{"doi":"10.1002/pon.70309","title":"Proactive Identification and Digital Mental Health Intervention for the Treatment of Depression Among Individuals With Likely Incurable Cancer: A Pilot Randomized Clinical Trial","abstract":"BACKGROUND: Although depression is prevalent and has significant consequences among individuals living with likely incurable cancer (ILLIC), optimal methods of identifying and treating depression in this population remain unknown. AIMS: To evaluate a paradigm of (1) proactive identification (ID) (i.e., remotely and asynchronously from clinical encounters) of depression among ILLIC and (2) digital mental health intervention (DMHI) for depression treatment. METHODS: In this decentralized randomized clinical trial, ILLIC with elevated depressive symptoms were proactively identified using electronic health record data and randomized 2:1 to a DMHI-based Behavioral Activation treatment or usual care (UC) depression treatment. Measures of feasibility (accrual, retention) and acceptability (engagement) were described; depression severity (change in PHQ-9 scores through 4 weeks post-randomization) was modeled with a generalized estimating equation. RESULTS: Among 88 ILLIC who completed screening, 30 were eligible and randomized to the trial. No patients were lost to follow-up or withdrew; 80% of patients randomized to proactive ID + DMHI used the app through 4 weeks. Proactive ID + DMHI improved depression from baseline to 4 weeks relative to proactive ID + UC (mean difference in change from baseline to week 4 = -2.7; 90% CI: -4.9 to -0.4). At 4 weeks, the odds of a clinical response (PHQ-9 decrease of ≥ 5 points) was 9.0-fold higher for patients in proactive ID + DMHI relative to proactive ID + UC (OR 9.0; 90% CI: 1.1-74.2). CONCLUSIONS: A proactive ID + DMHI approach to identifying and treating depression among ILLIC is feasible, acceptable, and potentially efficacious. These promising data support conducting a large efficacy trial evaluating this approach. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05932810.","journal":"Psycho-Oncology","year":2025,"id":578794,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9649,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT05932810"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1489049,"name":"Olivia Levins","orcid":null,"position":1,"is_corresponding":false},{"id":1220823,"name":"Reid DeMass","orcid":"0000-0002-8859-600X","position":2,"is_corresponding":false},{"id":1451043,"name":"Nivetha Baskar","orcid":null,"position":3,"is_corresponding":false},{"id":1159007,"name":"Noelle Natale","orcid":"0009-0003-3061-8899","position":4,"is_corresponding":false},{"id":323300,"name":"Katherine R. Sterba","orcid":"0000-0001-9780-8695","position":5,"is_corresponding":false},{"id":458375,"name":"Jihad S. Obeid","orcid":"0000-0002-7193-7779","position":6,"is_corresponding":false},{"id":1488683,"name":"Shivani Sharma","orcid":"0000-0002-1000-1352","position":7,"is_corresponding":false},{"id":317574,"name":"Elizabeth G. Hill","orcid":"0000-0003-0896-4106","position":8,"is_corresponding":false},{"id":350608,"name":"Jennifer Dahne","orcid":"0000-0001-7297-9420","position":9,"is_corresponding":false},{"id":1488682,"name":"Evan M. Graboyes","orcid":"0000-0003-3766-468X","position":0,"is_corresponding":true}],"reference_count":46,"raw_metadata":null,"created_at":"2026-07-19T02:58:24.957414Z","pmid":"41125447","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}