Internet-based Intervention Culturally Adapted for Treatment of Depression in the Ecuadorian Population

NCT ID: NCT04237714

Last Updated: 2021-06-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

153 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-10-10

Study Completion Date

2021-12-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Internet-Based Interventions are increasingly relevant as an alternative for reducing the gap in treatment of metal disorders such as depression, especially in resource-limited regions.

In this study the investigators will try to evaluate the effectiveness of an Internet-Based Intervention culturally adapted to the Ecuadorian population for treatment of depression.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Our participants will be randomized to one of the following three conditions: 1) Internet-Based intervention (IBI) with automated support (e.g. e-mails or text messages), 2) IBI plus human support by phone calls (automated + human support), 3) Waiting list control group .

The corresponding evaluations of the outcomes will be carried out at different moments of the process: baseline, three, six and twelve months.

This study will use the Smile is Fun program for the treatment of depression previously adapted to the Ecuadorian context.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Depression

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

IBI-based automated support

Internet-based intervention with automated support by the system. It consistes in phone text messages twice a week for users. The content of the messages focuses on motivating and reminding users to complete the activities proposed in the program and reviewing the treatment contents. Additionally an automatic email is send if participants have not access the program for a week. The program also provides continuous feedback to users through transversal tools.

Group Type EXPERIMENTAL

Smiling is fun

Intervention Type BEHAVIORAL

Smile is Fun is a self-applied program that combines elements of prevention and psychological treatment for emotional disorders. It is delivered via the Internet and it is based on CBT technics. The program consists of 8 therapeutic modules and includes 3 transversal tools (activity report, calendar, how am I?) to provide feedback and accompany patients during the intervention. The program requires 8 to 10 weeks to complete in its entirety.

The intervention, initially developed in Spain, will be adapted to the Ecuadorian culture including elements of the local population, such as, dialect, personal stories, examples and activities. The Ecuadorian version will be evaluate by health professional and users of public health system of Ecuador.

IBI-plus human support

In this condition, the participants receive automated support explained above and additionally human support for a maximum of 5 minutes that consist in a weekly phone call provided by a psychologist. The content of phone calls is related with resolve questions or doubts about the use and clinical content of the IBI and also motivating and reminding the importance to complete activities in the program.

Group Type EXPERIMENTAL

Smiling is fun

Intervention Type BEHAVIORAL

Smile is Fun is a self-applied program that combines elements of prevention and psychological treatment for emotional disorders. It is delivered via the Internet and it is based on CBT technics. The program consists of 8 therapeutic modules and includes 3 transversal tools (activity report, calendar, how am I?) to provide feedback and accompany patients during the intervention. The program requires 8 to 10 weeks to complete in its entirety.

The intervention, initially developed in Spain, will be adapted to the Ecuadorian culture including elements of the local population, such as, dialect, personal stories, examples and activities. The Ecuadorian version will be evaluate by health professional and users of public health system of Ecuador.

Control group

Waiting list control group.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Smiling is fun

Smile is Fun is a self-applied program that combines elements of prevention and psychological treatment for emotional disorders. It is delivered via the Internet and it is based on CBT technics. The program consists of 8 therapeutic modules and includes 3 transversal tools (activity report, calendar, how am I?) to provide feedback and accompany patients during the intervention. The program requires 8 to 10 weeks to complete in its entirety.

The intervention, initially developed in Spain, will be adapted to the Ecuadorian culture including elements of the local population, such as, dialect, personal stories, examples and activities. The Ecuadorian version will be evaluate by health professional and users of public health system of Ecuador.

Intervention Type BEHAVIORAL

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Ability to understand and read Spanish and access to Internet and having an email address
* Access to a computer or smart phone with internet at home
* Criteria for diagnosis of depression disorder according to the MINI interview and score between 5 to 9 (mild) 10 to 14 (moderate) and 15 to 19 (Moderate/severe) on PHQ-9

Exclusion Criteria

* Scores 20-27 (severe depression) on PHQ-9
* Suicidal risk
* Severe psychiatric disorders (schizophrenia, substance dependence, bipolar disorder, psychotic illness)
* Receiving psychological treatment for depression at the time of recruitment
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

University of Valencia

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Rosa M Baños, PhD

Role: STUDY_DIRECTOR

University of Valencia

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Carlos Quiñonez Freire

Santo Domingo, , Ecuador

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Ecuador

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Carlos E Quiñonez, MSc

Role: CONTACT

+593 999277152

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Carlos Quiñonez Freire, MSc

Role: primary

+593 999277152

References

Explore related publications, articles, or registry entries linked to this study.

Andersson G, Carlbring P, Titov N, Lindefors N. Internet Interventions for Adults with Anxiety and Mood Disorders: A Narrative Umbrella Review of Recent Meta-Analyses. Can J Psychiatry. 2019 Jul;64(7):465-470. doi: 10.1177/0706743719839381. Epub 2019 May 16.

Reference Type BACKGROUND
PMID: 31096757 (View on PubMed)

Andersson G, Cuijpers P, Carlbring P, Riper H, Hedman E. Guided Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: a systematic review and meta-analysis. World Psychiatry. 2014 Oct;13(3):288-95. doi: 10.1002/wps.20151.

Reference Type BACKGROUND
PMID: 25273302 (View on PubMed)

Berger T, Hammerli K, Gubser N, Andersson G, Caspar F. Internet-based treatment of depression: a randomized controlled trial comparing guided with unguided self-help. Cogn Behav Ther. 2011;40(4):251-66. doi: 10.1080/16506073.2011.616531.

Reference Type BACKGROUND
PMID: 22060248 (View on PubMed)

Cuijpers P, van Straten A, Andersson G, van Oppen P. Psychotherapy for depression in adults: a meta-analysis of comparative outcome studies. J Consult Clin Psychol. 2008 Dec;76(6):909-22. doi: 10.1037/a0013075.

Reference Type BACKGROUND
PMID: 19045960 (View on PubMed)

Devilly GJ, Borkovec TD. Psychometric properties of the credibility/expectancy questionnaire. J Behav Ther Exp Psychiatry. 2000 Jun;31(2):73-86. doi: 10.1016/s0005-7916(00)00012-4.

Reference Type BACKGROUND
PMID: 11132119 (View on PubMed)

Espinosa HD, Carrasco A, Moessner M, Caceres C, Gloger S, Rojas G, Perez JC, Vanegas J, Bauer S, Krause M. Acceptability Study of "Ascenso": An Online Program for Monitoring and Supporting Patients with Depression in Chile. Telemed J E Health. 2016 Jul;22(7):577-83. doi: 10.1089/tmj.2015.0124. Epub 2016 Jan 7.

Reference Type BACKGROUND
PMID: 26741190 (View on PubMed)

Hadjistavropoulos HD, Nugent MM, Alberts NM, Staples L, Dear BF, Titov N. Transdiagnostic Internet-delivered cognitive behaviour therapy in Canada: An open trial comparing results of a specialized online clinic and nonspecialized community clinics. J Anxiety Disord. 2016 Aug;42:19-29. doi: 10.1016/j.janxdis.2016.05.006. Epub 2016 May 13.

Reference Type BACKGROUND
PMID: 27244278 (View on PubMed)

Harper Shehadeh M, Heim E, Chowdhary N, Maercker A, Albanese E. Cultural Adaptation of Minimally Guided Interventions for Common Mental Disorders: A Systematic Review and Meta-Analysis. JMIR Ment Health. 2016 Sep 26;3(3):e44. doi: 10.2196/mental.5776.

Reference Type BACKGROUND
PMID: 27670598 (View on PubMed)

Bouwmans C, De Jong K, Timman R, Zijlstra-Vlasveld M, Van der Feltz-Cornelis C, Tan Swan S, Hakkaart-van Roijen L. Feasibility, reliability and validity of a questionnaire on healthcare consumption and productivity loss in patients with a psychiatric disorder (TiC-P). BMC Health Serv Res. 2013 Jun 15;13:217. doi: 10.1186/1472-6963-13-217.

Reference Type BACKGROUND
PMID: 23768141 (View on PubMed)

Hawthorne G, Richardson J, Osborne R. The Assessment of Quality of Life (AQoL) instrument: a psychometric measure of health-related quality of life. Qual Life Res. 1999 May;8(3):209-24. doi: 10.1023/a:1008815005736.

Reference Type BACKGROUND
PMID: 10472152 (View on PubMed)

Helms JE. An examination of the evidence in culturally adapted evidence-based or empirically supported interventions. Transcult Psychiatry. 2015 Apr;52(2):174-97. doi: 10.1177/1363461514563642. Epub 2014 Dec 22.

Reference Type BACKGROUND
PMID: 25534401 (View on PubMed)

Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13. doi: 10.1046/j.1525-1497.2001.016009606.x.

Reference Type BACKGROUND
PMID: 11556941 (View on PubMed)

Lara MA, Tiburcio M, Aguilar Abrego A, Sanchez-Solis A. A four-year experience with a Web-based self-help intervention for depressive symptoms in Mexico. Rev Panam Salud Publica. 2014 May-Jun;35(5-6):399-406.

Reference Type BACKGROUND
PMID: 25211568 (View on PubMed)

Mira A, Breton-Lopez J, Garcia-Palacios A, Quero S, Banos RM, Botella C. An Internet-based program for depressive symptoms using human and automated support: a randomized controlled trial. Neuropsychiatr Dis Treat. 2017 Mar 31;13:987-1006. doi: 10.2147/NDT.S130994. eCollection 2017.

Reference Type BACKGROUND
PMID: 28408833 (View on PubMed)

Munoz-Navarro R, Cano-Vindel A, Moriana JA, Medrano LA, Ruiz-Rodriguez P, Aguero-Gento L, Rodriguez-Enriquez M, Piza MR, Ramirez-Manent JI. Screening for generalized anxiety disorder in Spanish primary care centers with the GAD-7. Psychiatry Res. 2017 Oct;256:312-317. doi: 10.1016/j.psychres.2017.06.023. Epub 2017 Jun 12.

Reference Type BACKGROUND
PMID: 28666201 (View on PubMed)

Osma J, Quilez-Orden A, Suso-Ribera C, Peris-Baquero O, Norman SB, Bentley KH, Sauer-Zavala S. Psychometric properties and validation of the Spanish versions of the overall anxiety and depression severity and impairment scales. J Affect Disord. 2019 Jun 1;252:9-18. doi: 10.1016/j.jad.2019.03.063. Epub 2019 Mar 29.

Reference Type BACKGROUND
PMID: 30953927 (View on PubMed)

Parada F, Martinez V, Espinosa HD, Bauer S, Moessner M. Using Persuasive Systems Design Model to Evaluate "Cuida tu Animo": An Internet-Based Pilot Program for Prevention and Early Intervention of Adolescent Depression. Telemed J E Health. 2020 Feb;26(2):251-254. doi: 10.1089/tmj.2018.0272. Epub 2019 Jan 21.

Reference Type BACKGROUND
PMID: 30668227 (View on PubMed)

Richards D, Timulak L, O'Brien E, Hayes C, Vigano N, Sharry J, Doherty G. A randomized controlled trial of an internet-delivered treatment: Its potential as a low-intensity community intervention for adults with symptoms of depression. Behav Res Ther. 2015 Dec;75:20-31. doi: 10.1016/j.brat.2015.10.005. Epub 2015 Oct 21.

Reference Type BACKGROUND
PMID: 26523885 (View on PubMed)

Salamanca-Sanabria A, Richards D, Timulak L, Castro-Camacho L, Mojica-Perilla M, Parra-Villa Y. Assessing the efficacy of a culturally adapted cognitive behavioural internet-delivered treatment for depression: protocol for a randomised controlled trial. BMC Psychiatry. 2018 Feb 27;18(1):53. doi: 10.1186/s12888-018-1634-x.

Reference Type BACKGROUND
PMID: 29482586 (View on PubMed)

Schroder J, Sautier L, Kriston L, Berger T, Meyer B, Spath C, Kother U, Nestoriuc Y, Klein JP, Moritz S. Development of a questionnaire measuring Attitudes towards Psychological Online Interventions-the APOI. J Affect Disord. 2015 Nov 15;187:136-41. doi: 10.1016/j.jad.2015.08.044. Epub 2015 Aug 28.

Reference Type BACKGROUND
PMID: 26331687 (View on PubMed)

Tiburcio M, Lara MA, Aguilar Abrego A, Fernandez M, Martinez Velez N, Sanchez A. Web-Based Intervention to Reduce Substance Abuse and Depressive Symptoms in Mexico: Development and Usability Test. JMIR Ment Health. 2016 Sep 29;3(3):e47. doi: 10.2196/mental.6001.

Reference Type BACKGROUND
PMID: 27687965 (View on PubMed)

Tiburcio M, Lara MA, Martinez N, Fernandez M, Aguilar A. Web-Based Intervention to Reduce Substance Abuse and Depression: A Three Arm Randomized Trial in Mexico. Subst Use Misuse. 2018 Nov 10;53(13):2220-2231. doi: 10.1080/10826084.2018.1467452. Epub 2018 May 16.

Reference Type BACKGROUND
PMID: 29768070 (View on PubMed)

van Ballegooijen W, Cuijpers P, van Straten A, Karyotaki E, Andersson G, Smit JH, Riper H. Adherence to Internet-based and face-to-face cognitive behavioural therapy for depression: a meta-analysis. PLoS One. 2014 Jul 16;9(7):e100674. doi: 10.1371/journal.pone.0100674. eCollection 2014.

Reference Type BACKGROUND
PMID: 25029507 (View on PubMed)

Wagner B, Horn AB, Maercker A. Internet-based versus face-to-face cognitive-behavioral intervention for depression: a randomized controlled non-inferiority trial. J Affect Disord. 2014 Jan;152-154:113-21. doi: 10.1016/j.jad.2013.06.032. Epub 2013 Jul 23.

Reference Type BACKGROUND
PMID: 23886401 (View on PubMed)

Webb CA, Rosso IM, Rauch SL. Internet-Based Cognitive-Behavioral Therapy for Depression: Current Progress and Future Directions. Harv Rev Psychiatry. 2017 May/Jun;25(3):114-122. doi: 10.1097/HRP.0000000000000139.

Reference Type BACKGROUND
PMID: 28475503 (View on PubMed)

mhGAP Intervention Guide for Mental, Neurological and Substance Use Disorders in Non-Specialized Health Settings: Mental Health Gap Action Programme (mhGAP): Version 2.0. Geneva: World Health Organization; 2016. Available from http://www.ncbi.nlm.nih.gov/books/NBK390828/

Reference Type BACKGROUND
PMID: 27786430 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

00016-UV-E-2019

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.