The American College Health Association estimates that nearly half of college students suffer or have suffered from clinical depression. Most colleges and universities have mental healthcare infrastructure, the frontline of depression treatment, including counseling resources, psychiatrists, and social workers, but penetration of care and awareness is low. One significant barrier to providing care is lack of public awareness of the symptoms, treatment, and etiology of depression (Patel, Branch, Mottur-Pilson, & Pinard, 2004). One possible time efficient solution is using electronic methods of depression self-detection. Literature indicates that electronic self-tests that are conducted over the Internet are as accurate as traditional paper and pencil tests commonly used by clinicians (Proudfoot, Parker, Pavlovic, Manicavasagar, Alder, & Whitton, 2010). This CREU project, the Development of a Text Inventory for Depression (TIDE) in Educational Environments, will build on the use of interactive SMS systems to improve depression screening and disseminating relevant educational materials for college students. We will use the PHQ2 depression inventory, a self-administered tool for detecting depression. The PHQ2 is a validated and sensitive depression inventory that can screen for possible depression. The main research questions for this research are:
- How can we design a SMS-based system and accompanying web portal for college students who are not comfortable with depression screening?
- How can we design and implement an SMS-based system to distribute validated instrument questions to a specific population, log participants’ answers, and provide feedback to the participants based on their answers (e.g., resources for depression on where to get help)?
- How can we design and implement a web portal that will log answers to the SMS-based system over a period of time to provide participants with an opportunity to reflect on their answers and get more information on how to seek assistance?
- How would people use the SMS-based depression screening system with the web portal during a semester?
Patel, V. L., Branch, T., Mottur-Pilson, C., & Pinard, G. (2004). Public awareness about depression: The effectiveness of a patient guideline. International Journal of Psychiatry in Medicine, 34(1), 1-20.
Proudfoot, J., Parker, G., Pavlovic, D. H., Manicavasagar, V., Adler, E., & Whitton, A. (2010). Community attitudes to the appropriation of mobile phones for monitoring and managing depression, anxiety, and stress. Journal of Medical Internet Research, 12(5), 111-122.
Fall 2014 Update: Sara and Erin have actively worked on the TIDE project. The TIDE project currently has two concurrent phases – a user study design phase and the infrastructure phase. In August and September, they worked on the user study design phase by iterating on their paper prototyping, co-design workshop protocol. They conducted a mock workshop with peers to ensure their activities were meaningful and that they would be able to answer their research questions based on the workshop (this data will not be published; it is only for internal assessments). Professor Siek attended the mock workshop to provide them feedback on their respective facilitation and documentation duties. Once the co-design workshop protocol was finalized, they submitted the protocol and associated ethics documents to the Indiana University Institutional Research Board (IRB) for approval. We are currently iterating with the IRB to get the study finalized. For the infrastructure phase, Sara and Erin are learning a lot about apache, Twilio interfaces in Ruby and Java, and group coding practices (https://github.com/sarazhang/mythesis). Sara and Erin also evaluated other cloud-based services and went through the installation and Twilio-cloud experimentation process, however we opted to use internal IU servers to host the TIDE SMS system to ensure we have the ability to secure potentially sensitive mental health data. The entire TIDE team attended Grace Hopper where we enjoyed the CRA-W CDC REU breakfast. At Grace Hopper, we also mentioned our research to Twilio who were interested in Sara and Erin in possible internship opportunities and asked us to contact them so that they could highlight our project when it is working. Sara and Erin meet with Professor Siek once a week. Sara also attends the larger Proactive Health Informatics design group meeting weekly (Erin has class). Overall, the team is on track to create the TIDE system and complete a user study.
* denotes graduate student collaborators at the time of writing
# denotes undergraduate student collaborators at the time of writing
This material is based upon work supported by the National Science Foundation. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation.