AzTrials
AzTrials

Depression MildNCT04948996

Treatment of Depression Using a Mobile Application in the Dominican Republic

A study testing El Buen Consejo Móvil- Group (EBCM-G) and El Buen Consejo Móvil- Individual (EBCM-I) in people with Depression Mild and Depression Moderate, run by Northern Illinois University at 2 sites in 2 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The overall objective of this study is to develop a feasible and acceptable mental health app which delivers Cognitive Behavioral Therapy (CBT) for depressed patients in the Dominican Republic. Read more about this study

Who is it for?
Ages 18 to 110 years
Conditions the study is for
Depression Mild, Depression Moderate
What is being tested?
El Buen Consejo Móvil- Group (EBCM-G) and El Buen Consejo Móvil- Individual (EBCM-I)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
27 participants
Where
2 sitesin 2 countries
Study dates
30 Jan 2021to 31 Dec 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 110 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Equal to or greater than age 18 years of age
  • Baccalaureate degree in psychology
  • Licensed as a clinical psychologist
  • Able to speak and understand Spanish and read at a third grade level (for texting within the app).
  • Equal to or greater than age 18 years of age
  • Have a positive score on the Patient Health Questionnaire (PHQ-9) of >/=5 and <15 (indicating mild to moderate depressive disorder)
  • Have access to a working mobile smart phone
  • Able to speak and understand Spanish and read at a third grade level (for texting within the app).

Who cannot join

  • Age under 18 years
  • Participants in Aim 2, app users:
  • age under 18 years
  • PHQ-9 score < 5 or >/=15
  • A history of psychiatric hospitalization for bipolar disorder, severe mental disorder, significant cognitive impairment, hearing or speech impairment, non-Spanish speaking

Trial locations and contacts

2 sites in 2 countries.

2 sites in 2 countries

United States1 site

  • University of Northern Illinois

    DeKalb, Illinois, 60115

Other trials in United States

Dominican Republic1 site

  • University Autonoma de Santo Domingo

    Santo Domingo

Other trials in Dominican Republic

About this study

Official title: Effectiveness of Group Versus Individual Self-management of Depression Using a Mobile App to Increase Treatment Adherence Among Users of a University-based Helpline in the Dominican Republic.

The overall objective of this study is to develop a feasible and acceptable mental health app which delivers Cognitive Behavioral Therapy (CBT) for depressed patients in the Dominican Republic. This proposal meets the research objectives of NIMH in delivering mental health care to populations with low literacy, and supporting health care systems in monitoring and improving the quality of mental health. In the proposed study, the investigators will upgrade, implement, and evaluate a depression treatment app and assess trained facilitators' capacity in managing participants' depression symptoms using the app. The investigators will conduct a randomized controlled trial (RCT) among 120 participants who screen positive for mild to moderate depression or anxiety on the Patient Health Questionnaire (PHQ-9) or GAD- 7 via a university-based Covid mental health hotline. The app, El Buen Consejo Móvil (EBCM), will be downloaded to the participants' own Android phone. Participants will be randomized to receive the EBCM app with the functionality to connect individuals to one another via a facilitator-guided chat room (ECBM-G; n= 60) or to receive the same contents as an individualized facilitator-guided CBT program without the group functionality (ECBM-I; n=60).

Recruitment and mixed-methods data collection will be conducted by phone, given current circumstances surrounding the Covid-19 pandemic. Process outcomes will be evaluated for the trained facilitators. The primary outcomes for app users will be acceptability of the app and perceptions of social interactivity for those randomized to the group condition. Validated questionnaires will be administered to measure perceived emotional support, loneliness, and interactivity. Level of adherence and effectiveness, the secondary outcomes, will be assessed by frequency of interaction with the app, completion of treatment for either treatment modality, and change in depressive symptoms.

The investigators hypothesize that the use of the app for guided self-help can be enhanced through group interaction. EBCM can result in increased access to care in low-income community settings where patients are not currently receiving treatment due to logistical barriers and the stigma of seeking care in a mental health care setting.

Read the detailed description

Study design:

The investigators will implement an Optimization, Effectiveness and Implementation (OEI) Hybrid Trial, based upon preliminary work. During the first six months, the investigators will upgrade and modify the mental health app, EBCM, to improve the interface and user friendliness.

Aim 1 (Optimization): Investigators will integrate app enrollment within a mental health hotline staffed by research assistants who are licensed psychologists. Protocols will be developed and produced for all hotline volunteers, including depression screening, evaluation and criteria for referral, and recruitment of individuals for study participation. Facilitators will receive extensive training for encouraging and guiding participants in usage of the app, and for facilitating chat rooms among the EBCM-G study arm. Process outcomes assessed among the app facilitators will include 1) feasibility, 2) fidelity, 3) acceptability of the training, and 4) perceived confidence in identifying and managing patients' symptoms of depression.

Aim 2 (Effectiveness and Implementation): Investigators will conduct an RCT with 120 participants who will be randomized to receive either the group treatment modality (El Buen Consejo Móvil-Group; EBCM-G) or the individual treatment modality (El Buen Consejo Móvil-Individual; EBCM-I). Participants will be followed for the duration of the 6-week intervention. Participants randomized to EBCM-G will be placed in groups of five participants within the app. Their version of the app will have the functionality to connect individuals to one another via a facilitator-guided chat room where they may respond to suggested strategies within the app and communicate with each other or their facilitator using voice or text. Participants randomized to EBCM-I will receive the same program contents without the group functionality.

Procedures:

For study recruitment, research assistants staffing the hotline will screen patients initially with the PHQ-2,and GAD-2 followed by the PHQ-9 and/or GAD-7 if positive, and will refer individuals with mild to moderate depression to the research team for an explanation of the study and the informed consent process.

Study participants will undergo baseline data collection after providing informed consent, and will then be provided with one week of prepaid internet access to allow them to download and begin using the EBCM app. Upon installing the app, participants will watch an an introductory video on how to navigate the app. After initial log-in, participants will be randomized to EBCM-G or EBCM-I using a computer-generated randomization series. After demonstrating engagement with the app during the first week, participants will receive additional prepaid internet access to continue using the app during the subsequent five weeks. EBCM will be delivered in twice daily 1-3-minute presentations.

The facilitators will undergo extensive training and will also formally consent to study participation. They will participate in mock-trials of dissemination, and interviews concerning implementation of the app. For their training in facilitation of treatment engagement, they will first receive two days of training in the scripted protocol for app coaching including the previously developed EMPDA Motivational Interviewing intervention, such as the use of supportive dialogue such as praise, reminders, non-judgmental suggestions. Facilitators will also be trained in criteria for referral in the event of symptom exacerbation or suicidal ideation as well as confidentiality and privacy during this first phase of training.

Second, the facilitators will participate in a one-week trial period of the EBCM app where supportive dialogue will be modeled by the PI's responses to comments within the app. Third, through the administration of the Internet-delivered CBT - Therapist Rating Scale (ICBT-TRS), the investigators will provide feedback to the facilitators related to their fidelity to CBT principles. During the first week, monitoring and responses will be provided on a daily basis according to a scripted protocol, while during the second and third weeks, the facilitators will review the responses to each session three times/week and offer feedback to each participant. Finally, during Weeks 4-6, participants will receive responses on a twice weekly basis. The facilitators will participate in weekly in group discussions with the PI (Dr. Susan Caplan) and Co-Investigator (Lic. Angelina Sosa Lovera) using a secure group platform to share information and reinforce best practices.

Being tested
El Buen Consejo Móvil- Group (EBCM-G), El Buen Consejo Móvil- Individual (EBCM-I)
Keywords
depression, primary care, mobile health, motivational interviewing, global health, capacity building
Medical subject headings
Depression

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • El Buen Consejo Móvil- Group (EBCM-G)Behavioural

    1. Psycho-education and Information using a CBT "toolbox" approach.
    2. Self-Assessment to track, label and describe moods by daily prompts to state or text level of mood on the mood tracker ("termómetro de animo").
    3. Symptom Identification and Management: after identifying a label for type of thinking from a pull-down list, a corresponding short 1-3-minute recorded strategy such as Thought Stopping, Increasing Pleasurable Activity, Mindfulness or Priming will be provided.
    4. Monitoring of treatment engagement and response to treatment: Reminders to engage will include text messages and phone calls from the facilitator to encourage use of the app according to a scripted protocol.

    Additionally, participants in the Group Intervention will be able to communicate with and respond to one another through the group chat rooms within the app.

  • El Buen Consejo Móvil- Individual (EBCM-I)Behavioural

    1. Psycho-education and Information using a CBT "toolbox" approach.
    2. Self-Assessment to track, label and describe moods by daily prompts to state or text level of mood on the mood tracker ("termómetro de animo").
    3. Symptom Identification and Management: after identifying a label for type of thinking from a pull-down list, a corresponding short 1-3-minute recorded strategy such as Thought Stopping, Increasing Pleasurable Activity, Mindfulness or Priming will be provided.
    4. Monitoring of treatment engagement and response to treatment: Reminders to engage will include text messages and phone calls from the facilitator to encourage use of the app according to a scripted protocol.
Study groups in NCT04948996
Study groupRoleWhat they receive
El Buen Consejo Móvil- Group (EBCM-G)ExperimentalParticipants in the group condition will be placed in groups of five participants within the app. Their version of EBCM will have the functionality to connect individuals to one another via a facilitator-guided chat room (EBCM-G), where they can respond to suggested strategies within the app and communicate with each other or their facilitator guide using voice or text.
Receives: Behavioral: El Buen Consejo Móvil- Group (EBCM-G)
El Buen Consejo Móvil- Individual (EBCM-I)Active comparatorParticipants randomized to EBCM-I will receive the same program contents without the group functionality.
Receives: Behavioral: El Buen Consejo Móvil- Individual (EBCM-I)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Adapted Computer-Mediated Communication Questionnaire (CMCQ)

    Participants' perceptions of acceptability and social interactivity of the app will first be assessed at midline (three weeks after initiation of the 6-week intervention) through close-ended rating scale questions derived from the Computer-Mediated Communication Questionnaire (CMCQ). The CMCQ measures attitudes towards tech-mediated communication, consisting of four domains: social context, privacy, interactivity, and online communication (alpha coefficient of reliability = 0.83). In the present study, the adapted questions will explore these domains as they relate to app contents, engagement, mood states while using the app, and barriers and facilitators to app use. Follow-up open-ended questions will be administered alongside the close-ended questions to all participants in order to collect qualitative data that will provide context for interpreting the quantitative data.

    Measured: Midline (three weeks)

  2. Adapted Computer-Mediated Communication Questionnaire (CMCQ)

    Participants' perceptions of acceptability and social interactivity of the app will be assessed a second time at endline (immediately after the end of the 6-week intervention) through close-ended rating scale questions derived from the Computer-Mediated Communication Questionnaire (CMCQ). The CMCQ measures attitudes towards tech-mediated communication, consisting of four domains: social context, privacy, interactivity, and online communication (alpha coefficient of reliability = 0.83). In the present study, the adapted questions will explore these domains as they relate to app contents, engagement, mood states while using the app, and barriers and facilitators to app use. Follow-up open-ended questions will be administered to a sub-set of at least 15 participants at endline; it is anticipated that this qualitative data will provide context for interpreting the quantitative data.

    Measured: An average of six weeks

  3. Adapted Depression Training Program Evaluation (DTPE)

    The facilitators' impressions of the training and the app itself will be assessed through the administration of an adapted version of the Depression Training Program Evaluation (DTPE) at the end of the intervention period. Based on the Hartford Foundation's nurse depression training program, this tool assesses feasibility of implementation, perceived acceptability of the training, perceived changes in knowledge level and confidence in one's ability to identify and manage participants' depressive symptoms, perceived changes in confidence in one's ability to communicate with participants, and perceived outcomes of the intervention for participants. In the present study, the adapted data collection instrument includes both close-ended Likert-scale rating questions as well as open-ended questions with probes.

    Measured: Through study completion; 18 months

  4. Change in NIH Toolbox Emotional Support Scale score

    Participants' perceived emotional support will be assessed at baseline (pre-intervention) and endline (post-intervention). Emotional support will be measured using the 8-item emotional support sub-scale from the validated Spanish version of the NIH Toolbox Social Relationship Scales. This sub-scale includes items related to having someone available with whom to discuss problems and who may provide empathy, support, and suggestions. The alpha coefficient of reliability for the emotional support sub-scale is 0.969. Participants rate the eight items on a five-point frequency scale (1-Never; 2-Rarely; 3-Sometimes; 4-Usually; 5-Always) over a past-month time frame. Scores may range from 8 to 40, with higher scores indicating greater levels of emotional support.

    Measured: At Baseline (0 weeks) and at six weeks

  5. Change in Three-Item Loneliness Scale score

    Participants' perceived loneliness will be assessed at baseline (pre-intervention) and endline (post-intervention). Perceived loneliness will be measured through the Three-item Loneliness Scale, which was derived from the R-UCLA Loneliness Scale with the goal of providing a measure that is easy to administer through telephone surveys. The Three-item Loneliness Scale has high internal consistency and an alpha coefficient of reliability of 0.72. Participants respond to three questions about perceived loneliness using a three-point frequency scale (1-Hardly ever; 2-Some of the time; and 3-Often). Scores may range from 3 to 9, with higher scores indicating greater perceived loneliness.

    Measured: At Baseline (0 weeks) and at 6 weeks

  6. Adherence

    Participant adherence to EBCM by ascertainment of number of sessions with participation (either voice or text response) divided by maximum number of sessions (10)

    Measured: Week 1

  7. Adherence

    Participant adherence to EBCM by ascertainment of number of sessions with participation (either voice or text response) divided by maximum number of sessions (20)

    Measured: Week 2

  8. Adherence

    Participant adherence to EBCM by ascertainment of number of sessions with participation (either voice or text response) divided by maximum number of sessions (30)

    Measured: Week 3

  9. Adherence

    Participant adherence to EBCM by ascertainment of number of sessions with participation (either voice or text response) divided by maximum number of sessions (40)

    Measured: Week 4

  10. Adherence

    Participant adherence to EBCM by ascertainment of number of sessions with participation (either voice or text response) divided by maximum number of sessions (50)

    Measured: Week 5

  11. Adherence

    Participant adherence to EBCM by ascertainment of number of sessions with participation (either voice or text response) divided by maximum number of sessions (60)

    Measured: Week 6

Secondary outcomes (8)

  1. Measure of Staff/Patient interaction scale

    To assess the facilitators' fidelity to and use of motivational interviewing (MI) practices, participants will complete the Measure of Staff/Patient interaction scale at endline. This 10-item scale measures the extent to which participants perceive that the facilitator is communicating in a manner that is supportive and reflective of MI principles. The scale factors align with the the three components of MI: collaboration with the client; elicitation of client's own ideas about change; and autonomy/support to encourage the patient's decision-making. The factors have alpha coefficients of reliability ranging from 0.73-0.94; the overall scale has an alpha coefficient of 0.90. The rater (i.e. the participant) rates each items on a five-point frequency scale ranging from 1-Never to 5-Always or almost always. After reverse-scoring three items, final scores may range from 10 to 50, with higher scores indicating greater levels of fidelity to MI strategies.

    Measured: At six weeks

  2. Internet-delivered Cognitive Behavior Therapy - Therapist Rating Scale (ICBT-TRS)

    The Internet-delivered Cognitive Behavioral Therapy-Therapist Rating Scale (ICBT-TRS) will be employed to assess facilitator fidelity to the communication strategies delivered through the training for coaching participants. This validated behavioral checklist rates the adherence and quality of usage of specific behavior change communication strategies related to nine domains such as "Builds Rapport" and "Praises Effort." The scale has demonstrated excellent inter-rater reliability in total scores (ICC = 0.91; CI = 0.78, 0.97). For each domain, the study subject is given a rating of 0 (absence of behavior), 1 (inadequate performance/significant recommendations made), or 3 (adequate performance/minor recommendations). Scores may range from 0 to 27, with higher scores indicating increased fidelity. In the present study, the PI and co-I will use the ICBT-TRS to examine the facilitators' communication with participants throughout the intervention period.

    Measured: Intervention Weeks 1-6

  3. Change in Patient Health Questionnaire (PHQ-9) score

    Level of depression will be assessed by the Patient Heath Questionnaire (PHQ-9), which consists of the nine criteria on which DSM-IV diagnosis of depressive disorders is based. Each of the nine items is scored on a three-point frequency scale ranging from 0-"not at all" to 3-"nearly every day" for the previous two weeks. A score of 5-9 indicates mild depression; 10-14, moderate depression; 15-19, moderately severe depression; and 20-27, severe depression. In large scale primary care studies, sensitivity was 88% and specificity was 88% for major depression at a score of greater than or equal to 10. The Spanish version has demonstrated good to excellent reliability in various Latin American countries. In the present study, the PHQ-9 will be administered on four occasions within the app (weeks 1, 2, 4, and 5) and on two occasions by phone (weeks 3 and 6). It is anticipated that a decrease of 5 points on the PHQ-9 will result from participating in the full 6-week intervention.

    Measured: Baseline - 0 weeks and at Week 1

  4. Change in Patient Health Questionnaire (PHQ-9) score

    Level of depression will be assessed by the Patient Heath Questionnaire (PHQ-9), which consists of the nine criteria on which DSM-IV diagnosis of depressive disorders is based. Each of the nine items is scored on a three-point frequency scale ranging from 0-"not at all" to 3-"nearly every day" for the previous two weeks. A score of 5-9 indicates mild depression; 10-14, moderate depression; 15-19, moderately severe depression; and 20-27, severe depression. In large scale primary care studies, sensitivity was 88% and specificity was 88% for major depression at a score of greater than or equal to 10. The Spanish version has demonstrated good to excellent reliability in various Latin American countries. In the present study, the PHQ-9 will be administered on four occasions within the app (weeks 1, 2, 4, and 5) and on two occasions by phone (weeks 3 and 6). It is anticipated that a decrease of 5 points on the PHQ-9 will result from participating in the full 6-week intervention.

    Measured: Baseline - 0 weeks and at Week 2

  5. Change in Patient Health Questionnaire (PHQ-9) score

    Level of depression will be assessed by the Patient Heath Questionnaire (PHQ-9), which consists of the nine criteria on which DSM-IV diagnosis of depressive disorders is based. Each of the nine items is scored on a three-point frequency scale ranging from 0-"not at all" to 3-"nearly every day" for the previous two weeks. A score of 5-9 indicates mild depression; 10-14, moderate depression; 15-19, moderately severe depression; and 20-27, severe depression. In large scale primary care studies, sensitivity was 88% and specificity was 88% for major depression at a score of greater than or equal to 10. The Spanish version has demonstrated good to excellent reliability in various Latin American countries. In the present study, the PHQ-9 will be administered on four occasions within the app (weeks 1, 2, 4, and 5) and on two occasions by phone (weeks 3 and 6). It is anticipated that a decrease of 5 points on the PHQ-9 will result from participating in the full 6-week intervention.

    Measured: Baseline - 0 weeks and at Week 3

  6. Change in Patient Health Questionnaire (PHQ-9) score

    Level of depression will be assessed by the Patient Heath Questionnaire (PHQ-9), which consists of the nine criteria on which DSM-IV diagnosis of depressive disorders is based. Each of the nine items is scored on a three-point frequency scale ranging from 0-"not at all" to 3-"nearly every day" for the previous two weeks. A score of 5-9 indicates mild depression; 10-14, moderate depression; 15-19, moderately severe depression; and 20-27, severe depression. In large scale primary care studies, sensitivity was 88% and specificity was 88% for major depression at a score of greater than or equal to 10. The Spanish version has demonstrated good to excellent reliability in various Latin American countries. In the present study, the PHQ-9 will be administered on four occasions within the app (weeks 1, 2, 4, and 5) and on two occasions by phone (weeks 3 and 6). It is anticipated that a decrease of 5 points on the PHQ-9 will result from participating in the full 6-week intervention.

    Measured: Baseline - 0 weeks and at Week 4

  7. Change in Patient Health Questionnaire (PHQ-9) score

    Level of depression will be assessed by the Patient Heath Questionnaire (PHQ-9), which consists of the nine criteria on which DSM-IV diagnosis of depressive disorders is based. Each of the nine items is scored on a three-point frequency scale ranging from 0-"not at all" to 3-"nearly every day" for the previous two weeks. A score of 5-9 indicates mild depression; 10-14, moderate depression; 15-19, moderately severe depression; and 20-27, severe depression. In large scale primary care studies, sensitivity was 88% and specificity was 88% for major depression at a score of greater than or equal to 10. The Spanish version has demonstrated good to excellent reliability in various Latin American countries. In the present study, the PHQ-9 will be administered on four occasions within the app (weeks 1, 2, 4, and 5) and on two occasions by phone (weeks 3 and 6). It is anticipated that a decrease of 5 points on the PHQ-9 will result from participating in the full 6-week intervention.

    Measured: Baseline - 0 weeks and at Week 5

  8. Change in Patient Health Questionnaire (PHQ-9) score

    Level of depression will be assessed by the Patient Heath Questionnaire (PHQ-9), which consists of the nine criteria on which DSM-IV diagnosis of depressive disorders is based. Each of the nine items is scored on a three-point frequency scale ranging from 0-"not at all" to 3-"nearly every day" for the previous two weeks. A score of 5-9 indicates mild depression; 10-14, moderate depression; 15-19, moderately severe depression; and 20-27, severe depression. In large scale primary care studies, sensitivity was 88% and specificity was 88% for major depression at a score of greater than or equal to 10. The Spanish version has demonstrated good to excellent reliability in various Latin American countries. In the present study, the PHQ-9 will be administered on four occasions within the app (weeks 1, 2, 4, and 5) and on two occasions by phone (weeks 3 and 6). It is anticipated that a decrease of 5 points on the PHQ-9 will result from participating in the full 6-week intervention.

    Measured: Baseline - 0 weeks and at Week 6

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Jul 2021
  2. Study start30 Jan 2021
  3. Primary completion31 Dec 2021
  4. Study completion31 Dec 2021

Why it stopped: Due to COVID, recruitment in primary care was not possible, alternative proposed hotline recruitment methods yielded population that did not meet inclusion criteria and were too acutely ill to be eligible for study.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
27 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04948996
Sponsor's protocol ID
1R21MH119851-01
Status last verified
Jun 2022
First submitted
5 Mar 2020
Last updated
8 Jun 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Research resources generated with funds from this grant will be freely distributed, as available, to qualified academic investigators for noncommercial research. The investigators at University of Northern Illinois and the University Autonoma de Santo Domingo, will ensure that clinical trial(s) under the award are registered and results information is submitted to ClinicalTrials.gov

Publications

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Questions about this trial

What is this clinical trial studying?

A study testing El Buen Consejo Móvil- Group (EBCM-G) and El Buen Consejo Móvil- Individual (EBCM-I) in people with Depression Mild and Depression Moderate, run by Northern Illinois University at 2 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 8 Jun 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States, Dominican Republic. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: Due to COVID, recruitment in primary care was not possible, alternative proposed hotline recruitment methods yielded population that did not meet inclusion criteria and were too acutely ill to be eligible for study.). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Adapted Computer-Mediated Communication Questionnaire (CMCQ) (time frame: Midline (three weeks)). The study lists 11 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04948996, which also lists 122 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Jun 2022.

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