Grant: Operation:eHealth Innov Partnership Program(eHIPP)-Youth &Adolescent Mental Hlth

Our objective is to test out an evidence-based usable and acceptable mobile device software application (app) for the practice component of Cognitive Behaviour Therapy (CBT) for youth in treatment for anxiety and/or depression. Although CBT is an effective treatment for anxious or depressed adolescents, it depends on a practice component which is essential for acquiring and generalizing skills. Adherence to homework is often poor. Our app will deliver the practice exercises from manualized, evidence-based CBT programs for adolescents. The app will engage, motivate, and facilitate completion of assigned exercises. The app has been designed with input from adolescents and therapists familiar with CBT following a user-centred iterative design approach. Interviews were be conducted with adolescents who have previously completed CBT and trained CBT therapists, resulting in an initial prototype. The prototype is built on a Web-based platform to allow rich graphics and interactive features, with a small app for the smartphone to load the webpage. In the first 6 months of this proposal, the prototype will be evaluated using the think-aloud method in which participants verbalize their thoughts while completing tasks. The results will be a used to improve the prototype. Then, the remaining 2.5 years will involve evaluating the usability of the improved, high-fidelity prototype by having adolescents in CBT treatment assess its efficiency and satisfaction. Participants will be randomized to either a treatment as usual group or the app group. Results are expected to show that the app improves adherence to CBT homework and thus outcomes of treatment. The app has the potential to be a high-impact innovation that engages and empowers adolescents to be active agents in their treatment, increases the effectiveness of CBT, maximizes access to CBT, and reduces pressure on health system resources.