AUTHOR=Zarski Anna-Carlotta , Sextl-Plötz Theresa , Schmidt-Hantke Juliane , Hess Natalie Sarah , Buntrock Claudia 

TITLE=Participatory development and proof-of-concept of a dyadic-based, AI-driven, just-in-time adaptive intervention mechanism for preventing anxiety and depressive disorders via app: study protocol for a feasibility study

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1626428

DOI=10.3389/fpubh.2025.1626428

ISSN=2296-2565

ABSTRACT=BackgroundThe growing prevalence of anxiety and depressive disorders highlights the need for transdiagnostic prevention through innovative interventions that outperform existing applications. By delivering personalized, context-sensitive support in moments of need, Just-In-Time-Adaptive-Interventions (JITAIs) have the potential to boost intervention relevance, engagement, and adherence.AimsThe study aims to (1) develop a transdiagnostic dyadic, AI-based JITAI (DyAI-JITAI) app through a participatory process, and (2) evaluate its feasibility in terms of acceptability, usability, and preliminary intervention effects.MethodsStage I followed a participatory development process using focus groups, think-aloud tests, and qualitative interviews to explore expectations, ideas, and needs for a preventive DyAI-JITAI app among N = 28 target users with lived experience and potential users without clinical anxiety or depressive symptoms. Stage II involves a randomized-controlled proof-of-concept study (N = 60) to test the DyAI-JITAI app’s acceptability and clinical usability. Adults without a clinical anxiety or depressive disorder will be randomized to the 4-week JITAI or waitlist control group. The CBT-based app features a seven-day learning phase with Ecological Momentary Assessment (EMA) and optional geo-tracking to identify optimal intervention times and locations, followed by AI-driven JITAIs using reinforcement learning. Users will receive optional motivational support from a self-chosen buddy with shared app access. Feasibility will be evaluated using a formal framework. Assessments will be conducted at four time points: screening, pre-intervention (prior to randomization), mid-intervention (10 days following randomization), and post-intervention (4 weeks following randomization), complemented by qualitative interviews on user perspectives of the DyAI-JITAI.DiscussionThis study aims to participatorily develop and assess the feasibility of a DyAI-JITAI app that bridges the intention-behavior gap by supporting CBT skill use in daily life and offering optional buddy-based motivation. The goal is to tailor the app to users’ needs and inform the design, procedures, and safety management of a future large-scale efficacy RCT.