Digital delivery of behavioural activation therapy to overcome depression and facilitate social and economic transitions of adolescents in South Africa (the DoBAt study): protocol for a pilot randomised controlled trial
Date
2022-12-05
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Abstract
Introduction Scalable psychological treatments to
address depression among adolescents are urgently
needed. This is particularly relevant to low-income and
middle-income countries where 90% of the world’s
adolescents live. While digital delivery of behavioural
activation (BA) presents a promising solution, its feasibility,
acceptability and effectiveness among adolescents in an
African context remain to be shown.
Methods and analysis This study is a two-arm singleblind individual-level randomised controlled pilot trial to
assess the feasibility, acceptability and initial efficacy of
digitally delivered BA therapy among adolescents with
depression. The intervention has been coproduced with
adolescents at the study site. The study is based in the
rural northeast of South Africa in the Bushbuckridge
subdistrict of Mpumalanga province. A total of 200
adolescents with symptoms of mild to moderately severe
depression on the Patient Health Questionnaire Adolescent
Version will be recruited (1:1 allocation ratio). The
treatment group will receive BA therapy via a smartphone
application (the Kuamsha app) supported by trained peer
mentors. The control group will receive an enhanced
standard of care. The feasibility and acceptability of the
intervention will be evaluated using a mixed methods
design, and signals of the initial efficacy of the intervention
in reducing symptoms of depression will be determined
on an intention-to-treat basis. Secondary objectives are to
pilot a range of cognitive, mental health, risky behaviour
and socioeconomic measures; and to collect descriptive
data on the feasibility of trial procedures to inform the
development of a further larger trial.