Adrian Aguilera
University of California, Berkeley, Social Welfare, Faculty Member
- University of California, San Francisco, Department of Psychiatry, Department Memberadd
- Culture, Clinical Psychology, Mental Health, Mhealth, Social Welfare, Cognitive Behavioral Therapy, and 11 moreDepression, Public Health, Primary Care, Chronic illness, eHealth, Health Information Technology, Depresssion, Text Messaging, Emotional and Behavioral Disorders, Mobile Technology, and Emotional Disturbanceedit
- Adrian Aguilera, Ph.D., is an Assistant Professor in the School of Social Welfare at UC Berkeley. He was previously ... moreAdrian Aguilera, Ph.D., is an Assistant Professor in the School of Social Welfare at UC Berkeley. He was previously a postdoctoral fellow in the NIMH (T32) funded Clinical Services Research Training Program in the Department of Psychiatry at the University of California, San Francisco (UCSF) and San Francisco General Hospital (SFGH). He also completed a clinical psychology internship at the San Francisco VA. He graduated from Stanford University (B.A.) in 2002 and received his master’s (2006) and doctoral degree (2009) in Clinical Psychology at the University of California, Los Angeles. Dr. Aguilera’s research has focused on studying the influence of culture, community and SES on mental health along with developing interventions to address health disparities in low-income and minority populations. His dissertation examined how acculturation moderates the influence of negative family factors in the course of schizophrenia for Mexican-Americans. Dr. Aguilera’s current work has focused on the utilization of mobile technology to improve mental healthcare for underserved populations to reduce health disparities. He is currently developing and testing a text-messaging adjunct to group cognitive behavioral therapy in English and Spanish that is aimed at increasing treatment adherence and improving outcomes.edit
Research Interests:
Research Interests:
Research Interests:
Research Interests:
ABSTRACT: The growth of the Internet, mobile phones, social media and other digital technologies has changed our world in many ways. It has provided individuals with information that was previously only available to a select few. An... more
ABSTRACT: The growth of the Internet, mobile phones, social media and other digital technologies has changed our world in many ways. It has provided individuals with information that was previously only available to a select few. An example of the reach of technology is data that as of October 2012, there are over 6 billion phones worldwide. The availability of data in real time has presented hopes of intervening more efficiently and managing health problems by leveraging limited human resources. It also has an impact in changing the roles of providers and patients and in legal and ethical issues including privacy in digital health interactions. This paper will discuss why digital technology has received recent attention in the area of mental health, present some applications of technology for mental health to date, explore the challenges to full implementation in clinical settings, and present future opportunities for digital technologies.
Research Interests:
Background Mobile and automated technologies are increasingly becoming integrated into mental healthcare and assessment. The purpose of this study was to determine how automated daily mood ratings are related to the Patient Health... more
Background
Mobile and automated technologies are increasingly becoming integrated into mental healthcare and assessment. The purpose of this study was to determine how automated daily mood ratings are related to the Patient Health Questionnaire–9 (PHQ-9), a standard measure in the screening and tracking of depression symptoms.
Results
There was a significant relationship between daily mood scores and one-week average mood scores and PHQ-9 scores controlling for linear change in depression scores. PHQ9 scores were not related to the average of two week mood ratings. This study also constructed models using variance, maximum, and minimum values of mood ratings in the preceding week and two-week periods as predictors of PHQ-9. None of these variables significantly predicted PHQ-9 scores when controlling for daily mood ratings and the corresponding averages for each period.
Limitations
This study only assessed patients who were in treatment for depression therefore do not account for the relationship between text message mood ratings for those who are not depressed. The sample was also predominantly Spanish speaking and low-income making generalizability to other populations uncertain.
Conclusions
Our results show that automatic text message based mood ratings can be a clinically useful proxy for the PHQ9. Importantly, this approach avoids the limitations of the PHQ9 administration, which include length and a higher requirement for literacy.
Keywords
PHQ9; Depression; Text messaging; Mhealth; Digital health; Disparities
Mobile and automated technologies are increasingly becoming integrated into mental healthcare and assessment. The purpose of this study was to determine how automated daily mood ratings are related to the Patient Health Questionnaire–9 (PHQ-9), a standard measure in the screening and tracking of depression symptoms.
Results
There was a significant relationship between daily mood scores and one-week average mood scores and PHQ-9 scores controlling for linear change in depression scores. PHQ9 scores were not related to the average of two week mood ratings. This study also constructed models using variance, maximum, and minimum values of mood ratings in the preceding week and two-week periods as predictors of PHQ-9. None of these variables significantly predicted PHQ-9 scores when controlling for daily mood ratings and the corresponding averages for each period.
Limitations
This study only assessed patients who were in treatment for depression therefore do not account for the relationship between text message mood ratings for those who are not depressed. The sample was also predominantly Spanish speaking and low-income making generalizability to other populations uncertain.
Conclusions
Our results show that automatic text message based mood ratings can be a clinically useful proxy for the PHQ9. Importantly, this approach avoids the limitations of the PHQ9 administration, which include length and a higher requirement for literacy.
Keywords
PHQ9; Depression; Text messaging; Mhealth; Digital health; Disparities
Research Interests:
Background: Mobile health interventions are often standardized and assumed to work the same for all users; however, we may be missing cultural differences in the experiences of interventions that may impact how and if an intervention is... more
Background: Mobile health interventions are often standardized and assumed to work the same for all users; however, we may
be missing cultural differences in the experiences of interventions that may impact how and if an intervention is effective.
Objective: The objective of the study was to assess qualitative feedback from participants to determine if there were differences
between Spanish speakers and English speakers. Daily text messages were sent to patients as an adjunct to group Cognitive
Behavioral Therapy (CBT) for depression.
Methods: Messages inquired about mood and about specific themes (thoughts, activities, social interactions) of a manualized
group CBT intervention. There were thirty-nine patients who participated in the text messaging pilot study. The average age of
the participants was 53 years (SD 10.4; range of 23-72).
Results: Qualitative feedback from Spanish speakers highlighted feelings of social support, whereas English speakers noted
increased introspection and self-awareness of their mood state.
Conclusions: These cultural differences should be explored further, as they may impact the effect of supportive mobile health
interventions.
Trial Registration: Trial Registration: Clinicaltrials.gov NCT01083628; http://clinicaltrials.gov/ct2/show/study/NCT01083628
(Archived by WebCite at http://www.webcitation.org/6StpbdHuq).
be missing cultural differences in the experiences of interventions that may impact how and if an intervention is effective.
Objective: The objective of the study was to assess qualitative feedback from participants to determine if there were differences
between Spanish speakers and English speakers. Daily text messages were sent to patients as an adjunct to group Cognitive
Behavioral Therapy (CBT) for depression.
Methods: Messages inquired about mood and about specific themes (thoughts, activities, social interactions) of a manualized
group CBT intervention. There were thirty-nine patients who participated in the text messaging pilot study. The average age of
the participants was 53 years (SD 10.4; range of 23-72).
Results: Qualitative feedback from Spanish speakers highlighted feelings of social support, whereas English speakers noted
increased introspection and self-awareness of their mood state.
Conclusions: These cultural differences should be explored further, as they may impact the effect of supportive mobile health
interventions.
Trial Registration: Trial Registration: Clinicaltrials.gov NCT01083628; http://clinicaltrials.gov/ct2/show/study/NCT01083628
(Archived by WebCite at http://www.webcitation.org/6StpbdHuq).
Research Interests:
Abstract 1. Psychological assessment and intervention are extending from the clinic into daily life. Multiple forces are at play: Advances in mobile technology, constrained clinical care, and consumer demand for contextualized,... more
Abstract 1. Psychological assessment and intervention are extending from the clinic into daily life. Multiple forces are at play: Advances in mobile technology, constrained clinical care, and consumer demand for contextualized, nonstigmatizing, and low-cost alternatives are beginning to change the face of psychological assessment and interventions. Mobile, social, and wearable technologies are now enabling individuals to measure themselves and to integrate myriad forms of help and entertainment.
Background: Internet interventions have the potential to address many of the health problems that produce the greatest global burden of disease. We present a study illustrating this potential. The Spanish/English San Francisco Stop... more
Background: Internet interventions have the potential to address many of the health problems that produce the greatest global burden of disease. We present a study illustrating this potential. The Spanish/English San Francisco Stop Smoking Internet site, which yielded quit rates of 20% or more at 12 months in published randomized controlled trials (RCTs), was modified to make it accessible to Spanish- and English-speaking smokers 18 years of age or older anywhere in the world.
Objective: To illustrate that Internet interventions designed to conduct RCTs can be adapted to serve as universal health care resources. We also examine quit rates obtained in the current participant preference study (in which users could choose from all elements tested in previous RCTs) to determine whether they differ from the quit rates found in the RCTs.
Methods: We modified the San Francisco Stop Smoking Internet site so that, instead of being randomly assigned to a specific intervention, participants could personalize the site by choosing among nine site elements (eg, stop smoking guide, reminder emails, journal, mood management intervention, or virtual group). Participants completed a baseline assessment, and reported smoking and mood data at 1-, 3-, 6-, and 12-month follow-ups. We assessed the modified website’s reach and outcomes (quit rates), and compared the quit rates of the current participant preference study with those of the previous RCTs.
Results: In the first year of recruitment, 94,158 individuals from 152 countries and territories visited the site; 13,488 participants left some data; 9173 signed consent; 7763 completed the baseline survey; and 1976, 1372, 1111, and 1097 left 1-, 3-, 6-, and 12-month data, respectively. Observed quit rates were 38%, 45%, 44%, and 45%, respectively. The current participant preference study yielded higher observed quit rates (odds ratio 1.30) than the previous RCT when controlling for individuals’ demographic and smoking characteristics.
Conclusion: After strict RCTs are completed, Internet intervention sites can be made into worldwide health intervention resources without reducing their effectiveness.
Objective: To illustrate that Internet interventions designed to conduct RCTs can be adapted to serve as universal health care resources. We also examine quit rates obtained in the current participant preference study (in which users could choose from all elements tested in previous RCTs) to determine whether they differ from the quit rates found in the RCTs.
Methods: We modified the San Francisco Stop Smoking Internet site so that, instead of being randomly assigned to a specific intervention, participants could personalize the site by choosing among nine site elements (eg, stop smoking guide, reminder emails, journal, mood management intervention, or virtual group). Participants completed a baseline assessment, and reported smoking and mood data at 1-, 3-, 6-, and 12-month follow-ups. We assessed the modified website’s reach and outcomes (quit rates), and compared the quit rates of the current participant preference study with those of the previous RCTs.
Results: In the first year of recruitment, 94,158 individuals from 152 countries and territories visited the site; 13,488 participants left some data; 9173 signed consent; 7763 completed the baseline survey; and 1976, 1372, 1111, and 1097 left 1-, 3-, 6-, and 12-month data, respectively. Observed quit rates were 38%, 45%, 44%, and 45%, respectively. The current participant preference study yielded higher observed quit rates (odds ratio 1.30) than the previous RCT when controlling for individuals’ demographic and smoking characteristics.
Conclusion: After strict RCTs are completed, Internet intervention sites can be made into worldwide health intervention resources without reducing their effectiveness.
Research Interests:
This paper will outline the development and usability/feasibility testing of an automated text messaging adjunct to cognitive behavioral therapy (CBT) for depression in a public sector clinic serving low-income patients. The... more
This paper will outline the development and usability/feasibility testing of an automated text messaging adjunct to cognitive behavioral therapy (CBT) for depression in a public sector clinic serving low-income patients. The text-messaging adjunct is aimed at increasing homework adherence, improving self-awareness, and helping track patient progress. Daily text messages were sent to patients inquiring about their mood. Additional daily messages corresponded to themes of a manualized group CBT intervention. These included 1) thought tracking (both positive and negative), 2) tracking of pleasant activities, 3) tracking of positive and negative contacts, 4) tracking of physical well-being. We tested the adjunct in two CBT groups (1 English & 1 Spanish) consisting of 12 patients total during and after treatment. Participants responded at a rate of 65% to text messages and they reported overall positive experiences. We propose that text messaging has potential to improve mental health care broadly, and among low-income populations specifically, using cost effective means.