Abstract

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).

Details

Title
Digital psychosocial intervention for depression among older adults in socioeconomically deprived areas in Brazil (PRODIGITAL-D): protocol for an individually randomised controlled trial
Author
Nakamura, Carina Akemi 1 ; Scazufca, Marcia 1 ; Moretti, Felipe Azevedo 1 ; Didone, Thiago Vinicius Nadaleto 1 ; de Sá Martins, Mariana Mendes 1 ; Pereira, Luara Aragoni 2 ; de Souza, Caio Hudson Queiroz 1 ; de Oliveira, Gabriel Macias 1 ; da Costa, Marcelo Oliveira 1 ; Machado, Marcelo 3 ; da Silva Bitencourt, Evelyn 4 ; dos Santos, Monica Souza 1 ; Murdoch, Jamie 5 ; van de Ven, Pepijn 6 ; Seward, Nadine 7 ; Hollingworth, William 8 ; Peters, Tim J. 9 ; Araya, Ricardo 7   VIAFID ORCID Logo 

1  Universidade de Sao Paulo, Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Sao Paulo, Brazil (GRID:grid.11899.38) (ISNI:0000 0004 1937 0722) 
2  Universidade de Sao Paulo, Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Sao Paulo, Brazil (GRID:grid.11899.38) (ISNI:0000 0004 1937 0722) 
3  Debasé Audiovisual, Sao Paulo, Brazil (GRID:grid.11899.38) 
4  Universidade de Sao Paulo, Faculdade de Arquitetura e Urbanismo FAU, Sao Paulo, Brazil (GRID:grid.11899.38) (ISNI:0000 0004 1937 0722) 
5  King’s College London, Department of Population Health Sciences, London, UK (GRID:grid.13097.3c) (ISNI:0000 0001 2322 6764) 
6  University of Limerick, Health Research Institute, Limerick, Ireland (GRID:grid.10049.3c) (ISNI:0000 0004 1936 9692) 
7  Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Health Service and Population Research, London, UK (GRID:grid.13097.3c) (ISNI:0000 0001 2322 6764) 
8  University of Bristol, Health Economics Bristol, Population Health Sciences, Bristol Medical School, Bristol, UK (GRID:grid.5337.2) (ISNI:0000 0004 1936 7603) 
9  University of Bristol, Population Health Sciences, Bristol Medical School, and Bristol Dental School, Bristol, UK (GRID:grid.5337.2) (ISNI:0000 0004 1936 7603) 
Pages
761
Publication year
2022
Publication date
Dec 2022
Publisher
Springer Nature B.V.
e-ISSN
17456215
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s13063-022-06623-z
ProQuest document ID
2808574377
Copyright
© The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.