David C. Mohr

David C. Mohr
Northwestern University | NU · Department of Preventive Medicine

Ph.D.

About

335
Publications
144,092
Reads
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26,573
Citations
Additional affiliations
November 2006 - present
Northwestern University
Position
  • Northwestern University, Feinberg School of Medicine
January 1991 - November 2006
University of California, San Francisco

Publications

Publications (335)
Article
Full-text available
Two randomized controlled trials (RCTs) in Brazil and Peru demonstrated the effectiveness of CONEMO, a digital intervention supported by trained nurses or nurse assistants (NAs), to reduce depressive symptoms in people with diabetes and/or hypertension. This paper extends the RCTs findings by reflecting on the conditions needed for its wider implem...
Article
Full-text available
Background Fear of recurrence (FoR) is prevalent among breast cancer survivors (BCS) and may be exacerbated by avoidance coping. This study examined BCS with avoidance coping and their engagement in a FoR eHealth intervention (FoRtitude). Methods BCS (N = 196) with elevated FoR participated in FoRtitude. Patient-reported measures assessed avoidanc...
Article
Trials of digital mental health interventions (DMHIs) often exclude individuals with suicide-related thoughts and behaviors precluding an understanding of whether DMHIs for affective disorders are safe for, and perform similarly within, this high-risk group. We explore the safety and performance of a DMHI for depression in participants with and wit...
Article
Full-text available
Background: There is growing interest in the design of digital interventions to improve conditions for young people who engage in high-risk behaviors, like nonsuicidal self-injury (NSSI). However, few studies have focused on how young people self-manage NSSI, or their existing, and historic, use of technologies to support their goals related to NS...
Conference Paper
Young adults have high rates of mental health conditions, yet they are the age group least likely to seek traditional treatment. They do, however, seek information about their mental health online, including by filling out online mental health screeners. To better understand online self-screening, and its role in help-seeking, we conducted focus gr...
Conference Paper
Young adults have high rates of mental health conditions, but most do not want or cannot access formal treatment. We therefore recruited young adults with depression or anxiety symptoms to co-design a digital tool for self-managing their mental health concerns. Through study activities-consisting of an online discussion group and a series of design...
Article
Digital tools can support individuals managing mental health concerns, but delivering sufficiently engaging content is challenging. This paper seeks to clarify how individuals with mental health concerns can contribute content to improve push-based mental health messaging tools. We recruited crowdworkers with mental health symptoms to evaluate and...
Article
Depression is a challenging condition that requires individuals to manage their moods and emotions over time. Within CSCW, there has been an interest in understanding how individuals seek and share support on social media and in online communities. However, less attention has been paid to how collaboration as an aspect of self-management of depress...
Article
Background The prevalence of self-injurious thoughts and behaviors (SITB) signals a growing public health crisis. Despite a recognized need for improved and scalable interventions, the field of SITB intervention faces several challenges: existing interventions are often time and resource intensive, most individuals with SITB do not seek formal ment...
Preprint
Full-text available
BACKGROUND Depression is one of the most prevalent mental disorders and a leading cause of disability, disproportionately affecting specific groups, such as patients with non-communicable diseases. Over the last decade, digital interventions have been developed to provide treatment for these patients. CONEMO is an 18-session psycho-educational digi...
Article
Full-text available
Background College students endorse high rates of mental health problems. While many colleges offer on-campus services, many students who could benefit from mental health services do not receive care. Indeed, nearly half of students who screen positive for depression, for example, do not receive treatment. Digital mental health programs, such as th...
Article
Background Personal sensing has shown promise for detecting behavioral correlates of depression, but there is little work examining personal sensing of cognitive and affective states. Digital language, particularly through personal text messages, is one source that can measure these markers. Methods We correlated privacy-preserving sentiment analy...
Article
Full-text available
Objective Given the increasing number of publicly available mental health apps, we need independent advice to guide adoption. This paper discusses the challenges and opportunities of current mental health app rating systems and describes the refinement process of one prominent system, the One Mind PsyberGuide Credibility Rating Scale (PGCRS). Meth...
Article
Background: The assessment of behaviors related to mental health typically relies on self-report data. Networked sensors embedded in smartphones can measure some behaviors objectively and continuously, with no ongoing effort. Objective: This study aims to evaluate whether changes in phone sensor-derived behavioral features were associated with s...
Article
A large number of trials have consistently shown that guided digital mental health treatments (DMHTs) are effective for depression and anxiety. As DMHTs are adopted by healthcare organizations, payers, and employers, they are often considered most appropriate for people with mild-to-moderate levels of symptom severity. Thus, the aim of this study w...
Preprint
BACKGROUND The prevalence of self-injurious thoughts and behaviors (SITB) signals a growing public health crisis. Despite a recognized need for improved and scalable interventions, the field of SITB intervention faces several challenges: existing interventions are often time and resource intensive, most individuals with SITB do not seek formal ment...
Article
Background Fear of recurrence (FoR) is a prevalent concern among breast cancer survivors (BCS) yet few accessible interventions exist. This study evaluated a targeted eHealth intervention, “FoRtitude,” to reduce FoR using cognitive behavioral skills training and telecoaching. Methods BCS (N = 196) were recruited from an academic medical center and...
Preprint
BACKGROUND Bipolar disorder is a severe mental illness with high levels of morbidity and mortality. Even with pharmacologic treatment, frequent recurrence of episodes, long episode durations, and persistent inter-episode symptoms are common and disruptive. Combining psychotherapy with pharmacotherapy improves outcomes, but access to therapy is limi...
Article
Background: Bipolar disorder is a severe mental illness with high morbidity and mortality rates. Even with pharmacological treatment, frequent recurrence of episodes, long episode durations, and persistent interepisode symptoms are common and disruptive. Combining psychotherapy with pharmacotherapy improves outcomes; however, many individuals with...
Article
Full-text available
Importance Depression is a leading contributor to disease burden globally. Digital mental health interventions can address the treatment gap in low- and middle-income countries, but the effectiveness in these countries is unknown. Objective To investigate the effectiveness of a digital intervention in reducing depressive symptoms among people with...
Article
Background Internet cognitive behavioural therapy (iCBT) is a viable delivery format of CBT for depression. However, iCBT programmes include training in a wide array of cognitive and behavioural skills via different delivery methods, and it remains unclear which of these components are more efficacious and for whom. Methods We did a systematic revi...
Article
Full-text available
Engagement is a multifaceted construct and a likely mechanism by which digital interventions achieve clinical improvements. To date, clinical research on digital mental health interventions (DMHIs) has overwhelmingly defined engagement and assessed its association with clinical outcomes through the objective/behavioral metrics of use of or interact...
Article
Cognitive behavioral stress management (CBSM) improves quality of life and mitigates stress biology in patients with early-stage cancer, including men with localized prostate cancer. However, treatments for advanced prostate cancer like androgen deprivation therapy (ADT) can lead to significant symptom burden that may be further exacerbated by stre...
Preprint
BACKGROUND Using mobile health technology has sparked a broad engagement of data science and machine learning methods to leverage the complex, assorted amount of data for mental health purposes. Despite many studies, there is a reported underdevelopment of user engagement concepts, and the desire for high accuracy or significance has shown to lead...
Article
Full-text available
As U.S. healthcare organizations transition to value-based healthcare, they are increasingly focusing on supporting patients who have difficulties managing chronic care, including mental health, through the growing role of care managers (CMs). CMs communicate with patients, provide access to resources, and coach them toward healthy behaviors. CMs a...
Preprint
BACKGROUND There is incredible public health potential for developing digital mental health tools that can be easily integrated into people’s lives. Such tools have the potential to extend reach and maximize impact. Prior to implementing digital tools into new settings, it is critical to understand what is important to the organizations and individ...
Article
Full-text available
Background Digital mental health tools have substantial potential to be easily integrated into people’s lives and fundamentally impact public health. Such tools can extend the reach and maximize the impact of mental health interventions. Before implementing digital tools in new settings, it is critical to understand what is important to organizatio...
Article
A major obstacle to mental health treatment for many Americans is accessibility: the United States faces a shortage of mental health providers, resulting in federally designated shortage areas. Although digital mental health treatments (DMHTs) are effective interventions for common mental disorders, they have not been widely adopted by the U.S. hea...
Article
Full-text available
Importance Personalized treatment choices would increase the effectiveness of internet-based cognitive behavioral therapy (iCBT) for depression to the extent that patients differ in interventions that better suit them. Objective To provide personalized estimates of short-term and long-term relative efficacy of guided and unguided iCBT for depressi...
Article
Full-text available
Data from networked sensors, such as those in our phones, are increasingly being explored and used to identify behaviors related to health and mental health. While computer scientists have referred to this field as context sensing, personal sensing, or mobile sensing, medicine has more recently adopted the term digital phenotyping. This paper discu...
Preprint
UNSTRUCTURED Despite effective pharmacological treatment, bipolar disorder is a leading cause of disability due to the common recurrence of episodes, long episode durations, and persistence of inter-episode symptoms. While adding psychotherapy to pharmacotherapy improves outcomes, the availability of adjunctive psychotherapy is limited. To extend t...
Article
Full-text available
Despite effective pharmacological treatment, bipolar disorder is a leading cause of disability due to recurrence of episodes, long episode durations, and persistence of interepisode symptoms. While adding psychotherapy to pharmacotherapy improves outcomes, the availability of adjunctive psychotherapy is limited. To extend the accessibility and func...
Article
Background Telephone-administered psychotherapy (tCBT) and internet-based treatments (iCBT) may overcome barriers to mental health treatment. TCBT has demonstrated efficacy similar to traditional psychotherapy, however, few studies have compared iCBT to efficacious interventions. This exploratory study examined the noninferiority of iCBT relative t...
Article
U.S. health care systems are tasked with alleviating the burden of mental health, but are frequently underprepared and lack workforce and resource capacity to deliver services to all in need. Digital mental health interventions (DMHIs) can increase access to evidence-based mental health care. However, DMHIs commonly do not fit into the day-to-day a...
Article
Full-text available
Background: Interest is growing in digital and telehealth delivery of mental health services, but data are scarce on outcomes in routine care. The federally funded Australian MindSpot Clinic provides online and telephone psychological assessment and treatment services to Australian adults. We aimed to summarise demographic characteristics and trea...
Article
Full-text available
Background: In recent years, there has been an increase in symptoms of depression, anxiety, and other mental illnesses in college student populations alongside a steady rise in the demand for counseling services. Digital mental health programs, such as those delivered through mobile apps, can add to the array of available services but must be teste...
Article
This work‐in‐progress paper reports preliminary analysis of an online survey of 224 university students (undergraduate or graduate), examining their help‐seeking behavior, information needs, information‐seeking behavior, and information‐seeking satisfaction when experiencing stress, anxiety, or depression symptoms. Information on the Internet was t...
Preprint
BACKGROUND Accounting for how end-users engage with technologies is imperative for designing an efficacious mobile behavioral intervention. OBJECTIVE This mixed-methods analysis examined the translational potential of user-centered design and basic behavioral science to inform the design of a mobile intervention for obesity and binge eating. METH...
Article
Full-text available
Background Accounting for how end users engage with technologies is imperative for designing an efficacious mobile behavioral intervention. Objective This mixed methods analysis examined the translational potential of user-centered design and basic behavioral science to inform the design of a new mobile intervention for obesity and binge eating....
Article
Implementing a digital mental health service in primary care requires integration into clinic workflow. However, without adequate attention to service design, including designing referral pathways to identify and engage patients, implementation will fail. This article reports results from our efforts designing referral pathways for a randomized cli...
Preprint
BACKGROUND The assessment of behaviors related to mental health typically relies on self-report data. Networked sensors embedded in smartphones can measure some behaviors objectively and continuously, with no ongoing effort. OBJECTIVE This study aims to evaluate whether changes in phone sensor–derived behavioral features were associated with subse...
Preprint
BACKGROUND In recent years, there has been an increase in symptoms of depression, anxiety, and other mental illnesses in college student populations alongside a steady rise in the demand for counseling services. Digital mental health programs, such as those delivered through mobile apps, can add to the array of available services but must be tested...
Article
Full-text available
Since the emergence of psychological interventions delivered via the Internet they have differed in numerous ways. The wealth of formats, methods, and technological solutions has led to increased availability and cost-effectiveness of clinical care, however, it has simultaneously generated a multitude of terms. With this paper, we first aim to esta...
Preprint
BACKGROUND Bipolar disorder is a serious mental illness that results in significant morbidity and mortality. A combination of medications and psychotherapy improves outcomes, but accessibility of treatment is limited. Smartphones and other technologies have the potential to increase access to evidence-based strategies that enhance self-management w...
Article
Full-text available
Background Bipolar disorder is a serious mental illness that results in significant morbidity and mortality. Pharmacotherapy is the primary treatment for bipolar disorder; however, adjunctive psychotherapy can help individuals use self-management strategies to improve outcomes. Yet access to this therapy is limited. Smartphones and other technologi...
Article
Importance Depression and anxiety are common and disabling. Primary care is the de facto site for treating these mental health problems but is typically underresourced to meet the burden of these demands. Objective To evaluate the efficacy of a mobile intervention platform, IntelliCare, for addressing depression and anxiety among primary care pati...
Conference Paper
While the HCI field increasingly examines how digital tools can support individuals in managing mental health conditions, it remains unclear how these tools can accommodate these conditions' temporal aspects. Based on weekly interviews with five individuals with depression, conducted over six weeks, this study identifies design opportunities and ch...
Chapter
Behavioral intervention technologies through mobile applications have a great potential to enhance patient care by improving efficacy. One approach to optimize the utility of mobile health applications is through an individualized health application recommender system. We formalize such a recommender system as a policy that maps individual subject...
Article
Background: The expanding amount of information available from our use of technologies has led researchers to explore how this information can aid in the detection of mental health issues. We expand on past work in this area by exploring how browsing histories might be able to predict perceived barriers to psychological treatment. Methods: We ob...
Article
Background: Men with advanced prostate cancer (APC) face multiple challenges including poor prognosis, poor health-related quality of life (HRQOL), and elevated symptom burden. This study sought to establish the efficacy of a tablet-delivered, group-based psychosocial intervention for improving HRQOL and reducing symptom burden in men with APC. We...
Article
Full-text available
Technology-enabled mental health services have the potential to expand the reach of care and reduce clinician demand. While the efficacy of technology-enabled mental health services is well established, there have been few successful implementations of such services into community care settings. Using mixed methods, 89 clinicians and supervisors at...
Article
Full-text available
Background: Technological interventions provide many opportunities for improving the health and quality of life of older adults. However, interaction with new technologies can also cause frustration. Although these themes have been explored in extant research, much remains to be learned with regard to how the challenges of aging and technology use...
Preprint
Full-text available
BACKGROUND Technological interventions provide many opportunities for improving the health and quality of life of older adults. However, interaction with new technologies can also cause frustration. Although these themes have been explored in extant research, much remains to be learned with regard to how the challenges of aging and technology use a...
Article
Full-text available
A body of literature suggests that the provision of human support improves both adherence to and clinical outcomes for digital mental health interventions. While multiple models of providing human support, or coaching, to support digital mental health interventions have been introduced, specific guidance on how to develop coaching protocols has bee...
Article
Full-text available
Estimating the category and quality of interpersonal relationships from ubiquitous phone sensor data matters for studying mental well-being and social support. Prior work focused on using communication volume to estimate broad relationship categories, often with small samples. Here we contextualize communications by combining phone logs with demogr...
Article
Full-text available
Internet-based cognitive behavioral therapy (iCBT) may overcome barriers to mental health care and has proven efficacious. However, this approach currently exists outside the existing mental health care delivery system. Stepped care is a proposed framework for integrating digital mental health (DMH) into health systems by initiating iCBT and “stepp...
Article
Millions of Americans struggle with depression, a condition characterized by feelings of sadness and motivation loss. To understand how individuals managing depression conceptualize their self-management activities, we conducted visual elicitations and semi-structured interviews with 30 participants managing depression in a large city in the U.S. M...
Conference Paper
Psychosocial disability involves actual or perceived impairment due to a diversity of mental, emotional, or cognitive experiences. While assistive technology for psychosocial disabilities has been understudied in communities such as ASSETS, advances in computing have opened up a number of new avenues for assisting those with psychosocial disabiliti...
Preprint
BACKGROUND Nearly half of breast cancer patients experience clinically significant mental distress within the first year of receiving their cancer diagnosis. There is an urgent need to identify scalable and cost-efficient ways of delivering empirically supported mental health interventions to breast cancer patients. OBJECTIVE The current study eva...
Article
Full-text available
Background: Nearly half of the patients with breast cancer experience clinically significant mental distress within the first year of receiving their cancer diagnosis. There is an urgent need to identify scalable and cost-efficient ways of delivering empirically supported mental health interventions to patients with breast cancer. Objective: The...
Preprint
BACKGROUND Technology-based mental health interventions are an increasingly attractive option for expanding access to mental health services within the primary care system. Older adults are among the groups that could potentially benefit from the growing ubiquity of technology-based mental health interventions, yet older adults are assumed to be av...
Article
Full-text available
Background: Technology-based mental health interventions are an increasingly attractive option for expanding access to mental health services within the primary care system. Older adults are among the groups that could potentially benefit from the growing ubiquity of technology-based mental health interventions; however, older adults are perceived...
Article
Full-text available
This trial examined whether a stepped care program for depression, which initiated treatment with internet cognitive behavioral therapy, including telephone and messaging support, and stepped up non-responders to telephone-administered cognitive behavioral therapy (tCBT), was noninferior, less costly to deliver, and as acceptable to patients compar...
Article
The efficacy of digital mental health (DMH) services is well established. Digital mental health services are comprised of the technology, service protocol, and, ideally, implementation plan to support delivery. Like their traditional in-person treatment counterparts, DMH services have been developed and are being studied to target the behavioral, c...