Efficacy of a Culturally Adapted Cognitive Behavioural Internet-delivered Treatment for Depression
Condition: Depression
MeSH terms: Depression; Depressive Disorder
Study type: Interventional

Summary: 
      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.
    

Detailed description: 
      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).
    

Intervention name(s): Space from Depression
Intervention type(s): Behavioral
Intervention description(s): Space from Depression programme (Yo puedo sentirme Bien -Spanish version) consists of seven modules of cognitive-behavioural therapy. The treatment includes self-monitoring, behavioural activation, cognitive restructuring, and challenging core beliefs. All modules have the same structure and format, which consist of quizzes, videos, educational content, activities with homework suggestions and a module review page.
Other intervention name(s): Yo puedo sentirme bien
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Culturally adapted psychotherapy; Internet-delivered treatment; Depression; Latin America