NCT04948268

Brief Summary

This is a feasibility trial of a personalized 8-week text messaging intervention aimed at young adults (ages 18-25) with depression and anxiety who are not interested in -- or experience barriers to -- receiving traditional face-to-face psychological treatments. The trial will consist of a pilot test of (1) an 8-week adaptive (personalized) messaging intervention relative to (2) a non-personalized digital mental health intervention, or (3) an active control which will send weekly psychoeducation information by way of Uniform Resource Locators (URLs). The adaptive intervention will uses machine learning to tailor Short Message Service (SMS) messages to an individual's needs and preferences, and URL links to provide access to psychoeducational content to contextualize messages, when the length of that content exceeds the limitations of messages. The primary goals of the project are to conduct a feasibility trial using a sequential multiple assignment randomized treatment (SMART) design, which will evaluate (a) the effectiveness of an adaptive, personalized messaging intervention in reducing engagement relative to a non-personalized version; and (b) whether human coaching results in greater symptom reduction and engagement, relative an unguided implementation.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
120

participants targeted

Target at P50-P75 for not_applicable depression

Timeline
Completed

Started Oct 2023

Shorter than P25 for not_applicable depression

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

June 16, 2021

Completed
15 days until next milestone

First Posted

Study publicly available on registry

July 1, 2021

Completed
2.3 years until next milestone

Study Start

First participant enrolled

October 27, 2023

Completed
12 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 23, 2024

Completed
2 days until next milestone

Study Completion

Last participant's last visit for all outcomes

October 25, 2024

Completed
1.3 years until next milestone

Results Posted

Study results publicly available

February 9, 2026

Completed
Last Updated

February 9, 2026

Status Verified

January 1, 2026

Enrollment Period

12 months

First QC Date

June 16, 2021

Results QC Date

December 5, 2025

Last Update Submit

January 21, 2026

Conditions

Keywords

Text messagingDepressionAnxietyTelemedicineDigital Mental Healthmobile health (mHealth)Mobile phoneTechnology assistedSmartphoneCell phoneCoach

Outcome Measures

Primary Outcomes (2)

  • Kessler Psychological Distress Scale

    10-item self-report measure of transdiagnostic distress, used as outcome measure across diagnostic categories. Higher scores mean greater distress. Minimum score: 10; maximum score: 50

    16 weeks

  • Engagement Length

    Last message/content rating or click on content URL link received from participant. This measure can include select individuals who exceed 56 days of interaction due to user's ability to temporarily pause receipt of messages, resulting in messages extending beyond 8 weeks (56 days).

    62 days

Secondary Outcomes (2)

  • Patient Health Questionnaire-9

    16 weeks

  • Generalized Anxiety Disorder-7

    16 weeks

Other Outcomes (4)

  • Depression Symptom Inventory - Suicidality Subscale

    16 weeks

  • Cognitive Behavioral Response to Stress Scale

    16 weeks

  • Objective Engagement Markers: Percent of Messages Responded to

    62 days

  • +1 more other outcomes

Study Arms (5)

Adaptive digital mental health intervention without coaching

EXPERIMENTAL

The adaptive intervention will consist of SMS messages, symptom tracking, and psychological content that centers on evidence-based psychological strategies. Psychoeducational content will be delivered via a URL in an SMS message. Machine learning will be used to tailor messages and timing to meet participant preferences.

Behavioral: Adaptive messaging intervention

Non-personalized digital Mental Health intervention without coaching

EXPERIMENTAL

The non-personalized intervention will consist of SMS messages, symptom tracking, and psychological content that centers on evidence-based psychological strategies. Messages and content will not be tailored based on participants profile or usage.

Behavioral: Non-personalized messaging intervention

Adaptive digital mental health intervention with coaching

EXPERIMENTAL

The adaptive intervention will consist of SMS messages, symptom tracking, and psychological content that centers on evidence-based psychological strategies. Psychoeducational content will be delivered via a URL in an SMS message. Machine learning will be used to tailor messages and timing to meet participant preferences. Coaching will be provided to support engagement and intervention use via medium of participants choice (texts, calls, or emails).

Behavioral: Adaptive messaging interventionBehavioral: Coaching

Non-personalized digital Mental Health intervention with coaching

EXPERIMENTAL

The non-personalized intervention will consist of SMS messages, symptom tracking, and psychological content that centers on evidence-based psychological strategies. Messages and content will not be tailored based on participants profile or usage. Coaching will be provided to support engagement and intervention use via medium of participants choice (texts, calls, or emails).

Behavioral: Non-personalized messaging interventionBehavioral: Coaching

Active control

ACTIVE COMPARATOR

The active control condition will provide brief text messages that include a URL link to psychoeducational content, but will not include the interactive messaging component described in experimental arms.

Behavioral: Psychoeducational links

Interventions

Psychological content and messages delivered regularly over an 8-week period via interactive SMS messages. Content and messages will be tailored using machine learning.

Adaptive digital mental health intervention with coachingAdaptive digital mental health intervention without coaching

Psychological content and messages delivered regularly over an 8-week period via interactive SMS messages. Psychological content will center on a single psychological strategy each week. There will not be any tailoring of messaging and content based on group or individual level data.

Non-personalized digital Mental Health intervention with coachingNon-personalized digital Mental Health intervention without coaching

SMS messages with URLs containing brief psychoeducational information.

Active control
CoachingBEHAVIORAL

Human coaching to support intervention use and engagement via telephone calls, text or email

Adaptive digital mental health intervention with coachingNon-personalized digital Mental Health intervention with coaching

Eligibility Criteria

Age18 Years - 25 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64)

You may qualify if:

  • Ages 18 to 25 \*The age to provide consent in Nebraska is 19. Individuals recruited from the state of Nebraska must be 19 or older.
  • A positive screen on an MHA screen for depression (Patient Health Questionnaire - 9 \[PHQ-9\]) or anxiety (Generalized Anxiety Disorder - 7 \[GAD-7\]);
  • Resident of the United States.
  • Owns a smartphone

You may not qualify if:

  • Current treatment with psychotherapy or psychiatric medication management;
  • Seeking or plans to seek traditional mental health treatment (psychotherapy or psychiatric medication management) in next 8 weeks;
  • Serious mental illness for which intervention would be contraindicated (e.g., psychotic disorder, manic episode, etc.)
  • Severe suicidality (i.e., experiencing suicidal ideation with a plan and intent to act);
  • English insufficient to engage in design activities.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Northwestern University

Chicago, Illinois, 60611, United States

Location

MeSH Terms

Conditions

DepressionAnxiety DisordersSuicidal Ideation

Condition Hierarchy (Ancestors)

Behavioral SymptomsBehaviorMental DisordersSuicideSelf-Injurious Behavior

Limitations and Caveats

Loss to follow-up and missing data affect the interpretability of data from this trial (as all trials). Additionally, this trial was powered for feasibility not for efficacy.

Results Point of Contact

Title
Jonah Meyerhoff
Organization
Northwestern University

Study Officials

  • David C Mohr, PhD

    Northwestern University

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
SEQUENTIAL
Model Details: This study uses a sequential multiple assignment randomized trial (SMART) design. The first level of randomization is to one of the three treatment conditions: self-guided non-personalized intervention, self-guided adaptive intervention, or active control. The second level of randomization occurs during the first two weeks of intervention. Participants who meet criteria for disengagement from either the non-personalized or adaptive intervention are then randomized to receive coaching or continue as self-guided. This will provide the investigators with preliminary information on the need for and value of coaching. Participants will receive the assigned intervention from baseline to week 8, followed by an 8 week follow-up period
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

June 16, 2021

First Posted

July 1, 2021

Study Start

October 27, 2023

Primary Completion

October 23, 2024

Study Completion

October 25, 2024

Last Updated

February 9, 2026

Results First Posted

February 9, 2026

Record last verified: 2026-01

Data Sharing

IPD Sharing
Will share

De-identified data will be shared through and managed by the National Institute of Mental Health (NIMH) Data Archive (NDA). De-identified human subjects data, harmonized to a common standard, are available to qualified researchers.

Shared Documents
STUDY PROTOCOL
Time Frame
Data will be available after publication of the primary outcome papers.
Access Criteria
The NIMH Data Archive is managed by the NIMH. Access criteria are determined by the NIMH.
More information

Locations