Digital psychosocial intervention for depression among older adults in socioeconomically deprived areas in Brazil (PRODIGITAL-D): protocol for an individually randomised controlled trial.

Autor: Nakamura CA; Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil., Scazufca M; Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil. scazufca@usp.br., Moretti FA; Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil., Didone TVN; Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil., de Sá Martins MM; Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil., Pereira LA; Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil., de Souza CHQ; Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil., de Oliveira GM; Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil., da Costa MO; Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil., Machado M; Debasé Audiovisual, Sao Paulo, Brazil., da Silva Bitencourt E; Faculdade de Arquitetura e Urbanismo FAU, Universidade de Sao Paulo, Sao Paulo, Brazil., Dos Santos MS; Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil., Murdoch J; Department of Population Health Sciences, King's College London, London, UK., van de Ven P; Health Research Institute, University of Limerick, Limerick, Ireland., Seward N; Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK., Hollingworth W; Health Economics Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK., Peters TJ; Population Health Sciences, Bristol Medical School, and Bristol Dental School, University of Bristol, Bristol, UK., Araya R; Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Jazyk: angličtina
Zdroj: Trials [Trials] 2022 Sep 07; Vol. 23 (1), pp. 761. Date of Electronic Publication: 2022 Sep 07.
DOI: 10.1186/s13063-022-06623-z
Abstrakt: Background: Depression in older adults is a challenge for health systems in most low- and middle-income countries (LMICs). Digital strategies for the management of this condition have been emerging worldwide, but the effectiveness of most of them is still unclear, especially among older adults. Thus, we aim to assess the effectiveness and cost-effectiveness of a digital psychosocial intervention to treat depression among older adults living in socioeconomically deprived areas in Guarulhos, Brazil.
Methods: We will conduct a two-arm individually randomised controlled trial with 1:1 allocation ratio. Five hundred older adults aged 60 years or over with depressive symptomatology (9-item Patient Health Questionnaire score, PHQ-9 ≥ 10) and registered with one of the primary care clinics will be recruited to participate in this study. A 6-week digital psychosocial programme, named Viva Vida, will be delivered via WhatsApp to participants allocated to the intervention arm. The Viva Vida will send psychoeducational and behavioural activation audio and visual messages 4 days a week for 6 weeks. The control arm will only receive a single message with general information about depression. The primary outcome will be the proportion of depression recovery (PHQ-9 < 10) assessed at 3 months. The cost-effectiveness of the intervention will be assessed at 5 months. A detailed process evaluation will be used to explore context and important implementation outcomes.
Discussion: This programme was based on the PROACTIVE intervention and designed to be delivered without face-to-face contact. If effective, it could be a simple treatment option, appropriate not only when social distancing is required, but it could also be included as a regular public health programme to initiate depression treatment, particularly in LMICs where resources allocated to mental health are scarce.
Trial Registration: Registro Brasileiro de Ensaios Clínicos (ReBEC), RBR-4c94dtn. Registered on 22 October 2021 (submitted on 03 August 2021).
(© 2022. The Author(s).)
Databáze: MEDLINE
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