Expanding Access to Depression Treatment in Kenya Through Automated Psychological Support: Protocol for a Single-Case...

Area of Science:

• Digital mental health interventions
• Perinatal depression treatment
• Mobile health (mHealth)

Background:

• Perinatal depression is linked to adverse outcomes for mothers and infants.
• Effective interventions are underutilized in low- and middle-income countries due to a lack of trained professionals.
• Task-sharing models show promise but face scale-up barriers.

Purpose of the Study:

• To pilot the Healthy Moms mobile intervention for perinatal depression.
• To assess feasibility and acceptability in pregnant women and new mothers in Kenya.
• To gather preliminary data for a larger, more robust study.

Main Methods:

• Single-case experimental design with automated screening via text messages.
• Participants randomized to baseline periods, then use the Zuri (Tess) AI chatbot.
• Mood ratings collected via SMS; engagement studied through system logs and interviews.

Main Results:

• Intervention content adapted and refined based on prepilot formative testing with 10 women.
• Pilot study recruitment initiated in early 2019, with results anticipated by late 2019.
• Preliminary data on treatment response to be generated using visual inspection, interviews, and Bayesian estimation.

Conclusions:

• Pilot study focuses on urban/periurban Kenyan women, limiting generalizability.
• Primary objective is to inform the development of a more robust service and future studies.
• Results will guide the design of a larger study with a more diverse population.