{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:43:59Z","timestamp":1785545039728,"version":"3.56.0"},"reference-count":76,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Hum Factors"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Anxiety and depressive disorders remain highly prevalent and insufficiently treated, with many individuals experiencing persistent or untreated symptoms, limited access to evidence-based care, or insufficient support between clinical encounters. Adults with disabilities represent a particularly underserved subpopulation, often facing compounded barriers to mental health care and higher rates of anxiety and depression. Digital therapeutics offer a scalable opportunity to address these gaps by extending structured, evidence-based interventions beyond traditional care settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This pilot study evaluated Rauha, a novel digital therapeutic created by Toivoa Inc, that integrates cognitive behavioral therapy (CBT)\u2013based modules with live weekly sessions led by a National Board-Certified Health and Wellness Coach (NBC-HWC), delivering structured, smartphone-based psychoeducation and interactive therapeutic exercises combined with personalized mental health coaching to support behavior change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirteen adults with mobility and\/or hearing disabilities and clinically elevated anxiety and\/or depression were enrolled in a single-arm, within-participants design. Participants completed 8 weeks of CBT modules delivered via smartphone, accompanied by synchronous virtual mental health coaching. Anxiety and depression were assessed using the Hamilton Anxiety and Hamilton Depression Rating Scales, respectively, at baseline, post treatment, and at the 4-week follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean reductions were significant for both anxiety (\u221213.05, SD 2.51;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001) and depression (\u221212.83, SD 1.55;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001), exceeding thresholds for clinical significance and sustained through follow-up. Post treatment, 84.6% (11\/13) of participants showed clinically significant improvement in both anxiety and depression. At follow-up, 76.9% (10\/13) and 92.3% (12\/13) of participants showed clinically significant improvement in anxiety and depression, respectively. Between baseline and follow-up time points, these reductions corresponded to mean shifts from moderate to mild anxiety on the Hamilton Anxiety Rating Scale and from moderate to mild\/nondepressed on the Hamilton Depression Rating Scale. Participants reported strongly favorable acceptability, experience, and usability ratings for the Rauha treatment program, demonstrating 100% treatment retention and an average replay rate of 5.5 for personalized smartphone content.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings suggest that a combined digital CBT and NBC-HWC approach can yield clinically meaningful and durable symptom reductions in depression and anxiety, coupled with high user acceptability and engagement, for adults with disabilities. These findings provide preliminary evidence supporting Rauha as a scalable, evidence-informed mental health intervention with the strong potential to improve access and address key barriers to care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/92448","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T06:05:06Z","timestamp":1779861906000},"page":"e92448-e92448","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating a Dual Digital Cognitive Behavioral Therapy and Health and Wellness Coaching Intervention for Anxiety and Depression: Single-Arm Pilot Study"],"prefix":"10.2196","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6654-7506","authenticated-orcid":false,"given":"Alex","family":"Kirk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4148-8836","authenticated-orcid":false,"given":"Christopher S","family":"King","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9986-2994","authenticated-orcid":false,"given":"Robert","family":"Gallop","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5873-344X","authenticated-orcid":false,"given":"Brian D","family":"Doan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6749-7072","authenticated-orcid":false,"given":"Lorelei","family":"Simpson Rowe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8795-0636","authenticated-orcid":false,"given":"Laura E","family":"Randa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.15620\/cdc\/64018","article-title":"Symptoms of anxiety and depression among adults: United States, 2019 and 2022","author":"Terlizzi","journal-title":"Natl Health Stat Report"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjmad.2026.100166","article-title":"Sociodemographic disparities, healthcare system trust, and social support in mental health treatment among U.S. adults with depressive or anxiety symptoms","volume":"13","author":"Ramachandiran","journal-title":"J Mood Anxiety Disord"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2018.05.041","article-title":"Explaining the increasing disability prevalence among mid-life US adults, 2002 to 2016","volume":"211","author":"Zajacova","journal-title":"Soc Sci Med"},{"issue":"36","key":"R4","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.15585\/mmwr.mm6936a2","article-title":"Frequent mental distress among adults, by disability status, disability type, and selected characteristics\u2014United States, 2018","volume":"69","author":"Cree","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-023-02035-w","article-title":"Health equity for persons with disabilities: a global scoping review on barriers and interventions in healthcare services","volume":"22","author":"Gr\u00e9aux","journal-title":"Int J Equity Health"},{"issue":"4","key":"R6","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1037\/rep0000512","article-title":"Barriers to mental health service use among people with disabilities during the COVID-19 pandemic","volume":"68","author":"Manning","journal-title":"Rehabil Psychol"},{"key":"R7","unstructured":"Mental Health Care Health Professional Shortage Areas (HPSAs). Kaiser Family Foundation (KFF). URL: https:\/\/www.kff.org\/other-health\/state-indicator\/mental-health-care-health-professional-shortage-areas-hpsas\/ [Accessed 08-09-2025]"},{"key":"R8","unstructured":"Key Substance Use and Mental Health Indicators in the United States: Results from the 2024 National Survey on Drug Use and Health. Center for Behavioral Health Statistics and Quality (CBHSQ), Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services; 2025. URL: https:\/\/www.samhsa.gov\/data\/report\/2023-nsduh-annual-national-report [Accessed 08-09-2025]"},{"issue":"5","key":"R9","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1037\/0278-6133.26.5.554","article-title":"Reduction in disability in a randomized controlled trial of telephone-administered cognitive-behavioral therapy","volume":"26","author":"Mohr","journal-title":"Health Psychol"},{"issue":"3","key":"R10","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1037\/rep0000491","article-title":"Psychosocial group therapy interventions for patients with physical disabilities: a scoping review of implementation considerations","volume":"68","author":"Steinberg","journal-title":"Rehabil Psychol"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2024.111998","article-title":"Cognitive behavioural therapy versus other interventions on mental health in people with sensory impairments: a systematic review and meta-analysis","volume":"189","author":"Trott","journal-title":"J Psychosom Res"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2025.1434376","article-title":"The efficacy of telemedicine interventions on quality of life and depression in individuals with spinal cord injury: a systematic review and meta-analysis","volume":"16","author":"Tan","journal-title":"Front Psychiatry"},{"issue":"2","key":"R13","doi-asserted-by":"publisher","DOI":"10.5195\/ijt.2021.6402","article-title":"Telehealth use by persons with disabilities during the COVID-19 pandemic","volume":"13","author":"Friedman","journal-title":"Int J Telerehabil"},{"issue":"11","key":"R14","doi-asserted-by":"publisher","first-page":"976","DOI":"10.1176\/appi.ps.201900104","article-title":"Increasing mental health care access, continuity, and efficiency for veterans through telehealth with video tablets","volume":"70","author":"Jacobs","journal-title":"Psychiatr Serv"},{"issue":"1264893","key":"R15","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2024.1264893","article-title":"Examining differences in time to appointment and no-show rates between rural telehealth users and non-users","volume":"6","author":"Pullyblank","journal-title":"Front Digit Health"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2023.05.012","article-title":"Low availability, long wait times, and high geographic disparity of psychiatric outpatient care in the US","volume":"84","author":"Sun","journal-title":"Gen Hosp Psychiatry"},{"issue":"4","key":"R17","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1001\/jamapsychiatry.2020.4364","article-title":"Internet-based cognitive behavioral therapy for depression: a systematic review and individual patient data network meta-analysis","volume":"78","author":"Karyotaki","journal-title":"JAMA Psychiatry"},{"issue":"8","key":"R18","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.28372","article-title":"Efficacy of a mobile app-based intervention for young adults with anxiety disorders: a randomized clinical trial","volume":"7","author":"Bress","journal-title":"JAMA Netw Open"},{"issue":"1","key":"R19","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-023-00777-z","article-title":"Digital therapeutics from bench to bedside","volume":"6","author":"Wang","journal-title":"NPJ Digit Med"},{"issue":"11","key":"R20","doi-asserted-by":"publisher","DOI":"10.2196\/41689","article-title":"Effectiveness of mental health apps for distress during COVID-19 in US unemployed and essential workers: remote pragmatic randomized clinical trial","volume":"10","author":"Comtois","journal-title":"JMIR mHealth uHealth"},{"key":"R21","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2024.102518","article-title":"Do the effects of internet-delivered cognitive-behavioral therapy (i-CBT) last after a year and beyond? A meta-analysis of 154 randomized controlled trials (RCTs)","volume":"114","author":"Zainal","journal-title":"Clin Psychol Rev"},{"issue":"8","key":"R22","doi-asserted-by":"publisher","DOI":"10.2196\/18100","article-title":"Effects of internet-based cognitive behavioral therapy in routine care for adults in treatment for depression and anxiety: systematic review and meta-analysis","volume":"22","author":"Etzelmueller","journal-title":"J Med Internet Res"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2025.119409","article-title":"A digital therapeutic (CT-152) as adjunct to antidepressant medication: a phase 3 randomized controlled trial (the Mirai study)","volume":"388","author":"Rothman","journal-title":"J Affect Disord"},{"issue":"4","key":"R24","doi-asserted-by":"publisher","first-page":"359","DOI":"10.47067\/ramss.v7i4.386","article-title":"Digital therapeutics in mental health care: a critical evaluation of mobile applications and online interventions for anxiety and depression","volume":"7","author":"Rehman","journal-title":"Rev Appl Manag Soc Sci"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.900615","article-title":"Digital therapeutics for mental health: is attrition the Achilles heel?","volume":"13","author":"Nwosu","journal-title":"Front Psychiatry"},{"issue":"3","key":"R26","doi-asserted-by":"publisher","DOI":"10.2196\/24387","article-title":"Barriers to and facilitators of user engagement with digital mental health interventions: systematic review","volume":"23","author":"Borghouts","journal-title":"J Med Internet Res"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1016\/j.invent.2023.100646","article-title":"Use of tailoring features and reasons for dropout in a guided internet-based transdiagnostic individually-tailored cognitive behavioral therapy for symptoms of depression and\/or anxiety in college students","volume":"34","author":"Ciharova","journal-title":"Internet Interv"},{"issue":"1","key":"R28","doi-asserted-by":"publisher","DOI":"10.2196\/71852","article-title":"Therapists\u2019 role in patient adherence to internet-based cognitive behavioral therapy: qualitative study","volume":"27","author":"Seittu","journal-title":"J Med Internet Res"},{"key":"R29","doi-asserted-by":"publisher","DOI":"10.1177\/20552076241277712","article-title":"A qualitative study exploring the digital therapeutic alliance with fully automated smartphone apps","volume":"10","author":"Brotherdale","journal-title":"Digit Health"},{"key":"R30","unstructured":"Global report on health equity for persons with disabilities. World Health Organization; 2022. URL: https:\/\/www.who.int\/publications\/i\/item\/9789240063600 [Accessed 05-06-2026]"},{"key":"R31","unstructured":"Web Content Accessibility Guidelines (WCAG) 2.2. World Wide Web Consortium (W3C). URL: https:\/\/www.w3.org\/TR\/WCAG22\/ [Accessed 11-12-2025]"},{"issue":"4","key":"R32","doi-asserted-by":"publisher","first-page":"38","DOI":"10.7453\/gahmj.2013.042","article-title":"A systematic review of the literature on health and wellness coaching: defining a key behavioral intervention in healthcare","volume":"2","author":"Wolever","journal-title":"Glob Adv Health Med"},{"key":"R33","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2023.107975","article-title":"The impact of health and wellness coaching on patient-important outcomes in chronic illness care: a systematic review and meta-analysis","volume":"117","author":"Boehmer","journal-title":"Patient Educ Couns"},{"issue":"8","key":"R34","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0070086","article-title":"A randomized controlled trial evaluating a manualized TeleCoaching protocol for improving adherence to a web-based intervention for the treatment of depression","volume":"8","author":"Mohr","journal-title":"PLoS One"},{"key":"R35","unstructured":"Gierisch JM Hughes JM Edelman D et al. The effectiveness of health coaching. Veterans Health Administration, Department of Veterans Affairs, Health Services Research & Development Service (HSR&D), Evidence-based Synthesis Program (ESP); 2017. URL: https:\/\/www.hsrd.research.va.gov\/publications\/esp\/health-coaching-REPORT.pdf [Accessed 05-06-2026]"},{"key":"R36","unstructured":"The WebAIM Million\u2014the 2025 report on the accessibility of the top 1,000,000 home pages. WebAIM. URL: https:\/\/webaim.org\/projects\/million\/2025 [Accessed 19-01-2026]"},{"key":"R37","unstructured":"Beck JS . Cognitive Behavior Therapy: Basics and Beyond. 3rd ed. The Guilford Press; 2020. ISBN: 9781462544196"},{"key":"R38","unstructured":"CCBHC Impact Report. National Council for Mental Wellbeing; 2024. URL: https:\/\/www.thenationalcouncil.org\/resources\/2024-ccbhc-impact-report\/ [Accessed 08-09-2025]"},{"key":"R39","unstructured":"Psychologists reaching their limits as patients present with worsening symptoms year after year. American Psychological Association; 2023. URL: https:\/\/www.apa.org\/pubs\/reports\/practitioner\/2023-practitioner-pulse-survey.pdf [Accessed 29-04-2026]"},{"issue":"1","key":"R40","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1002\/wps.20083","article-title":"Advantages and limitations of internet-based interventions for common mental disorders","volume":"13","author":"Andersson","journal-title":"World Psychiatry"},{"key":"R41","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2021.742196","article-title":"Accessibility and digital mental health: considerations for more accessible and equitable mental health apps","volume":"3","author":"Bunyi","journal-title":"Front Digit Health"},{"issue":"1","key":"R42","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.1602","article-title":"Supportive accountability: a model for providing human support to enhance adherence to eHealth interventions","volume":"13","author":"Mohr","journal-title":"J Med Internet Res"},{"issue":"1","key":"R43","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1111\/j.2044-8341.1959.tb00467.x","article-title":"The assessment of anxiety states by rating","volume":"32","author":"Hamilton","journal-title":"Br J Med Psychol"},{"issue":"1","key":"R44","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1136\/jnnp.23.1.56","article-title":"A rating scale for depression","volume":"23","author":"Hamilton","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"9","key":"R45","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke","journal-title":"J Gen Intern Med"},{"issue":"10","key":"R46","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","journal-title":"Arch Intern Med"},{"key":"R47","doi-asserted-by":"crossref","unstructured":"Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; 2013. [doi: 10.1176\/appi.books.9780890425596]","DOI":"10.1176\/appi.books.9780890425596"},{"issue":"3","key":"R48","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1097\/MLR.0b013e318160d093","article-title":"Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population","volume":"46","author":"L\u00f6we","journal-title":"Med Care"},{"issue":"12","key":"R49","doi-asserted-by":"publisher","first-page":"1266","DOI":"10.1176\/appi.ajp.2011.10111704","article-title":"The Columbia-Suicide Severity Rating Scale: initial validity and internal consistency findings from three multisite studies with adolescents and adults","volume":"168","author":"Posner","journal-title":"Am J Psychiatry"},{"issue":"4","key":"R50","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1002\/mpr.323","article-title":"Identifying HAM-A cutoffs for mild, moderate, and severe generalized anxiety disorder","volume":"19","author":"Matza","journal-title":"Int J Methods Psychiatr Res"},{"issue":"4","key":"R51","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1590\/s0004-282x2010000400005","article-title":"Generalized anxiety disorder and the Hamilton Anxiety Rating Scale in Parkinson\u2019s disease","volume":"68","author":"Kummer","journal-title":"Arq Neuropsiquiatr"},{"issue":"2","key":"R52","doi-asserted-by":"publisher","first-page":"384","DOI":"10.1016\/j.jad.2013.04.028","article-title":"Severity classification on the Hamilton Depression Rating Scale","volume":"150","author":"Zimmerman","journal-title":"J Affect Disord"},{"issue":"8","key":"R53","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1016\/j.euroneuro.2006.04.008","article-title":"The Montgomery Asberg and the Hamilton ratings of depression: a comparison of measures","volume":"16","author":"Carmody","journal-title":"Eur Neuropsychopharmacol"},{"issue":"3","key":"R54","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.2777","article-title":"Internet-based cognitive behavioral therapy for patients with chronic somatic conditions: a meta-analytic review","volume":"16","author":"van Beugen","journal-title":"J Med Internet Res"},{"issue":"1","key":"R55","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1002\/wps.20610","article-title":"Internet-delivered psychological treatments: from innovation to implementation","volume":"18","author":"Andersson","journal-title":"World Psychiatry"},{"issue":"2","key":"R56","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1007\/s10865-018-9984-x","article-title":"Internet-delivered cognitive behaviour therapy for chronic health conditions: a systematic review and meta-analysis","volume":"42","author":"Mehta","journal-title":"J Behav Med"},{"issue":"1","key":"R57","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/16506073.2017.1401115","article-title":"Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: an updated systematic review and meta-analysis","volume":"47","author":"Carlbring","journal-title":"Cogn Behav Ther"},{"key":"R58","doi-asserted-by":"crossref","unstructured":"Molenberghs G Verbeke G . Linear Mixed Models for Longitudinal Data. Springer; 2000. [doi: 10.1007\/978-1-4419-0300-6]","DOI":"10.1007\/978-1-4419-0300-6"},{"key":"R59","doi-asserted-by":"crossref","unstructured":"Cohen J . Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Routledge; 2013. [doi: 10.4324\/9780203771587]","DOI":"10.4324\/9780203771587"},{"issue":"1","key":"R60","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1037\/\/0022-006x.59.1.12","article-title":"Clinical significance: a statistical approach to defining meaningful change in psychotherapy research","volume":"59","author":"Jacobson","journal-title":"J Consult Clin Psychol"},{"issue":"4","key":"R61","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1001\/archpsyc.62.4.409","article-title":"Cognitive therapy vs medications in the treatment of moderate to severe depression","volume":"62","author":"DeRubeis","journal-title":"Arch Gen Psychiatry"},{"issue":"1","key":"R62","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/00001648-199001000-00010","volume":"1","author":"Rothman","journal-title":"Epidemiology"},{"issue":"9","key":"R63","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.32133","article-title":"Effectiveness of acupuncture for anxiety among patients with Parkinson disease: a randomized clinical trial","volume":"5","author":"Fan","journal-title":"JAMA Netw Open"},{"key":"R64","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S305331","article-title":"Clinically significant changes in the 17- and 6-item Hamilton Rating Scales for depression: a STAR*D report","volume":"17","author":"Rush","journal-title":"Neuropsychiatr Dis Treat"},{"key":"R65","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2015.05.001","article-title":"Dropout from individual psychotherapy for major depression: a meta-analysis of randomized clinical trials","volume":"40","author":"Cooper","journal-title":"Clin Psychol Rev"},{"issue":"1","key":"R66","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-016-0819-4","article-title":"Determinants of dropout in a community-based mental health crisis centre","volume":"16","author":"Henzen","journal-title":"BMC Psychiatry"},{"issue":"5","key":"R67","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1192\/bjp.bp.115.177576","article-title":"Exercise and internet-based cognitive-behavioural therapy for depression: multicentre randomised controlled trial with 12-month follow-up","volume":"209","author":"Hallgren","journal-title":"Br J Psychiatry"},{"issue":"1","key":"R68","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-020-0293-8","article-title":"A pragmatic randomized waitlist-controlled effectiveness and cost-effectiveness trial of digital interventions for depression and anxiety","volume":"3","author":"Richards","journal-title":"NPJ Digit Med"},{"issue":"10","key":"R69","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1176\/appi.ajp.2011.10111669","article-title":"Cognitive-behavioral therapy for depression in Parkinson\u2019s disease: a randomized, controlled trial","volume":"168","author":"Dobkin","journal-title":"Am J Psychiatry"},{"issue":"9","key":"R70","doi-asserted-by":"publisher","DOI":"10.2196\/36577","article-title":"The clinical effectiveness of blended cognitive behavioral therapy compared with face-to-face cognitive behavioral therapy for adult depression: randomized controlled noninferiority trial","volume":"24","author":"Mathiasen","journal-title":"J Med Internet Res"},{"issue":"46","key":"R71","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta21460","article-title":"Cost and Outcome of BehaviouRal Activation (COBRA): a randomised controlled trial of behavioural activation versus cognitive-behavioural therapy for depression","volume":"21","author":"Richards","journal-title":"Health Technol Assess"},{"issue":"9","key":"R72","doi-asserted-by":"publisher","DOI":"10.2196\/10743","article-title":"Web-based cognitive behavioral therapy blended with face-to-face sessions for major depression: randomized controlled trial","volume":"20","author":"Nakao","journal-title":"J Med Internet Res"},{"issue":"3","key":"R73","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1007\/s10608-023-10363-y","article-title":"Effectiveness of blended cognitive behavioral therapy versus treatment as usual for depression in routine specialized mental healthcare: E-COMPARED trial in the Netherlands","volume":"47","author":"Kemmeren","journal-title":"Cogn Ther Res"},{"issue":"7","key":"R74","doi-asserted-by":"publisher","DOI":"10.2196\/18723","article-title":"Blended care-cognitive behavioral therapy for depression and anxiety in real-world settings: pragmatic retrospective study","volume":"22","author":"Lungu","journal-title":"J Med Internet Res"},{"issue":"8","key":"R75","doi-asserted-by":"publisher","first-page":"1126","DOI":"10.4088\/JCP.15m10511","article-title":"Effectiveness of supplementary cognitive-behavioral therapy for pharmacotherapy-resistant depression: a randomized controlled trial","volume":"78","author":"Nakagawa","journal-title":"J Clin Psychiatry"},{"key":"R76","unstructured":"NBHWC welcomes new executive director and board chair to lead the future of health and wellness coaching. PR Newswire. URL: https:\/\/www.prnewswire.com\/news-releases\/nbhwc-welcomes-new-executive-director-and-board-chair-to-lead-the-future-of-health-and-wellness-coaching-302457952.html [Accessed 11-12-2025]"}],"container-title":["JMIR Human Factors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/humanfactors.jmir.org\/2026\/1\/e92448","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:23:55Z","timestamp":1785536635000},"score":1,"resource":{"primary":{"URL":"https:\/\/humanfactors.jmir.org\/2026\/1\/e92448"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,25]]},"references-count":76,"URL":"https:\/\/doi.org\/10.2196\/92448","relation":{},"ISSN":["2292-9495"],"issn-type":[{"value":"2292-9495","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,25]]},"article-number":"v13i36e92448"}}