TY - JOUR
T1 - Self-help mobile messaging intervention for depression among older adults in resource-limited settings
T2 - a randomized controlled trial
AU - Scazufca , Marcia
AU - Nakamura , Carina Akemi Nakamura
AU - Seward, Nadine
AU - Vinicius Nadaleto Didone, Thiago
AU - Azvedo Moretti, Felipe
AU - da Costa, Marcelo Oliveira
AU - Hudson Querioz de Souza, Caio
AU - Macias de Oliveira, Gabriel
AU - Souza dos Santos, Monica
AU - Aragona Pereira, Luara
AU - Mendes de Sa Martins, Mariana
AU - van de Ven, Pepijn
AU - Hollingworth, William
AU - Peters, Tim J
AU - Araya, Ricardo
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/4/1
Y1 - 2024/4/1
N2 - Scalable solutions to treat depression in older adults in low-resourced settings are urgently needed. The PRODIGITAL-D pragmatic, single-blind, two-arm, individually randomized controlled trial assessed the effectiveness of a mobile messaging psychosocial intervention in improving depressive symptomatology among older adults in socioeconomically deprived areas of Guarulhos, Brazil. Older adults (aged 60+ years) registered with 24 primary care clinics and identified with depressive symptomatology (9-item Patient Health Questionnaire (PHQ-9) scores ≥ 10) received the 6-week Viva Vida intervention based on psychoeducation and behavioral activation (n = 298) or a single message (n = 305). No health professional support was offered. The primary outcome was improvement from depressive symptomatology (PHQ-9 < 10) at 3 months. Of the 603 participants enrolled (mean age = 65.1 years; 451 (74.8%) women), 527 (87.4%) completed the follow-up assessment. In the intervention arm, 109 of 257 (42.4%) participants had an improved depressive symptomatology, compared with 87 of 270 (32.2%) participants in the control arm (adjusted odds ratio = 1.57; 95% confidence interval = 1.07–2.29; P = 0.019). No severe adverse events related to trial participation were observed. These results demonstrate the usefulness of a digital messaging psychosocial intervention in the short-term improvement from depressive symptomatology that can potentially be integrated into primary care programs for treating older adults with depression. Brazilian Registry of Clinical Trials registration: ReBEC (RBR-4c94dtn).
AB - Scalable solutions to treat depression in older adults in low-resourced settings are urgently needed. The PRODIGITAL-D pragmatic, single-blind, two-arm, individually randomized controlled trial assessed the effectiveness of a mobile messaging psychosocial intervention in improving depressive symptomatology among older adults in socioeconomically deprived areas of Guarulhos, Brazil. Older adults (aged 60+ years) registered with 24 primary care clinics and identified with depressive symptomatology (9-item Patient Health Questionnaire (PHQ-9) scores ≥ 10) received the 6-week Viva Vida intervention based on psychoeducation and behavioral activation (n = 298) or a single message (n = 305). No health professional support was offered. The primary outcome was improvement from depressive symptomatology (PHQ-9 < 10) at 3 months. Of the 603 participants enrolled (mean age = 65.1 years; 451 (74.8%) women), 527 (87.4%) completed the follow-up assessment. In the intervention arm, 109 of 257 (42.4%) participants had an improved depressive symptomatology, compared with 87 of 270 (32.2%) participants in the control arm (adjusted odds ratio = 1.57; 95% confidence interval = 1.07–2.29; P = 0.019). No severe adverse events related to trial participation were observed. These results demonstrate the usefulness of a digital messaging psychosocial intervention in the short-term improvement from depressive symptomatology that can potentially be integrated into primary care programs for treating older adults with depression. Brazilian Registry of Clinical Trials registration: ReBEC (RBR-4c94dtn).
U2 - 10.1038/s41591-024-02864-4
DO - 10.1038/s41591-024-02864-4
M3 - Article (Academic Journal)
C2 - 38486075
SN - 1078-8956
VL - 30
SP - 1127
EP - 1133
JO - Nature Medicine
JF - Nature Medicine
IS - 4
ER -