Pilot randomized controlled trial of a Spanish-language Behavioral Activation mobile app (¡Aptívate!) for the treatment of depressive symptoms among united states Latinx adults with limited English proficiency

Abstract Background To address the need for disseminable, evidence-based depression treatment options for Latinx adults with limited English proficiency (LEP), our team developed iAptivate!, a Spanish-language Behavioral Activation self-help mobile application. Primary aims of this study were to: 1) examine feasibility and uptake of iAptivate! among depressed Latinx adults with LEP and 2) preliminarily examine iAptivate! efficacy for depression treatment. Methods Participants ( N  = 42) with elevated depressive symptoms were randomized 2:1:1 to: 1) iAptivate! ( n  = 22), 2) an active control Spanish-language app (“iCouch CBT”; n  = 9), or 3) Treatment As Usual (i.e., no app; n  = 11). Feasibility was assessed via self-reported app utilization and app analytics data. Depressive symptoms were assessed weekly for eight weeks via self report. Results All iAptivate! participants used the app at least once, 81.8% of participants used the app ≥8 times, and 36.4% of participants used the app ≥56 times. Weekly retention was strong: 72.7% and 50% of participants continued to use the app at one- and two-months post-enrollment, respectively. Generalized Estimating Equation models indicated a significant interaction between time and treatment, such that iAptivate! participants reported significantly lower depressive symptoms over time than TAU. Depressive symptoms did not differ on average across time between the iCouch and TAU conditions, nor between iCouch and iAptivate!. Limitations Limitations include small sample size, limited follow-up, and lack of analytics data for the active control condition. Conclusions With further research, iAptivate! may offer a feasible, efficacious approach to extend the reach of evidence-based depression treatment for Latinx adults with LEP.