The purpose of this study is to determine the extent to which an online pathway to depression treatment (iPath\*D) is acceptable and usable to patients receiving cancer treatment who report symptoms of depression.
The investigators will determine the extent to which an online pathway to depression treatment (iPath\*D) is acceptable and usable to patients receiving cancer treatment who report symptoms of depression. iPath\*D will be designed to increase screening, mental health literacy, and treatment access. Patients will access their iPath\*D account online to review their PHQ-9 score and its interpretation, followed by an interactive depression decision aid comparing information on a range of online and in-person treatment options. Upon review of the decision aid, participants will be able to directly connect to a treatment path via embedded hyperlinks in the decision aid. The investigators will determine the usability, acceptability, and feasibility of iPath\*D. The investigators will explore the hypothesis that iPath\*D will be highly usable, acceptable to patients, feasible to implement, and will result in improved mental health literacy, and greater treatment access. The tool for the study was developed during a preliminary portion (Aim 1) of the project, under D-H IRB number STUDY02001240 . This approach uses an open-label, single arm pilot, with adult patients receiving treatment for cancer in a rural cancer clinic, St Johnsbury, VT (Dartmouth Cancer Center North) (n=30) with moderate-severe depression, Aim 2 of the project.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
30
Online pathway from screening to treatment for depression in cancer patients.
Dartmouth Cancer Center St. Johnsbury
Saint Johnsbury, Vermont, United States
System usability
System Usability Scale (10 items; mean ≥68/100),
Time frame: 2 weeks
Acceptability of intervention
Acceptability of Intervention Measure (4 items), mean ≥4/5
Time frame: 2 weeks
Feasibility of intervention
Feasibility of Intervention Measure (4 items), mean ≥4/5
Time frame: 2 weeks
Change in number of patients selecting a treatment path to access
Click on link to access online treatment service \| indicate in self-report survey accessing local resources
Time frame: 2 weeks, 4 weeks, 6 weeks
Change in Mental Health Literacy (MHL)
A modified 10-item version for the validated multiple choice questionnaire (MCQ) for depression assesses treatment knowledge, understanding \& beliefs. Higher scores indicate higher MHL.
Time frame: Baseline, 2 weeks
Change in PHQ-9 completion (exploratory outcome)
Number of patients who complete Patient Health Questionnaire (PHQ-9), a validated nine item depression scale. A score total of 0-4 points equals "normal" or minimal depression. Scoring between 5-9 points indicates mild depression, 10-14 points indicates moderate depression, 15-19 points indicates moderately severe depression, and 20 or more points indicates severe depression.
Time frame: Baseline, 2 weeks, 4 weeks, 6 weeks
Change in treatment initiation (exploratory outcome)
Proportion of patients who self-report treatment initiation e.g., fill antidepressant prescription, visited with psychiatrist for talk therapy, began a cCBT program, or other service
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Time frame: 2 weeks, 4 weeks, 6 weeks
Change in treatment adherence (exploratory outcome)
Proportion of patients who self-report continued adherence to treatment e.g., antidepressant refill (yes/no), number of talk therapy sessions completed, or Computerised Cognitive Behavioural Therapy (cCBT) modules completed
Time frame: 2 weeks, 4 weeks, 6 weeks
Decisional regret (exploratory outcome)
The Decisional Regret Scale assesses satisfaction with a healthcare decision (5-items, scores range from 0-100, with higher scores indicating high regret)
Time frame: 6 weeks
Change in PHQ-9 score (exploratory outcome)
Response; 5-point reduction in baseline PHQ-9 score. Remission; PHQ-9 score of \<5 points
Time frame: Baseline, 2 weeks, 4 weeks, 6 weeks
Change in quality of life (exploratory outcome)
Functional Assessment of Cancer Therapy-General (FACT-G) scale (27-items, scores range from 0-108 with higher scores indicating higher quality of life)
Time frame: Baseline, 6 weeks