Approach Taken for Developing the Intervention
depressive, anxiety
We aimed to develop and evaluate a fully automated intervention, TreadWill, that would be engaging and effective without any expert guidance or contact. We reviewed the existing cCBT interventions before starting the development process and considered factors that may be responsible for the high dropout rates. The common shortcomings that we identified included the lack of interactive content, lack of tailoring of the content to different users, lack of peer support for users, and lack of engaging games. Different interventions addressed some of these shortcomings by including the corresponding features; however, none of them included all the features. We developed TreadWill to address these shortcomings. During the development process, we used the inputs on initial prototypes from the institute counselors and psychiatrists and from 13 pilot users (not included in the eventual trial), before finalizing the content and user experience in TreadWill. We hypothesized that TreadWill would lead to a high adherence rate and a significant reduction in depressive and anxiety symptom severity. As we did not plan to charge the users, we also expected TreadWill to be more accessible, especially in LMICs, compared with paid interventions.