Evaluating smartphone-based interventions for anxiety and depressive symptoms: A randomized controlled trial

Authors

• Michael J. Zvolensky, University of Houston, Houston, TX
• Lorra Garey, University of Houston, Houston, TX
• Matthew W. Gallagher, University of Houston, Houston, TX
• Marshall K. Cheney, University of Oklahoma, Norman, OK
• Anka A. Vujanovic, Texas A&M University, College Station, TX
• Darla E. Kendzor, Stephenson Cancer Center, Oklahoma City, OK
• Lancer D. Stephens, University of Oklahoma Health Sciences, Oklahoma City, OK
• Ashley B. Cole, Oklahoma State University, Stillwater, OK
• Bingjing Mao, LSU Health Sciences Center - New OrleansFollow
• Krista M. Kezbers, Stephenson Cancer Center, Oklahoma City, OK
• Audrey R. Montgomery, Stephenson Cancer Center, Oklahoma City, OK
• Justin M. Shepherd, University of Houston, Houston, TX
• Duckhyun Jo, University of Houston, Houston, TX
• Brooke Y. Redmond, University of Houston, Houston, TX
• Jessica M. Thai, University of Houston, Houston, TX
• Michael S. Businelle, Stephenson Cancer Center, Oklahoma City, OK

Document Type

Article

Publication Date

8-14-2026

Publication Title

Behaviour Research and Therapy

Abstract

OBJECTIVE: The study evaluated the impact of two smartphone-based interventions on anxiety and depression symptoms during the COVID-19 pandemic.

METHOD: Racially and ethnically diverse adults from the United States (US) with elevated anxiety and/or depression (N = 822; 64.4% female; M = 38.3 years, SD = 12.76) were randomly assigned to receive a smartphone delivered anxiety, depression, and anxiety sensitivity reduction intervention (EASE) or a mindfulness and relaxation-based (MR) digital intervention; 206 (25.1%) identified as African American, 208 (25.3%) as American Indian, 202 (24.6%) as Latinx, and 206 (25.1%) as non-Latinx White.

RESULTS: There was a high degree of engagement for both groups. For our primary analysis, between-group differences at the 6-month primary endpoint were small and not statistically significant for anxiety and depression. Within-person effect sizes indicated decreases in anxiety, depression, probable clinical anxiety and/or depression disorder status, anxiety sensitivity, and COVID-19 fear through the follow-up. Exploratory subgroup analyses suggested variable patterns of within-condition change across racial and ethnic groups, but these analyses were not powered to test moderation or equivalence.

CONCLUSIONS: Findings indicated that two low cost and highly disseminatable digital interventions that targeted distinct psychological processes offered clinical benefit among a diverse sample of adults in the US during the COVID-19 pandemic.

First Page

1

Last Page

14

PubMed ID

42617378

Volume

205

Issue

105144

Publisher

Elsevier

Rights

© 2026 Elsevier Ltd

Recommended Citation

Zvolensky, Michael J.; Garey, Lorra; Gallagher, Matthew W.; Cheney, Marshall K.; Vujanovic, Anka A.; Kendzor, Darla E.; Stephens, Lancer D.; Cole, Ashley B.; Mao, Bingjing; Kezbers, Krista M.; Montgomery, Audrey R.; Shepherd, Justin M.; Jo, Duckhyun; Redmond, Brooke Y.; Thai, Jessica M.; and Businelle, Michael S., "Evaluating smartphone-based interventions for anxiety and depressive symptoms: A randomized controlled trial" (2026). School of Public Health Faculty Publications. 620.
https://digitalscholar.lsuhsc.edu/soph_facpubs/620
10.1016/j.brat.2026.105144