Depression Clinical Trial
Official title:
Assessing the Efficacy of a Culturally Adapted Cognitive Behavioural Internet-delivered Treatment for Depression: Protocol for a Randomised Controlled Trial
The study seeks to evaluate the efficacy of a culturally adapted internet-delivered treatment for depression in Colombia. The research involves two studies: (a) the cultural adaptation of the Space from Depression cognitive-behavioural internet-delivered programme, and (b) the implementation of the culturally adapted intervention using a randomised controlled trial methodology. The study will be a first contribution of a culturally adapted low-intensity internet-delivered intervention with Latin Americans.
Depression is the principal cause of disability in the world. High rates of prevalence of
depression in general populations and college students have been found worldwide and in
various cultural groups. For instance, a 12-month prevalence rate has been estimated in the
U.S. at 9.5% and in Europe at 8.5% of the population. In Colombia, 12-month prevalence is
between 6.2% and 12.1%. The Colombian National Mental Health Survey has estimated point
prevalence of mild to moderate depressive symptoms at 15.6% and severe depressive symptoms at
4.2% of adults. On the other hand, there are significant barriers for accessing mental health
services in Colombia. About 50% of the population does not have access to health services,
while the majority of the population with mental health problems do not have adequate mental
health insurance coverage.
Although low-intensity interventions for depression have been developed in western
high-income countries and these interventions therefore have been influenced by their
specific cultural context (for example, Ireland, UK, Australia), it is important to consider
how cultural context may impact on the adaptation for use in LMICs such as Colombia. The
authors argue that cultural aspects need to be taken into consideration when translating and
adapting interventions to help guarantee similar results to what have been achieved in
high-income countries.
General method Aims and Hypothesis: We aim to assess the efficacy of a culturally adapted
cognitive behavioural internet-delivered treatment for college students with depressive
symptoms in Colombia. In line with other studies in high-income countries (HICs), and using
an already established intervention, we hypothesise that the culturally adapted Space from
Depression programme will be efficacious, with significant changes within the treatment group
and differences post-treatment between the active treatment and the waiting list control
group.
The study is a mixed method approach utilising in study 1, quantitative and qualitative
methods to assist in the cultural adaptation of the Space from Depression intervention and in
study 2 a randomised control design to examine the efficacy of the culturally-adapted
intervention.
Procedure The programme Space from Depression will be culturally adapted for a Colombian
population using cultural sensitivity and ecological validity frameworks, including
principles from cross-cultural assessment research. (Study 1). Once the programme is
culturally adapted, it will be tested using a randomised controlled trial methodology (Study
2).
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