Bridging the "digital divide": A comparison of use and effectiveness of an online intervention for depression between Baby Boomers and Millennials

J Affect Disord. 2018 Aug 15;236:243-251. doi: 10.1016/j.jad.2018.04.101. Epub 2018 Apr 22.


Background: Psychological online interventions (POIs) for depression have demonstrated promising effects. However, there are fewer randomized controlled studies on POIs among older adults with depression. The goal of the present study was to compare the use and efficacy of Deprexis, an online intervention for depression, among Millennials (18-35 years) and Baby Boomers (50-65 years).

Methods: We completed a secondary data analysis on a subset (N = 577) of participants in the EVIDENT trial, a parallel-groups, pragmatic, randomized, controlled single-blind study, which compared a 12-week POI (Deprexis) to care as usual (CAU). Outcomes were assessed at baseline, 3 months (post-assessment) and 6 months (follow-up). The main outcome of interest was change on self-rated depression severity (PHQ-9).

Results: Compared to Millennials, Boomers used the intervention significantly more often (d = 0.45) and for a longer duration (d = 0.46), and endorsed more positive attitudes towards POIs (d = 0.14). There was no significant Age Group by Intervention Group interaction for change in PHQ-9. The post-assessment between-group effect size (intervention vs. CAU control) for Millennials and Boomers were d = 0.26 and d = 0.39, respectively, and were stable at follow-up (d = 0.37 and d = 0.39).

Limitations: Age-based dichotomization may not accurately represent participants' experiences with and use of technology.

Conclusions: The POI examined in this trial was superior to CAU and was comparably effective among groups of adults defined as Millennials and Baby Boomers. Adults of the Baby Boomer generation who participate in POIs may have more positive attitudes towards POIs compared to their younger counterparts.

Keywords: Aging; Cognitive-behavioral therapy; Major depressive disorder; Older adults; Online interventions; eHealth.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors*
  • Aged
  • Cohort Effect
  • Comparative Effectiveness Research
  • Depression / epidemiology
  • Depression / therapy*
  • Digital Divide*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Online Systems / statistics & numerical data
  • Patient Acceptance of Health Care / psychology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Pragmatic Clinical Trials as Topic
  • Psychotherapy / methods*
  • Single-Blind Method
  • Treatment Outcome
  • Young Adult