Reviewing tailoring mechanisms of apps for depression

According to the World Health Organisation, depression is the leading cause of disability, when measured by years lived with disability. While the prevalence of depression is rising worldwide, resources for treating it are limited and most individuals in need still do not receive care. Mobile applications (apps) may have the potential to address the rising prevalence and Resource Insufficiency.

These apps to address depression and simultaneously reduce the individual’s burden if the content and timing of the apps were tailored according to measurements available through the smartphone. By using the JITAI (Just-in-time Adaptive Intervention) framework, these apps can offer support when an individual is in need (vulnerable) or is able to process and use support (receptive).

external page In this systematic review of apps for depression available from the Apple App Store and Google Play Store Gisbert W. Teepe, Dr Tobias Kowatsch, and Prof. Elgar Fleisch from ETH Zurich and Dr Alicia Salamanca Sanabria and Dr Lorainne Tudor Car from FHT reviewed what these apps measure, how they measure these metrics, and to what degree apps tailor their content to the situation and individual. They also examined if existing peer-reviewed studies reported an increase in effectiveness when using these apps.

The results show that, while a range of digital markers to measure symptoms of depression have been found in recent related studies, the apps almost exclusively rely on measuring changes by self-reports. These self-reported outcomes were used to describe changes in depressive symptoms, but not tailor the content or timing. Furthermore, the reviewed apps did not measure or use any outcomes that could be used to tailor to the receptivity of an individual. Studies comparing the effectiveness of tailoring app content to not tailoring app content could also not be found for the reviewed apps.

The study concludes that by not tailoring their content and timing, the reviewed apps do not leverage the full and unique potential of apps to reach individuals in times of need. Due to the limited studies comparing the effectiveness of tailored content, further research was also proposed to understand the effects of these tailoring methods in the real world.