Publications
999 Multiuser Application for the Diagnosis and Treatment of Depression in Women’s Self-Help Groups: Pilot Randomized Controlled Trial
Amritha Bhat; Ruben Johnson-Pradeep; Bharat Kalidindi4 Author Orcid Image ; Dhinagaran Devadass4 Author Orcid Image ; B Ramakrishna Goud5 Author Orcid Image ; Tony Raj4, 6 Author Orcid Image ; Sumithra Selvam7 Author Orcid Image ; Yesenia Navarro-Aguirre1, 8 Author Orcid Image ; Pamela Y Collins9, 10 Author Orcid Image ; Krishnamachari Srinivasan2, 3 Author Orcid Image Background:Depression in women results in elevated morbidity rates, functional impairment, diminished quality of life, and an increased risk of suicide. Numerous obstacles impede access to mental health treatment for women in India. Digital mental health solutions can bridge the treatment gap, but it is important to tailor these solutions to the context and to end-users.
Objective:We conducted a pilot randomized controlled trial to test the feasibility, acceptability, and preliminary effectiveness of a mental health app deployed in community-based organizations in improving depression outcomes.
Methods:The Multiuser Interactive Health Response Application (MITHRA) is a multiple-user mobile app used in community-based organizations for screening, tracking, and supporting stepped-care treatment for depression. MITHRA is based on the healthy activity program, a brief psychological intervention based on behavioral activation. It includes audio, video, and enhanced touchscreen capabilities to overcome the barrier of illiteracy and lack of access. It was developed in collaboration with a participatory design group consisting of primary and secondary end-users and is available on tablets installed in self-help groups (SHGs), which are community-based organizations in India. The SHGs were randomized to MITHRA (n=3) or enhanced usual care (EUC; n=3). During SHG meetings, women completed the Patient Health Questionnaire-9 (PHQ-9). Based on their PHQ-9 scores, they were assigned different modules. In the EUC SHGs, women viewed one module of education on symptoms of depression. Primary outcomes include feasibility and acceptability, and secondary outcomes include depressive symptoms and functioning. Repeated-measures ANOVA was performed to compare the change in the outcome scores over time between study groups. A P value of<.05 was considered statistically significant.
