Step-by-Step, an E-Mental Health Intervention for Depression: A Mixed Methods Pilot Study From Lebanon

Area of Science:

• Digital mental health interventions
• Global mental health research
• Public health

Background:

• E-mental health is established in high-income countries but lacks evidence in lower-income settings.
• This study piloted the WHO-guided Step-by-Step e-mental health intervention in Lebanon.
• It aimed to gather feasibility data and lessons learned before larger controlled trials.

Purpose of the Study:

• To pilot test the Step-by-Step e-mental health intervention in Lebanon.
• To assess the feasibility and acceptability of the intervention and research methods.
• To collect preliminary data on effectiveness for depression and anxiety.

Main Methods:

• A mixed-methods approach was used, combining quantitative and qualitative data.
• Participants (n=129) were recruited via social media and clinics, completing questionnaires on depression, anxiety, and well-being.
• Thematic analysis of interviews with participants and staff, alongside website analytics, informed the findings.

Main Results:

• Of 129 sign-ups, 26 completed baseline and post-intervention data. Significant improvements were observed in depression (PHQ-8) and secondary outcomes.
• Client satisfaction was positive; interviews indicated a need for tailoring to younger, single individuals and suggested improvements for motivation and usability.
• High dropout rates were noted, with some participants preferring specialist support and e-helpers desiring more training.

Conclusions:

• The Step-by-Step intervention, service integration model, and non-specialist support are acceptable in Lebanon.
• Preliminary results suggest potential effectiveness in reducing depression and anxiety symptoms and improving well-being.
• Findings will guide content revision, app development, and future research methodology for effectiveness studies.