Evaluating smartphone-based interventions for anxiety and depressive symptoms: A randomized controlled trial

OBJECTIVE: The study evaluated the impact of two smartphone-based interventions on anxiety and depression symptoms during the COVID-19 pandemic. METHOD: Racially and ethnically diverse adults from the United States (US) with elevated anxiety and/or depression (N = 822; 64.4% female; Mage = 38.3 years, SD = 12.76) were randomly assigned to receive a smartphone delivered anxiety, depression, and anxiety sensitivity reduction intervention (EASE) or a mindfulness and relaxation-based (MR) digital intervention; 206 (25.1%) identified as African American, 208 (25.3%) as American Indian, 202 (24.6%) as Latinx, and 206 (25.1%) as non-Latinx White. RESULTS: There was a high degree of engagement for both groups. For our primary analysis, between-group differences at the 6-month primary endpoint were small and not statistically significant for anxiety and depression. Within-person effect sizes indicated decreases in anxiety, depression, probable clinical anxiety and/or depression disorder status, anxiety sensitivity, and COVID-19 fear through the follow-up. Exploratory subgroup analyses suggested variable patterns of within-condition change across racial and ethnic groups, but these analyses were not powered to test moderation or equivalence. CONCLUSIONS: Findings indicated that two low cost and highly disseminatable digital interventions that targeted distinct psychological processes offered clinical benefit among a diverse sample of adults in the US during the COVID-19 pandemic.