Professor
Northwestern University
Adaptive Health (Products/Services: Yes) (Ownership Interest)Optum (Products/Services: No) (Consultant)Otsuka (Products/Services: No) (Advisory Board)
OMB No. 0925-0001 and 0925-0002 (Rev. 03/2020 Approved Through 02/28/2023)
BIOGRAPHICAL SKETCH
NAME: Mohr, David Curtis
eRA COMMONS USER NAME (credential, e.g., agency login): DAMOHR
POSITION TITLE: Professor
EDUCATION/TRAINING
INSTITUTION AND LOCATION DEGREE
(if applicable)
Completion Date
MM/YYYY
FIELD OF STUDY
University of California, Berkeley, CA B.A. 06/1980 Literature
University of California, Berkeley, CA M.A. 08/1988 Clinical Psychology
University of Arizona, Tucson, AZ Ph.D. 08/1991 Clinical Psychology
A. Personal Statement
I am the Director of Northwestern University’s Center for Behavioral Intervention Technologies (CBITs) and a tenured professor in the Department of Preventive Medicine. CBITs, which was founded in 2011, is a unique center in the United States, focused on the development, evaluation and implementation of technologies, including computer, mobile, and sensors, aimed at changing behavior in support of health, mental health, function, quality of life, and wellness. My work lies at the intersection of behavioral science, technology, and clinical intervention research, and is focused on developing and evaluating interventions that harness Internet and wireless technologies to promote health. This work in development includes the design, development, and evaluation of mobile and computer-based treatments for depression and anxiety. We have advanced the science of digital mental health through the development of methods that integrate human computer interaction into the design of technologies and services, and adapted evaluation methods to integration optimization and engineering principles into trial design. Our design work has led to more basic research to develop personal sensing methods that harness embedded mobile phone sensor data to identify behavioral phenotypes related to depression and mental health. Our current work is extending our focus on to include implementation of digital mental health in real-world healthcare settings. My work has resulted in more than 260 publications in peer-reviewed journals that have been cited over 15,000 times according to Scopus (more than 28,000 citations by Google Scholar). Pertinent to this NICHD R01 proposal, I serve as the contact PI for Northwestern University’s ALACRITY Center (P50MH119029). The Center’s objective is to advance digital mental health research and accelerate those discoveries into clinical practice. This R01 application is exactly the kind of research we hope to support, and I look forward to collaborating with Dr. Miller, and leveraging the resources of our Center, to ensure the success of Nursery2Home.
Citations:
1. Burns MN, Begale M, Duffecy J., Gergle, D., Karr, J., Giangrande, E., Mohr, D.C. Harnessing context sensing to develop a mobile intervention for depression. J Med Internet Res. 2011;13(3):e55. PMCID: PMC3222181.
2. Mohr, D.C., Montague, E., Stiles-Shields, C., Kaiser, S.M., Brenner, C., Carty-Fickes, E., Palac, H., Duffecy, J. (2015) MedLink: A mobile intervention to address failure points in the treatment of depression in general medicine. The Proceedings of Pervasive Health ’15. IEEE. PMCID: PMC4667803.
3. Saeb S, Zhang M, Karr CJ, Schueller SM, Corden ME, Kording KP, Mohr DC. Mobile Phone Sensor Correlates of Depressive Symptom Severity in Daily-Life Behavior: An Exploratory Study. J Med Internet Res. 2015;17:e175. PMCID: PMC4526997.
4. Graham A.K., Greene C.J., Kwasny M.J., Kaiser, S.M., Lieponis, P. Powell, T., Mohr, D.C. (2020) Coached mobile app platform for the treatment of depression and anxiety among primary care patients: A randomized clinical trial. JAMA Psychiatry, 77, 906-914. PMCID: PMC7240649
B. Positions, Scientific Appointments and Honors
Positions and Scientific Appointments
2006 – present Professor, Department of Preventive Medicine, Northwestern University
2011 – present Director, Northwestern University Center for Behavioral Intervention Technologies
2012 – present Deputy Director, Northwestern University Center for Engineering and Health
2011 – 2019 Board of Directors, International Society for Research in Internet Intervention
2006 Professor, Department of Psychiatry, University of California, San Francisco
2001 – 2006 Director of Psychology Research, Mental Health Division, Veterans Affairs Medical Center, San Francisco
2001 – 2006 Associate Professor, Departments of Neurology and Psychiatry, University of California, San
2000 – 2002 Member of the Committee on Professional Practice and Standards ,
American Psychological Association
1994 – 2001 Assistant Professor, Department of Neurology, University of California, San Francisco
Licensure
Illinois Clinical Psychologist: #071.007246
California Clinical Psychologist: PSY 13374 (inactive)
Honors
1989 – 1990 Fullbright Scholarship, University of Munich, Germany
2007 Elected Fellow of the Academy of Behavioral Medicine Research
2008 Elected Fellow of the Society of Behavioral Medicine
2014 Elected Fellow of the American Psychological Association
C. Contributions to Science
1. Digital Mental Health. Over the past 15 years, my work work has focused on the use of new and emerging technologies to support psychological and behavioral change for mental health and wellness. This work began with using web-based interventions for depression and has since incorporated the use of mobile devices. My work has made three significant contributions in this area. First, a large body of literature indicates that human support (e.g. coaching) improves adherence to technology-based interventions and outcomes. We have developed and evaluated a model of coaching, called supportive accountability. This model is now being adapted in a peer network that uses these principles to engineer peer interactions. Secondly, we have begun harnessing sensor data from mobile phones and devices to passively identify patient states and behaviors that are relevant to the treatment of depression without the need for patients to perform self-ratings. Phone sensor data is particularly useful as people keep their phones with them, and therefore can provide a continuous stream of data without changing any of their normal behaviors. Phone sensing holds promise to monitor at risk populations and develop a new generation of mHealth interventions that require minimal patient effort. We are also using sensor enabled pill dispensers to support pharmacologic treatment for depression delivered through primary care. Finally, we have developed a software architecture that supports the development of these eHealth and mHealth tools in a modular and extensible manner, allowing components to be reused. This architecture, housed in the Center for Behavioral Intervention Technologies, now supports more than 50 projects throughout the United States, as well as several in Africa and Latin America, including 30 funded by the NIH.
a. Burns, M.N., Begale, M., Duffecy, J., Gergle, D., Karr, C., Giangrande, E., Mohr, D.C. (2011) Harnessing context sensing to develop a mobile intervention for depression. J Med Internet Res 13, e55. PMCID: PMC3222181.
b. Mohr, D.C., Montague, E., Stiles-Shields, C., Kaiser, S.M., Brenner, C., Carty-Fickes, E., Palac, H., Duffecy, J. (2015) MedLink: A mobile intervention to address failure points in the treatment of depression in general medicine. Int Conf Pervasive Comput Technol Healthc. IEEE PMCID: PMC4667803.
c. Saeb S, Zhang M, Karr CJ, Schueller SM, Corden ME, Kording KP, Mohr DC. Mobile phone sensor correlates of depressive symptom severity in daily-life behavior: An exploratory study. J Med Internet Res. 2015;17:e175. PMCID: PMC4526997.
d. Mohr D.C., Lattie E.G., Tomasino K.N., Kwasny, M.J., Kaiser, S.M., Gray, E.L., Alam, N., Jordan, N., Schueller, S.M. (2019) A randomized noninferiority trial evaluating remotely-delivered stepped care for depression using internet cognitive behavioral therapy (CBT) and telephone CBT. Behav Res Ther. 123, 103485. PMCID: PMC6916718
e. Graham A.K., Greene C.J., Kwasny M.J., Kaiser, S.M., Lieponis, P. Powell, T., Mohr, D.C. (2020) Coached mobile app platform for the treatment of depression and anxiety among primary care patients: A randomized clinical trial. JAMA Psychiatry, 77, 906-914. PMCID: PMC7240649
2. Telemental health. My early work began examining the use of the telephone to extend psychotherapy for depression to patients who could not otherwise access it. While perhaps quaint today, when this work began, clinicians were dubious of the use of the telephone, several professional organizations had recommendations against the use of the telephone, and there were no major care programs using the telephone. I was the principal investigator on all of these trials, which were funded by the NIH and the Veterans Administration (VA). These trials established clear treatment implementation methods and were among the first well controlled trials to document both the efficacy and safety of telephone psychotherapy. This work began among disabled patients with multiple sclerosis. As we progressed we saw that general medical populations experienced many of the same barriers encountered in disabled populations. This led to additional work within the VA, culminating in a trial comparing telephone to face-to-face administered therapy, which found equivalent outcomes and improved retention using the telephone. This work contributed to a large shift in attitudes and policies around telemental health, both in the VA, which now has telemental health programs in policy (for example, telephone therapy is frequently reimbursable for patients in rural areas or with disabilities), and in many care organizations.
a. Mohr, D. C., Likosky, W., Dick, L.P., Van Der Wende, J., Dwyer, P., Bertagnolli, D., Goodkin, D. E. (2000). Telephone-administered cognitive-behavioral therapy for the treatment of depressive symptoms in multiple sclerosis. J Consult Clin Psychol, 68, 356-361. PMID:10780138.
b. Mohr, D.C., Hart, S.L., Julian, L.J., Honos-Webb, L., Catledge, C., Vella, L., Tasch, E.T. (2005). Telephone-administered psychotherapy for depression. Arch Gen Psychiatry, 62, 1007-1014. PMID:16143732.
c. Mohr, D.C., Carmody, T., Erickson, L., Jin, L., Leader, J. (2011) Telephone-administered cognitive behavioral therapy for veterans served by community-based outpatient clinics. J Consult Clin Psychol, 79, 261-265. PMID: 21299274.
d. Mohr, D.C., Ho, J., Duffecy, J. ,Reifler, D., Sokol, L., Burns, M.N., Jin, L., Siddique, J. (2012) Effect of telephone-administered vs. face-to-face cognitive behavioral therapy on adherence to therapy and depression outcomes among primary care patients: A randomized trial. J Am Med Assoc, 307, 2278-2285. PMCID: PMC3697075.
3. Clinical Trials Methodology. I have had a long-standing interest in clinical trials methodology. Earlier work established a framework for selecting and defining control conditions for trials of psychological and behavioral interventions that balances the needs for statistical power with threats to internal validity and considers the needs of stakeholders. A meta-analysis of RCTs in depression added empirical support for this framework, demonstrating the comparative effect of different forms and methods of implementing control conditions. We have extended this methodological work to the evaluation of eHealth and mHealth technologies. In particular, we have explored methods of evaluating continuously evolving interventions under two conditions. Given that the shelf life of technology-based interventions is brief, that the number of apps in stores is enormous, and that these interventions change frequently in their instantiation, we proposed that RCTs, particularly those conducted in academic settings, should focus primarily on the evaluation of eHealth and mHealth principles, rather than validation of individual applications themselves. Using our Behavioral Intervention Technology (BIT) model, which incorporates behavioral theory and technical application design that can serve as a framework for defining principles, we defined the methodology for Trials of Intervention Principles (TIPs). We have extended these models to consider how technology based interventions can be continuously monitored for effectiveness during deployment, thereby collapsing the clinical trial with post-deployment monitoring to protect the interests of patients, providers, and payers.
a. Mohr, D.C., Spring, B., Freedland, K., Beckner, V., Arean, P., Hollon, S., Ockene, J., Kaplan, R. (2009) The selection and design of control conditions for randomized controlled trials of psychological interventions. Psychother Psychosom, 78, 275-284. PMID: 19602916.
b. Mohr, D.C., Cheung, K., Schueller, S.M., Brown, C.H., Duan, N. (2013) Continuous Evaluation of Evolving Behavioral Intervention Technologies: An implementation and quality improvement framework. Am J Prev Med, 45, 517-523. PMCID: PMC3828034.
c. Mohr, D.C., Schueller, S.M., Montague, E., Burns, M.N., Rashidi, P. (2014). The Behavioral Intervention Technology model: An integrated conceptual and technological model for eHealth and mHealth interventions. J Med Internet Res, 16, e146. PMCID: PMC4071229.
d. Mohr, D.C., Schueller, S.M., Riley, W.T., Brown, C.H., Cuijpers, P., Duan, N., Kwasny, M.J., Stiles-Shields,C., Cheung, K. (2015) Trials of Intervention Principles: Evaluation methods for evolving behavioral intervention Technologies. J Med Internet Res, 17, e166. PMCID: PMC26155878,
4. Effects of stress on the brain and immune function in multiple sclerosis. As I began my work studying the treatment of depression in multiple sclerosis, I noticed that many patients complained that stress and depression worsened their disease and caused exacerbations. While the association between stress and disease activation had been noted in the literature, research was generally poor and the neurology community was largely skeptical. This question launched a program of research that began with the first study examining the longitudinal relationship between stress events and neuroimaging markers of disease activity, in which we found that stressful life events increased the likelihood of new gadolinium enhancing (Gd+) MRI brain lesions (a marker of MS disease activation) 4-8 weeks later. Subsequent work examining biological pathways found that depression was associated with increased levels of interferon gamma (a cytokine implicated in MS exacerbation), and the treatment of depression reduced interferon gamma levels. This culminated in a RCT, which confirmed that a stress management program significantly reduced the occurrence of new Gd+ brain MRI lesions, relative to a wait-list control, suggesting that behavioral treatments may be useful for the management of MS among patients experiencing high levels of stress.
a. Mohr, D. C., Goodkin, D.E., Bacchetti, P., Boudewyn, A.C., Huang, L., Marietta, P., Cheuk, W., Dee, B. (2000). Psychological stress and the subsequent appearance of new brain MRI lesions in MS. Neurology, 55, 55-61. PMID:10891906.
b. Mohr, D.C., Hart, S.L., Julian, L., Cox, D.C., Pelletier, D. (2004). Association between stressful life events and exacerbation in multiple sclerosis: a meta-analysis. Br Med J, 328, 731-736. PMID: 15033880.
c. Mohr, D.C., Goodkin, D.E., Islar, J., Hauser, S.L., Genain, C.G. (2001). Treatment of depression is associated with suppression of non-specific and antigen-specific Th1 responses in multiple sclerosis. Arch Neurol, 58, 1081-1086. PMID:11448297.
d. Mohr, D.C., Lovera, J., Brown, T, Cohen, B., Neylan, T., Henry, R., Siddique, J., Jin, L., Daikh, D., Pelletier, D. (2012) A randomized trial of stress management for the prevention of new brain lesions in MS. Neurology, 79, 412-419. PMCID: PMC3405245.
Complete List of Published Work in MyBibliography: http://www.ncbi.nlm.nih.gov/sites/myncbi/david.mohr.1/bibliography/40030881/public/?sort=date&direction=ascending