps for depression self-management can improve patient self-management, treatment engagement, and mental health outcomes, with over half of the apps reviewed having acceptable quality. Additionally, app-based interventions, including those delivering content just-in-time, have been shown to decrease depressive symptoms. ^{1 2 3 4 5}

How is the Kandoo App treatment for depression different from other treatments?

The Kandoo App for depression is unique because it leverages mobile technology to provide just-in-time interventions, mood monitoring, and self-management tools, which can complement traditional in-person treatments and help overcome barriers to accessing care. ^{1 4 6 7 8}

What is the purpose of this trial?

The current project is a pilot study that seeks to compare the efficacy of Brief Behavioral Activation's treatment-as-usual that uses paper and pencil tools to Kandoo, a digital, gamified version of activity scheduling and self-monitoring, in a diverse sample of youth presenting with clinically significant symptoms of depression. We will compare the level of pre- and post-treatment depressive symptoms in participants, who will participate in an 8-week brief behavioral activation treatment protocol augmented with Kandoo to the pre- and post- treatment depressive symptoms in the control participants, who will participate in 8-week, treatment as usual, brief behavioral activation treatment protocol. To explore treatment response for the clinically significant symptoms, we will obtain pre- and post-treatment measures of depression, global functioning, and patient goals. During the standard clinical intake, additional information will be obtained, including detailed demographics, medical history, mental health status, and social skills. Beyond determining the overall effectiveness of BBA augmented with Kandoo, the sample diversity and availability of clinical behavioral observations of the participants will permit the development of explanatory models of predictive factors for BBA with Kandoo intervention outcomes.

Research Team

Michael Milham, MD, PhD

Principal Investigator

Child Mind Institute

Eligibility Criteria

This trial is for young individuals with symptoms of mood disorders or depression. Participants will use either traditional paper tools or the Kandoo smartphone app as part of an 8-week treatment program. They must be willing to have their depressive symptoms and overall functioning assessed before and after the treatment.

Inclusion Criteria

Internet connectivity

I am either male or female.

Currently enrolled as a patient in the CMI clinic or Fort Health Virtual Outpatient Mental Health Clinic

Exclusion Criteria

Any neurologic impairment that limits the ability to use a touch screen

Current exclusionary psychiatric conditions are: eating disorder, manic episode (any current or history), psychotic episode or psychotic disorder, active suicidality, homicidal

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive an 8-week Brief Behavioral Activation treatment protocol, augmented with Kandoo for the experimental group, or using traditional paper-pencil tracking for the control group.

8 weeks

8 weekly sessions

Follow-up

Participants are monitored for depressive symptoms and global functioning 6 weeks after the completion of the treatment.

6 weeks

1 visit (virtual or in-person)

Treatment Details

Interventions

• Kandoo

Trial Overview The study tests if using the Kandoo app, which gamifies activity scheduling and self-monitoring, is more effective than standard paper-based methods in treating depression over an 8-week period. It measures changes in depressive symptoms, global functioning, and patient goals.

Participant Groups

Group I: Brief Behavioral Activation with Kandoo Experimental Treatment 1 Intervention

Participants will use Kandoo to track their activities while receiving Brief Behavioral Activation treatment.

Group II: Brief Behavioral Activation with traditional paper pencil tracking Active Control 1 Intervention

Participants will use paper and pencil worksheets to track their activities while receiving Brief Behavioral Activation treatment.

Who Is Running the Clinical Trial?

Child Mind Institute

Lead Sponsor

Trials

4

Recruited

1,400+

Fort Health

Collaborator

Trials

1

Recruited

200+

Findings from Research

A study involving 235 participants showed that the app-based intervention ImproveYourMood+ significantly reduced depressive symptoms and negative automatic thoughts over a 3-week period, with effects lasting up to one month after the intervention.

The most effective features of the app included mood monitoring, content delivery, and just-in-time prompts, indicating that comprehensive, multi-modal approaches may enhance user experience and treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring the features of an app-based just-in-time intervention for depression. Everitt, N., Broadbent, J., Richardson, B., et al.[2021]

A smartphone-based intervention (SBI) combining group psychoeducation and 14 days of app training showed high usability and engagement among participants, indicating it is user-friendly and well-received.

The pilot trial with 16 individuals suggested that the SBI effectively reduced depressive symptoms compared to a waitlist control, providing preliminary evidence for its efficacy in treating depression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Blending group-based psychoeducation with a smartphone intervention for the reduction of depressive symptoms: results of a randomized controlled pilot study. Lukas, CA., Berking, M.[2021]

A systematic review of mobile health apps for depression found that 74% of the evaluated apps had acceptable quality, with 32% scoring 4.0 or higher on the Mobile Application Rating Scale (MARS), indicating their potential effectiveness.

These high-quality apps can enhance patient self-management and treatment engagement, suggesting they may be valuable tools for individuals with depression who face barriers to traditional treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluating Commercially Available Mobile Apps for Depression Self-Management. Myers, A., Chesebrough, L., Hu, R., et al.[2022]

The Behavioral Apptivation mobile application was developed to support Brief Behavioral Activation Treatment for Depression (BATD), which is a well-supported psychotherapy for treating depression.

Initial pilot testing of the app in a small open-label trial showed feasibility for use alongside individual BATD therapy, suggesting it could enhance clinical practice for treating depressive symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and Preliminary Feasibility Study of a Brief Behavioral Activation Mobile Application (Behavioral Apptivation) to Be Used in Conjunction With Ongoing Therapy. Dahne, J., Kustanowitz, J., Lejuez, CW.[2020]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

Exploring the features of an app-based just-in-time intervention for depression. [2021]

2. England pubmed.ncbi.nlm.nih.gov

Blending group-based psychoeducation with a smartphone intervention for the reduction of depressive symptoms: results of a randomized controlled pilot study. [2021]

3. Canada pubmed.ncbi.nlm.nih.gov

Development of a Mobile Clinical Prediction Tool to Estimate Future Depression Severity and Guide Treatment in Primary Care: User-Centered Design. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Evaluating Commercially Available Mobile Apps for Depression Self-Management. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Development and Preliminary Feasibility Study of a Brief Behavioral Activation Mobile Application (Behavioral Apptivation) to Be Used in Conjunction With Ongoing Therapy. [2020]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Evaluation of Android and Apple Store Depression Applications Based on Mobile Application Rating Scale. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Computer interviews for depression management. [2007]

8. United States pubmed.ncbi.nlm.nih.gov

Screening accuracy of a 14-day smartphone ambulatory assessment of depression symptoms and mood dynamics in a general population sample: Comparison with the PHQ-9 depression screening. [2021]