Addressing Depression Comorbid With Diabetes or Hypertension in Resource-Poor Settings: A Qualitative Study About User Perception of a Nurse-Supported Smartphone App in Peru

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorBRANDT, Lena R.
dc.contributor.authorHIDALGO, Liliana
dc.contributor.authorDIEZ-CANSECO, Francisco
dc.contributor.authorARAYA, Ricardo
dc.contributor.authorMOHR, David C.
dc.contributor.authorMENEZES, Paulo R.
dc.contributor.authorMIRANDA, J. Jaime
dc.date.accessioned2019-08-20T14:46:24Z
dc.date.available2019-08-20T14:46:24Z
dc.date.issued2019
dc.description.abstractBackground: Smartphone apps could constitute a cost-effective strategy to overcome health care system access barriers to mental health services for people in low- and middle-income countries. Objective: The aim of this paper was to explore the patients' perspectives of CONEMO (Emotional Control, in Spanish: Control Emocional), a technology-driven, psychoeducational, and nurse-supported intervention delivered via a smartphone app aimed at reducing depressive symptoms in people with diabetes, hypertension or both who attend public health care centers, as well as the nurses' feedback about their role and its feasibility to be scaled up. Methods: This study combines data from 2 pilot studies performed in Lima, Peru, between 2015 and 2016, to test the feasibility of CONEMO. Interviews were conducted with 29 patients with diabetes, hypertension or both with comorbid depressive symptoms who used CONEMO and 6 staff nurses who accompanied the intervention. Using a content analysis approach, interview notes from patient interviews were transferred to a digital format, coded, and categorized into 6 main domains: the perceived health benefit, usability, adherence, user satisfaction with the app, nurse's support, and suggestions to improve the intervention. Interviews with nurses were analyzed by the same approach and categorized into 4 domains: general feedback, evaluation of training, evaluation of study activities, and feasibility of implementing this intervention within the existing structures of health system. Results: Patients perceived improvement in their emotional health because of CONEMO, whereas some also reported better physical health. Many encountered some difficulties with using CONEMO, but resolved them with time and practice. However, the interactive elements of the app, such as short message service, android notifications, and pop-up messages were mostly perceived as challenging. Satisfaction with CONEMO was high, as was the self-reported adherence. Overall, patients evaluated the nurse accompaniment positively, but they suggested improvements in the technological training and an increase in the amount of contact. Nurses reported some difficulties in completing their tasks and explained that the CONEMO intervention activities competed with their everyday work routine. Conclusions: Using a nurse-supported smartphone app to reduce depressive symptoms among people with chronic diseases is possible and mostly perceived beneficial by the patients, but it requires context-specific adaptations regarding the implementation of a task shifting approach within the public health care system. These results provide valuable information about user feedback for those building mobile health interventions for depression.eng
dc.description.indexPubMedeng
dc.description.sponsorshipNational Institute of Mental Health [1U19MH098780]
dc.identifier.citationJMIR MENTAL HEALTH, v.6, n.6, article ID UNSP e11701, 20p, 2019
dc.identifier.doi10.2196/11701
dc.identifier.issn2368-7959
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/33160
dc.language.isoeng
dc.publisherJMIR PUBLICATIONS, INCeng
dc.relation.ispartofJmir Mental Health
dc.rightsopenAccesseng
dc.rights.holderCopyright JMIR PUBLICATIONS, INCeng
dc.subjectmental healtheng
dc.subjectdepressioneng
dc.subjectnoncommunicable diseaseseng
dc.subjectmHealtheng
dc.subjectsmartphoneeng
dc.subjectdeveloping countrieseng
dc.subject.otherbehavioral activation treatmenteng
dc.subject.othermental-healtheng
dc.subject.otherself-helpeng
dc.subject.otherdisorderseng
dc.subject.otherinterneteng
dc.subject.otherefficacyeng
dc.subject.othertherapyeng
dc.subject.othercareeng
dc.subject.otherinterventionseng
dc.subject.otherassociationeng
dc.subject.wosPsychiatryeng
dc.titleAddressing Depression Comorbid With Diabetes or Hypertension in Resource-Poor Settings: A Qualitative Study About User Perception of a Nurse-Supported Smartphone App in Perueng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countryEstados Unidos
hcfmusp.affiliation.countryPeru
hcfmusp.affiliation.countryInglaterra
hcfmusp.affiliation.countryisope
hcfmusp.affiliation.countryisogb
hcfmusp.affiliation.countryisous
hcfmusp.author.externalBRANDT, Lena R.:Univ Peruana Cayetano Heredia, CRONICAS Ctr Excellence Chron Dis, Ave Armendariz 497, Lima, Peru
hcfmusp.author.externalHIDALGO, Liliana:Univ Peruana Cayetano Heredia, CRONICAS Ctr Excellence Chron Dis, Ave Armendariz 497, Lima, Peru
hcfmusp.author.externalDIEZ-CANSECO, Francisco:Univ Peruana Cayetano Heredia, CRONICAS Ctr Excellence Chron Dis, Ave Armendariz 497, Lima, Peru
hcfmusp.author.externalARAYA, Ricardo:Kings Coll London, Inst Psychiat Psychol & Neurosci, Hlth Serv & Populat Res, Ctr Global Mental Hlth & Primary Care Res, London, England
hcfmusp.author.externalMOHR, David C.:Northwestern Univ, Ctr Behav Intervent Technol, Chicago, IL 60611 USA
hcfmusp.author.externalMIRANDA, J. Jaime:Univ Peruana Cayetano Heredia, CRONICAS Ctr Excellence Chron Dis, Ave Armendariz 497, Lima, Peru; Univ Peruana Cayetano Heredia, Sch Med, Dept Med, Lima, Peru
hcfmusp.citation.scopus22
hcfmusp.contributor.author-fmusphcPAULO ROSSI MENEZES
hcfmusp.description.articlenumberUNSP e11701
hcfmusp.description.issue6
hcfmusp.description.volume6
hcfmusp.origemWOS
hcfmusp.origem.pubmed31215511
hcfmusp.origem.scopus2-s2.0-85097182201
hcfmusp.origem.wosWOS:000472679500001
hcfmusp.publisher.cityTORONTOeng
hcfmusp.publisher.countryCANADAeng
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