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Digitally Enhanced Cognitive-Behavioral Therapy (CBT+)

1 september 2026 bijgewerkt door: Colorado State University

Digitally Enhanced Cognitive-Behavioral Therapy for Adolescents With Depression and Obesity

Adolescent depression is a major public health problem. Depression affects adolescents' emotional well-being now and in the future, and it also affects their physical health, especially the risk for heart disease and other cardiovascular and metabolic health problems. In adolescents with depression and obesity, evidence-based programs for depression, like cognitive-behavioral therapy (CBT), might improve physical health, in part by supporting healthy behaviors such as physical activity, nutritious eating, and getting enough sleep. Our preliminary studies provide support for this overarching hypothesis. If adolescents have access to a digital app to support practicing CBT skills in between program sessions, it might especially help them to learn skills that help to feel better and be healthier in their day-to-day lives. We are tailoring a digital app for this purpose and we will make changes to the app based on feedback from adolescents, their parents, and their doctors. Once the app is well-liked and helpful, and works well as a support for taking part in CBT, we will randomly assign 60 adolescents with depression and overweight/obesity to either "CBT+" - a CBT group program plus the app, or "CBT-only" - the CBT group program only. We will pilot test whether this research is feasible, likeable, and credible, learning information that will inform a larger study to test of CBT+ can support emotional well-being, health behavior, and cardiovascular and metabolic health in adolescents.

Studie Overzicht

Toestand

Nog niet aan het werven

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

Adolescent depression is a major public health problem that has serious consequences for cardiometabolic disease, predicting heightened risk for glucose dysregulation, type 2 diabetes onset, and cardiovascular events. Evidence-based interventions such as cognitive-behavioral therapy (CBT) to decrease depression in adolescents with elevated body mass index (BMI ≥85th percentile for age and sex) are anticipated to improve cardiometabolic health, in part by ameliorating the negative impacts of depression on health behavior (e.g., physical activity, eating, and sleep). Our preliminary studies provide support for this overarching hypothesis. However, effect sizes for CBT were small-to-moderate, possibly due to less-than-optimal home practice in between sessions. Homework completion tracks with treatment effects in our team's and others' studies, likely because homework facilitates skills acquisition in daily life. Our overarching study rationale is that enhancement of CBT-group with a digital app is likely to strengthen homework completion and translation of CBT skills to healthier coping and behavior, leading to stronger improvements in cardiometabolic health than CBT-group alone. We will leverage mobile health (mHealth) to adapt a CBT-digital app for the distinct needs and preferences of adolescents with depression and elevated BMI. After we optimize the app's integration with CBT-group virtual sessions through focus groups and iterative pilot testing with adolescents, we will conduct a two-arm, single-site pilot and feasibility randomized controlled trial to compare a digitally-enhanced CBT-group (CBT+) with a virtual CBT-group only in 60 adolescents with depression and overweight/obesity to assess feasibility, acceptability, proof-of-concept, and implementation outcomes.

Studietype

Ingrijpend

Inschrijving (Geschat)

60

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Locaties

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Kind

Accepteert gezonde vrijwilligers

Nee

Beschrijving

Inclusion Criteria:

  • Age 12-17 years
  • Body mass index (BMI) ≥85th percentile for age and sex
  • Elevated depression symptoms, Center for Epidemiologic Studies-Depression Scale (CES-D) ≥21

Exclusion Criteria:

  • Type 2 diabetes; Fasting glucose ≥126 mg/dL or HbA1c ≥6.5
  • Major developmental (e.g., intellectual developmental disability) or medical or genetic condition (e.g. cancer, Bardet-Biedhl)
  • Pregnancy/breastfeeding (females)
  • Bariatric surgery, weight loss medication, or weight loss >3% in the past 3 months
  • Active suicidality or self-harm

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Preventie
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Enkel

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Actieve vergelijker: Cognitive-behavioral therapy (CBT)
Six-week, six-session group cognitive-behavioral therapy (CBT) delivered virtually; CBT focuses on changing thoughts and changing behaviors to improve mood
Gedragsmatig: Cognitive-behavioral therapy (CBT)
Six-week, six-session group cognitive-behavioral therapy (CBT) delivered virtually
Experimenteel: Cognitive-behavioral therapy-Plus (CBT+)
Six-week, six-session group cognitive-behavioral therapy (CBT) delivered virtually; CBT focuses on changing thoughts and changing behaviors to improve mood PLUS access to a digital app to use throughout the CBT group program
Gedragsmatig: Cognitive-behavioral therapy (CBT)
Six-week, six-session group cognitive-behavioral therapy (CBT) delivered virtually
Gedragsmatig: Digital app
App tailored to support cognitive-behavioral therapy (CBT) skills and homework practices

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Intervention Acceptability
Tijdsspanne: Six-week follow-up
≥80% of adolescents will report likeability/benefit (≥4 on 1-5 scale where 5=Extremely)
Six-week follow-up
Intervention Feasibility
Tijdsspanne: Six-week follow-up
≥80% of adolescents will receive 80% group dosage (≥5 of 6 sessions)
Six-week follow-up
App Acceptability
Tijdsspanne: Six-week follow-up
Of those in CBT+, ≥80% of adolescents will use the app regularly (≥3 times per week)
Six-week follow-up

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Enrollment Feasibility
Tijdsspanne: End-of-enrollment
10 teens in ≤12 weeks to form CBT+ vs. CBT-group only parallel cohorts
End-of-enrollment
Enrollment Feasibility
Tijdsspanne: End-of-enrollment
≥75% of those determined to be eligible will enroll
End-of-enrollment
Protocol Feasibility
Tijdsspanne: End-of-3-month follow-ups
<10% missing data
End-of-3-month follow-ups
Protocol Feasibility
Tijdsspanne: End-of-3-month follow-ups
≥80% 3-month follow-up retention
End-of-3-month follow-ups

Andere uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Depression Symptoms
Tijdsspanne: Six-week follow-up and 3-month follow-up
Adolescent report on the 20-item Center for Epidemiologic Studies-Depression Scale (CES-D), total score
Six-week follow-up and 3-month follow-up
Negative Automatic Thoughts
Tijdsspanne: Six-week follow-up and 3-month follow-up
Adolescent report on the Negative Automatic Thoughts subscale of the Children's Automatic Thoughts Scale-Negative/Positive
Six-week follow-up and 3-month follow-up
Pleasant Activities
Tijdsspanne: Six-week follow-up and 3-month follow-up
Adolescent report of frequency/pleasantness of pleasant activities on the Pleasant Events Schedule
Six-week follow-up and 3-month follow-up
Homework Completion
Tijdsspanne: Six-week follow-up
Adolescent report on the Homework Rating Scale-Version 2
Six-week follow-up
Coping
Tijdsspanne: Six-week follow-up and 3-month follow-up
Adolescent report on the Brief COPE inventory
Six-week follow-up and 3-month follow-up
Self-efficacy
Tijdsspanne: Six-week follow-up and 3-month follow-up
Adolescent report on the Self-efficacy Questionnaire for Children
Six-week follow-up and 3-month follow-up
Loneliness
Tijdsspanne: Six-week follow-up and 3-month follow-up
Adolescent report on the UCLA Loneliness Scale
Six-week follow-up and 3-month follow-up
Physical Activity
Tijdsspanne: Six-week follow-up and 3-month follow-up
Time spent in moderate-to-vigorous physical activity measured from the adolescent-worn actigraphy
Six-week follow-up and 3-month follow-up
Sedentary Time
Tijdsspanne: Six-week follow-up and 3-month follow-up
Time spent sedentary measured from adolescent-worn actigraphy
Six-week follow-up and 3-month follow-up
Emotional Eating
Tijdsspanne: Six-week follow-up and 3-month follow-up
Adolescent report on the Emotional Eating Scale-Adapted for Children and Adolescents
Six-week follow-up and 3-month follow-up
Loss-of-control Eating
Tijdsspanne: Six-week follow-up and 3-month follow-up
Adolescent report of loss-of-control episodes on the Loss-of-Control Eating Disorder Questionnaire for Children
Six-week follow-up and 3-month follow-up
Insulin Resistance
Tijdsspanne: Six-week follow-up and 3-month follow-up
Homeostatic model assessment of insulin resistance derived from adolescent fasting insulin and fasting glucose
Six-week follow-up and 3-month follow-up
Blood pressure
Tijdsspanne: Six-week follow-up and 3-month follow-up
Systolic blood pressure derived from adolescent ambulatory monitoring
Six-week follow-up and 3-month follow-up
Blood Pressure
Tijdsspanne: Six-week follow-up and 3-month follow-up
Diastolic blood pressure derived from adolescent ambulatory monitoring
Six-week follow-up and 3-month follow-up
Lipids
Tijdsspanne: Six-week follow-up and 3-month follow-up
Adolescent triglycerides
Six-week follow-up and 3-month follow-up
Lipids
Tijdsspanne: Six-week follow-up and 3-month follow-up
Adolescent HDL cholesterol
Six-week follow-up and 3-month follow-up
Lipids
Tijdsspanne: Six-week follow-up and 3-month follow-up
Adolescent LDL cholesterol
Six-week follow-up and 3-month follow-up
Glycemic Variability
Tijdsspanne: Six-week follow-up and 3-month follow-up
Standard deviation of glucose derived from adolescent wear of continuous glucose monitor
Six-week follow-up and 3-month follow-up

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Colorado State University

Medewerkers

National Heart, Lung, and Blood Institute (NHLBI)

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

1 januari 2027

Primaire voltooiing (Geschat)

1 januari 2028

Studie voltooiing (Geschat)

1 augustus 2028

Studieregistratiedata

Eerst ingediend

29 april 2026

Eerst ingediend dat voldeed aan de QC-criteria

29 april 2026

Eerst geplaatst (Werkelijk)

6 mei 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

3 september 2026

Laatste update ingediend die voldeed aan QC-criteria

1 september 2026

Laatst geverifieerd

1 september 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • 25-0997
  • R34HL180788 (Subsidie/contract van de Amerikaanse NIH)

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

JA

Beschrijving IPD-plan

CBT-app usage and CBT group attendance; adolescent depression questionnaire data; CBT and CBT-app adolescent questionnaires assessing CBT-group and CBT-app therapeutic targets (thoughts, pleasant activities, coping, self-efficacy, loneliness); health behavior measured by actigraphy (physical activity/sleep) and adolescent questionnaire (eating); adolescent cardiometabolic health indicators by fasting blood draw to assess lipids (triglycerides, cholesterol) and glucose/insulin to calculate insulin resistance, continuous glucose monitoring data, and heart rate/blood pressure

IPD-tijdsbestek voor delen

Data will be made available no later than the time of an associated publication

IPD-toegangscriteria voor delen

We will use the openICPSR data repository, an NIH-approved self-publishing repository for social, behavioral, and health sciences research data; to request access of the data, researchers will follow the standard process at openICPSR

IPD delen Ondersteunend informatietype

  • LEERPROTOCOOL
  • ICF

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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