{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T20:50:34Z","timestamp":1785876634334,"version":"3.56.0"},"reference-count":94,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Ment Health"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n The COVID-19 pandemic highlighted a critical need for effective population mental health approaches to target the most prevalent disorders (eg, depression) during periods of elevated community distress. The effectiveness of remotely delivered and web-based interventions should be investigated to identify and innovate high-quality models for population mental health service delivery.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The primary objective investigated the effectiveness of adding Mindfulness-Based Cognitive Therapy for Resilience (MBCT-R)\u2014a live, online, synchronous, remotely delivered, group-based intervention\u2014to Cambridge Health Alliance MindWell (CHA-MW), a web-based population health screening and stratified support program, compared with CHA-MW alone, on depression symptom severity. The secondary objective evaluated adding internet Cognitive Behavioral Therapy (iCBT)\u2014an asynchronous, web-based, individual, digital intervention\u2014to CHA-MW, compared with CHA-MW alone.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Participants (N=97) were randomized in a 2:2:1 ratio to receive MBCT-R+CHA-MW (n=37), iCBT+CHA-MW (n=41), or CHA-MW alone (n=19) in a 3-arm randomized clinical trial, from May 2021 to September 2022 in an urban public safety net hospital outpatient setting. CHA-MW served as a low-intensity control condition. For the MBCT-R+CHA-MW arm, MBCT-R was an 8-session program mildly adapted from MBCT to address COVID-19\u2013related risks for depression. For the iCBT+CHA-MW arm, iCBT was a 6-session curriculum added to CHA-MW. All study procedures, including regular mental health symptom screenings, were conducted remotely or via a web-based platform. The primary outcome was change in depression symptom severity during the 24-week study period using an intention-to-treat approach that used generalized linear mixed-effects models to evaluate the comparative effectiveness of MBCT-R+CHA-MW vs CHA-MW over time. A secondary analysis compared iCBT+CHA-MW vs CHA-MW on depression severity. Completer analyses were conducted (per-protocol 6+ sessions). The secondary outcome was mental health visit utilization frequency during the study period.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Both MBCT-R+CHA-MW (mean difference \u221214.1, 95% CI \u221221.0 to \u22127.2) and CHA-MW (mean difference \u221215.2, 95% CI \u221221.8 to \u22128.6) had significant reductions in depression symptom severity, with no statistically significant between-group differences. iCBT+CHA-MW (mean difference \u221212.7, 95% CI \u221217.4 to \u22128.1) also reduced depression symptoms but without between-group differences when compared with CHA-MW. Intervention completion rates were low (MBCT-R: 30% and iCBT: 24%), and completers demonstrated significantly greater reductions in depression severity than noncompleters (mean difference \u22128.5, 95% CI \u221216.2 to \u22120.8). Overall mental health clinician visits by group had no statistically significant differences. CHA-MW had the largest increase in participants with new psychopharmacology treatment visits during the 24-week study (CHA-MW +21%, MBCT-R +10%, and iCBT \u22125%).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n MBCT-R+CHA-MW, iCBT+CHA-MW, and CHA-MW were each effective in treating depression, without any intervention demonstrating superiority in intention-to-treat analyses. CHA-MW was as efficacious during the COVID-19 pandemic as more resource-intensive interventions that demanded greater time and effort from participants. Low completion rates for MBCT-R and iCBT during the COVID-19 pandemic may have contributed to these results.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/88388","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T04:25:09Z","timestamp":1780892709000},"page":"e88388-e88388","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Remotely Delivered and Web-Based Interventions on Depression Severity During the COVID-19 Pandemic: 3-Arm Randomized Controlled 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