Effects of an internet-delivered behavioral self-monitoring intervention on depressive symptoms in older widowed adults: A randomized controlled trial

Why clinicians should know about it

• Picked for Family Practice (paper of the day, 25 October 2026): Internet self‑monitoring RCT reducing depression in widowed elders

Abstract

OBJECTIVE: Late-life bereavement triggers substantial change to surviving spouses' routine health behaviors. Behavioral self-monitoring interventions are promising tools for promoting change across multiple behavioral domains, yet little is known about their efficacy in the spousal bereavement period. This trial evaluated the efficacy of an internet-delivered behavioral self-monitoring intervention for reducing depressive symptoms in older widowed adults. METHOD: We conducted an assessor-blind randomized controlled trial at a single site in Pittsburgh, Pennsylvania, from January 2020 to August 2025. We randomly assigned adults aged 60+ years who experienced the recent death of a spouse or life partner and had subsyndromal depressive symptoms (defined as a Hamilton Depression Rating Scale score of ≥9) to either behavioral self-monitoring or enhanced usual care. We measured change in Hamilton Depression Rating Scale at 3 months as our primary outcomes using intent-to-treat analyses. Secondary outcomes included changes in anxiety, complicated grief, and posttraumatic stress at 3 months. RESULTS: We randomized 151 protocol-eligible patients to either our intervention or control arms. Their M (SD) age was 70.3 (6.9) years, 121 (81%) were female, and 124 (82%) completed their 3-month follow-up assessment. The intervention produced significant effect size improvements in depression, Cohen's d = 0.48; 95% confidence interval (CI) [0.1, 0.8]; p < .001, anxiety (0.57; 95% CI [0.2, 0.9]; p < .001), but not in complicated (prolonged) grief or posttraumatic stress. CONCLUSIONS: Internet-delivered behavioral self-monitoring for older widowed adults is more effective than enhanced usual care at reducing depression and anxiety symptoms during the spousal bereavement period. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Abstract as published, via PubMed.