Trial reportInternational journal of environmental research and public health2019
Stepping Up: Predictors of 'Stepping' within an iCBT Stepped-Care Intervention for Depression.
Trial report in International journal of environmental research and public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Stepped-care models for cancer symptom management: a systematic review of efficacy and cost-effectiveness.Journal of the National Cancer Institute · 2026Pooled it
- Next-Generation Cognitive-Behavioral Therapy for Depression: Integrating Digital Tools, Teletherapy, and Personalization for Enhanced Mental Health Outcomes.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Incorporating a Stepped Care Approach Into Internet-Based Cognitive Behavioral Therapy for Depression: Randomized Controlled Trial.JMIR mental health · 2024Trial
- Culturally sensitive stepped care for adolescent refugees: efficacy and cost-utility of a multicentric randomized controlled trial.European child & adolescent psychiatry · 2024Trial
- AI-Enabled, Text-Based Health Coaching and Navigation for Employees to Support Health Outcomes: Pre-Post Observational Study.JMIR formative research · 2025Observational
- After the Shock: Impact of Ectopic Pregnancy on Subsequent Fertility and Parenthood.Biomedicines · 2025Review
- Equity in Digital Mental Health Interventions in the United States: Where to Next?Journal of medical Internet research · 2024Article
- A guide for self-help guides: best practice implementation.Cognitive behaviour therapy · 2024Article
- The evaluation of a stepped care approach for early intervention of borderline personality disorder.Borderline personality disorder and emotion dysregulation · 2024Article
- Mobile Apps to Support Mental Health Response in Natural Disasters: Scoping Review.Journal of medical Internet research · 2024Article
- Patient and Therapist Perceptions of a Publicly Funded Internet-Based Cognitive Behavioral Therapy (iCBT) Program for Ontario Adults During the COVID-19 Pandemic: Qualitative Study.JMIR formative research · 2024Article
- Technology-Assisted Stepped-Care to Promote Adherence in Adolescents with Asthma: A Pilot Study.Journal of clinical psychology in medical settings · 2023Article
- User experiences of an online therapist-guided psychotherapy platform, OPTT: A cross-sectional study.Internet interventions · 2023Article
- Effectiveness and cost-effectiveness for the treatment of depressive symptoms in refugees and asylum seekers: A multi-centred randomized controlled trial.The Lancet regional health. Europe · 2022Article
- Exploring the impact of a complex intervention for women with depression in contexts of adversity: A pilot feasibility study of COURRAGE-plus in South Africa.The International journal of social psychiatry · 2022Article
- eHealth Interventions for Treatment and Prevention of Depression, Anxiety, and Insomnia During Pregnancy: Systematic Review and Meta-analysis.JMIR mental health · 2022Review
- Participant retention in a fully remote trial of digital psychotherapy: Comparison of incentive types.Frontiers in digital health · 2022Article
- Traditional and Nontraditional Mental Healthcare Services: Usage and Preferences Among Adolescents and Younger Adults.The journal of behavioral health services & research · 2021Article
- An emotion-based online intervention for reducing anxiety and depression in cancer patients: Study protocol for a randomized controlled trial.Internet interventions · 2021Article
- Stakeholders' views on online interventions to prevent common mental health disorders in adults implemented into existing healthcare systems in Europe.European journal of public health · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
Internet-based cognitive behavioral therapy (iCBT) may overcome barriers to mental health care and has proven efficacious. However, this approach currently exists outside the existing mental health care delivery system. Stepped care is a proposed framework for integrating digital mental health (DMH) into health systems by initiating iCBT and "stepping up" care to a more intensive intervention should iCBT prove ineffective. This study explores pre-treatment factors associated with reaching stepping criteria among patients receiving iCBT. This exploratory analysis of a stepped care arm of a larger randomized trial examined participants who were stepped to a more intensive intervention if they did not respond to iCBT. The association of pre-treatment factors on stepping were examined using Kruskal-Wallis and Chi-square tests. One-fifth of the 151 participants met criteria for stepping within the 20-week treatment period. Only pre-treatment depression severity and treatment preference were associated with increased likelihood of stepping (
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.