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Anxiety treatment

IntelliCare app suite field trial

Mohr DC, Mohr DC, Tomasino KN, et al. · Journal of medical Internet research · 2017

Open access · cc by · source: Europe PMC

Eight weeks of IntelliCare apps plus light coaching produced large pre–post drops in depression and anxiety symptoms.

Study at a glance

Design
Human experiment — Single-arm 8-week field trial of IntelliCare Android suite with low-intensity coaching
N
N=105 · PHQ-9 ≥10 and/or GAD-7 ≥8 at enrollment
Population
Adults with elevated depression and/or anxiety symptoms
Outcome
PHQ-9 and GAD-7 change over 8 weeks

Structured fields used in claim comparison tables when every cited study has a complete layer.

Key findings

Among participants with paired outcomes, PHQ-9 and GAD-7 improved significantly. By end of treatment many met remission or mild-symptom ranges (e.g., 37% PHQ-9 <5; 42% GAD-7 <5). Authors argue modular, eclectic apps can deliver scalable skills-based care.

Methodology

105 adults with PHQ-9 ≥10 and/or GAD-7 ≥8 enrolled in a single-arm field trial of the elemental IntelliCare Android suite with low-intensity coaching for 8 weeks. Usability and symptom outcomes were assessed repeatedly.

Limitations

No control group, so expectancy and concurrent care could drive change. Android-only recruitment and coaching support limit generalizability to fully self-guided public app stores.

How this study connects

Role on claims

Each row is a claim on a concept or method page where this paper supports, challenges, or qualifies the statement. Roles are hand-checked — not a model guess.

  • SupportsAnxiety Treatmentconcept

    Multiple studies in this library examine anxiety treatment with empirical patient or population outcomes rather than opinion alone.

    Evidence for the claim as stated.

  • SupportsAnxiety Treatmentconcept

    Among participants with paired outcomes, PHQ-9 and GAD-7 improved significantly. By end of treatment many met remission or mild-symptom ranges (e.g., 37% PHQ-9 <5; 42% GAD-7 <5). Authors argue modular, eclectic apps can deliver scalable skills-based care.

    Evidence for the claim as stated.

  • SupportsAnxiety Treatmentconcept

    Effect sizes and settings differ across anxiety treatment studies — digital vs clinic, trial vs observational — so results should not be pooled casually.

    Evidence for the claim as stated.

  • SupportsMixed-Effects Modelmethod

    Single-arm and exploratory mixed-model papers describe trajectories without a randomised comparator. Among 105 IntelliCare users enrolled at PHQ-9 ≥10 and/or GAD-7 ≥8, paired outcomes improved and 37% reached PHQ-9 <5 and 42% GAD-7 <5 by end of treatment. Among 42 cancer survivors in a Fitbit subsample, mean wear was 6.2 of 7 days weekly and intervention MVPA rose from 93.8 to 195.3 min/week — use patterns, not a Fitbit-only causal test.

    Evidence for the claim as stated.

  • SupportsMixed-Effects Modelmethod

    A mixed model with a randomised control (MoodGYM, Kokoro-app, Facebook walking, Glucose Buddy) answers a different question from a mixed model of change inside one arm (IntelliCare field trial, Fitbit wear). Significant PHQ-9/GAD-7 improvement to 37%/42% below 5, or MVPA doubling from 93.8 to 195.3 min/week, can be expectancy, concurrent care, or the surrounding activity trial. Those papers do not licence the same causal sentence as a 2.5-point randomised PHQ-9 gap.

    Evidence for the claim as stated.

  • IntelliCare used PHQ-9 both to enter and to judge outcome. A single-arm field trial of 105 adults (PHQ-9 ≥10 and/or GAD-7 ≥8) found significant paired-score improvement, with 37% reaching PHQ-9 <5 and 42% GAD-7 <5 by end of treatment. A later 2×2 factorial RCT found PHQ-9 and GAD-7 fell across arms; coaching produced larger GAD-7 reductions than self-guided care, while weekly recommendations strengthened PHQ-9 gains and raised median sessions (median 216; last use day 56). Coaching did not clearly beat self-guidance on depression.

    Evidence for the claim as stated.

  • Mean PHQ-9 change, response, remission and 'score <5' are different claims. Kokoro-app's 2.5-point ITT advantage came without a significant remission difference. IntelliCare's uncontrolled 37% below 5 is a threshold count, not a randomised remission rate. iCBT's 51% versus 18% is reliable improvement among completers with data, not the same as g=0.78 on the full ITT sample. Treating those percentages as one 'PHQ-9 worked' statistic collapses the disagreements the papers actually report.

    Evidence for the claim as stated.

Open questions

Tensions this paper is part of

From concept pages' “where studies disagree.” Disagreement means the same question; scope means different assays, populations, or outcomes.

  • Scope difference — different assays, populations, or outcomes

    Effect sizes and settings differ across anxiety treatment studies — digital vs clinic, trial vs observational — so results should not be pooled casually.

  • Scope difference — different assays, populations, or outcomes

    A mixed model with a randomised control (MoodGYM, Kokoro-app, Facebook walking, Glucose Buddy) answers a different question from a mixed model of change inside one arm (IntelliCare field trial, Fitbit wear). Significant PHQ-9/GAD-7 improvement to 37%/42% below 5, or MVPA doubling from 93.8 to 195.3 min/week, can be expectancy, concurrent care, or the surrounding activity trial. Those papers do not licence the same causal sentence as a 2.5-point randomised PHQ-9 gap.

  • Scope difference — different assays, populations, or outcomes

    Mean PHQ-9 change, response, remission and 'score <5' are different claims. Kokoro-app's 2.5-point ITT advantage came without a significant remission difference. IntelliCare's uncontrolled 37% below 5 is a threshold count, not a randomised remission rate. iCBT's 51% versus 18% is reliable improvement among completers with data, not the same as g=0.78 on the full ITT sample. Treating those percentages as one 'PHQ-9 worked' statistic collapses the disagreements the papers actually report.

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Same topic cluster — not a recommendation engine.