AniMovil mHealth Support for Depression Management in a Low-Income Country (AniMovil)
Depression
About this trial
This is an interventional health services research trial for Depression
Eligibility Criteria
Inclusion Criteria:
- A score of 10+ on the Spanish-validated version of the PHQ-9
Exclusion Criteria:
- Less than a 6-month life expectancy
- A history of psychiatric hospitalization or bipolar disorder
- A substance use disorder or cognitive impairment
Sites / Locations
- Hospital San Jose
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Intervention
Enhanced Usual Care
Patients randomized to the intervention group will receive the AniMóvil intervention, including: the Sentirse Mejor manual that patients can refer to for information about CBT and skill practice, weekly IVR depression symptom assessments and psychoeducational messages, daily SMS mood monitoring and CBT reinforcement messages, and CHW telephone CBT sessions in the event of elevated PHQ-9 scores during the study. CHWs will use information from patients' IVR/SMS monitoring to support intervention-group patients' depression self-management under close supervision from their mental health specialist supervisor. Intervention patients will be part of a 'stepped' intervention based on the severity of their depression upon entry into the program and assessment throughout the intervention.
Enhanced usual care patients will receive usual care, including the Sentirse Mejor manual developed by the research team in conjunction with local Ministries of Mental Health and tailored by the study team, emphasizing CBT principles, and daily SMS messages asking participants to report their mood on a 1 to 9 scale. Enhanced usual care group patients who report mood scores of 1 or 2 (worst scores) for at least 3 days per week and 3 consecutive weeks will be called by the Community health worker and referred to the national program office for depression services support - a free service available to all citizens diagnosed with depression. Enhanced usual care patients will be part of a 'stepped' program based on the severity of their depression upon entry into the program and assessment throughout the intervention.