MoodRing: A multi-stakeholder platform to monitor and manage adolescents' depression in primary care with passive mobile sensing.

ABSTRACT As rates of adolescent depression and suicidality continue to trend upwardsthe healthcare system struggles to address the need for and lack of mental health service useThe pediatric patient centered medical home model may improve adolescent depression outcomes by enhancing access to and coordinating careas well as providing ongoing monitoringUnfortunatelydespite guideline recommendationsoverof adolescents identified with depression symptoms in primary care do not receive symptom monitoring anddo not receive symptom reassessmentThis lack of symptom monitoring and reassessment can result in untoward health outcomes including a decrease in functioningincreased use of acute and crisis servicesand hospitalizations due to suicidalityCurrent technologies which incorporate data passively collected from smartphones offer an opportunity for intercurrent monitoring between patient visits which limits burden on the patient to selfreport and limits burden on the healthcare systemallowing primary care teams to triage contacting and assessing patients a system identifies with an increase in disease severityThis formative study will demonstrate the usability and potential clinical utility of MoodRinga technology intervention which will collect passive mobile phone sensor data on aspects of adolescent phone use related to depressive symptom severitye gcommunication patternssocial media usetraveland integrate this data into a multi useradolescentparentprimary care provider care managerplatform from which symptoms can be viewed and secure communication can occurMoodRingas supported by Health Belief Modelmay lead to improved quality of depression managementincreased symptom reassessmenttherapy medication adherencethrough increasing self efficacysocial support from parent and care teamas well as encouraging application of self management skills through increased self management knowledgeskillsand symptom feedbackMoodRing builds on a solid foundation of investigators experienced in design of technology interventions to increase adolescent initiation of depression treatmentwho have already developed machine algorithms for passive sensing and a small business partner with vast experience in working with health researchers to develop multi user web mobile platformsThis STTR Phase I study seeks to accomplish two aimsThe first is to apply a machine learning pipeline developed for college aged youth to adolescents with depression and determine whether self reported depressive symptoms can be reliably predicted from passive data with at leastaccuracyThe second is the user design and system architecture of MoodRingIf milestones are achieved that models are successful at predicting depressive symptoms and the proposed MoodRing intervention is acceptable to adolescentsparentsand primary care providers care managersthen we will pursue the STTR Phase II studyThe aims of Phase II include the development and subsequent efficacy trial of MoodRingSpecificallywe will conduct a cluster randomized controlled trial in a primary care setting of MoodRing as compared to usual care PROJECT NARRATIVE Depression affects up to a fifth of adolescents but less than half get treatmentThis project aims to develop and design MoodRinga technology platformwhich will gather information about how an adolescent uses their mobile phone and translate that into what it means about symptoms of depression they are experiencingThis platform will provide symptom feedback to the adolescent themselvestheir parentand their healthcare providerwith the goal that having awareness of symptoms and a safe place to communicate with parents and healthcare providers will allow for more adolescents to better self manage their mood and get better quality treatment for depression