{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T04:23:41Z","timestamp":1793075021712,"version":"4.5.0"},"reference-count":117,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Bio-Industrial Technology Development Program","award":["RS-2024-00431485"],"award-info":[{"award-number":["RS-2024-00431485"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["DIGITAL HEALTH"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite the clinical potential of digital interventions for young adults with depression, low engagement remains a persistent challenge. A conversational therapeutic companion agent (TCA) can foster a digital therapeutic alliance to address this barrier.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to develop a Wizard-of-Oz TCA prototype integrating behavioral activation, ecological momentary assessment\/intervention (EMA\/EMI), and gamification, and to evaluate its proof-of-concept feasibility, acceptability, and preliminary clinical efficacy for young adults with depressive symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>58 Korean young adults ages 20 to 39 (50.0% female) with subclinical to moderately severe depressive symptoms (Patient Health Questionnaire-9) were recruited. The intervention group (n=29) interacted with the TCA for six weeks, while a frequency-matched passive control group (n=29) continued usual routines. Primary outcomes were feasibility (adherence) and acceptability (satisfaction). Secondary outcomes for efficacy (Beck Depression Inventory-II, Generalized Anxiety Disorder-7, Quality-of-Life Enjoyment and Satisfaction Questionnaire-Short Form) were assessed biweekly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 58 participants, 57 completed the study. The intervention proved feasible, acceptable, and usable, achieving 69.5% strict on-time EMA adherence, 66.2% behavioral activation routine completion, a mean daily satisfaction of 3.49\/5.0, and a mean System Usability Scale (SUS) score of 74.02, meeting\n                      <jats:italic toggle=\"yes\">a priori<\/jats:italic>\n                      benchmarks. Exploratory analyses indicated the intervention group showed significantly greater reductions in depressive symptoms and improvements in quality of life compared to controls.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The TCA-based intervention is feasible and acceptable, successfully cultivating a digital therapeutic alliance. While preliminary clinical signals are promising, future fully powered randomized controlled trials are required to definitively establish clinical efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20552076261464801","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:19:46Z","timestamp":1787775586000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Investigating the mobile messenger app-based intervention delivered by a therapeutic companion agent for young adults with depressive symptoms: A proof-of-concept and quasi-experimental study"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5412-7769","authenticated-orcid":false,"given":"Youngjae","family":"Yoo","sequence":"first","affiliation":[{"name":"Yonsei University"},{"name":"HAII Corp"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7541-6840","authenticated-orcid":false,"given":"Minuk","family":"Kim","sequence":"additional","affiliation":[{"name":"Yonsei University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0740-7104","authenticated-orcid":false,"given":"Soyoung","family":"Kim","sequence":"additional","affiliation":[{"name":"Yonsei University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4182-8047","authenticated-orcid":false,"given":"Gayeon","family":"Lee","sequence":"additional","affiliation":[{"name":"Yonsei University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0162-5446","authenticated-orcid":false,"given":"Jinwoo","family":"Kim","sequence":"additional","affiliation":[{"name":"Yonsei University"},{"name":"Yonsei University"},{"name":"HAII Corp"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.54730"},{"key":"e_1_3_8_3_2","first-page":"157","volume-title":"The Psychology of Depression: Contemporary Theory and Research","author":"Lewinsohn PM","year":"1974","unstructured":"Lewinsohn PM. 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