Meru Health Ascend Mobile Intervention for Depression in Middle Aged and Older Adults

The Meru Health Ascend program is a guided self-management program that uses a mobile
application to deliver content of the intervention. A licensed therapist (Meru Health
employed) provides support to participants as needed and reviews practice logs within the
app.The 8-week program teaches cognitive behavioral techniques and mindfulness skills with
the aim of improving the user's mental health. The platform provides informational videos,
skills practices, group discussion, and messaging with the therapist. The Meru Health program
enrolls participants in treatment groups that work through the program at the same time and
can provide support to on another on the discussion board within the app.

We are conducting two studies in middle aged and older adults with elevated depressive
symptoms to evaluate the Meru Health Ascend program. In the first study (study 1), we will
examine the feasibility of the intervention in individuals aged 40 years or older with
elevated depression symptoms using an iterative case series. Specifically, we will examine
the usability of app and materials, dropout and reasons for dropout, and user perceptions of
the program.

We will then conduct a proof-of-concept study (study 2) using a nonrandomized pre-post design
to examine whether individuals achieve clinically significant reductions in depressive
symptoms.

Inclusion Criteria:

- Owns a smart phone, resides in California, PHQ-9 score greater than or equal to 10,
stable dose of medication (if taking psychotropic), able to read and understand
English.

Exclusion Criteria:

- Psychotic disorder, possible cognitive impairment, evidence of problematic drinking
behavior, active suicide ideation with a plan, active psychological treatment