The results of this study may aid in understanding whether behavioral activation as an intervention is acceptable for the population and how feasible it will be to deliver such interventions for depression in noncommunicable disease in South Asian countries such as India.
Authors
Rayeesa Zainab, National Institute of Mental Health and Neuro Sciences, Bangalore, India
Arun Kandasamy, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
Naseer Ahmad Bhat, Jindal School of Psychology and Counselling, O.P. Jindal Global University, Sonipat, Haryana, India.
Chrishma Violla Dsouza, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
Hannah Jennings, Department of Health Sciences, University of York & Hull York Medical School, Heslington, United Kingdom.
Cath Jackson, Valid Research LTD, West Yorkshire, United Kingdom.
Papiya Mazumdar, School of Politics and International Studies, Faculty of Social Science, University of Leeds, Leeds, United Kingdom.
Catherine Elizabeth Hewitt, Department of Health Sciences, University of York, Heslington, United Kingdom.
David Ekers, Tees Esk and Wear Valleys NHS Foundation Trust, North Yorkshire, United Kingdom; Department of Medicine, Pharmacy, and Health, Durham University, North Yorkshire, United Kingdom.
Gitanjali Narayanan, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
Girish N Rao, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
Karen Coales, Department of Health Sciences, University of York & Hull York Medical School, Heslington, United Kingdom.
Krishna Prasad Muliyala, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
Santosh K Chaturvedi, Leicestershire Partnership NHS Trust, Leicester, United Kingdom.
Pratima Murthy, National Institute of Mental Health and Neuro Sciences, Bangalore, India.
Najma Siddiqi, Department of Health Sciences, University of York & Hull York Medical School, Heslington, United Kingdom.
Summary
The increasing burden of depression and noncommunicable disease (NCD) is a global challenge, especially in low- and middle-income countries, considering the resource constraints and lack of trained human resources in these settings. Effective treatment of depression in people with NCDs has the potential to enhance both the mental and physical well-being of this population. It will also result in the effective use of the available health care resources. Brief psychological therapies, such as behavioral activation (BA), are effective for the treatment of depression. BA has not been adapted in the community health care services of India, and the feasibility of using BA as an intervention for depression in NCD and its effectiveness in these settings have not been systematically evaluated.
Objective:
Our objective is to adapt BA for the Indian NCD context and test the acceptability, feasibility, and implementation of the adapted BA intervention (BEACON intervention package [BIP]). Additionally, we aim to test the feasibility of a randomized controlled trial evaluation of BIP for the treatment of depression compared with enhanced usual care.
Methods:
Following well-established frameworks for intervention adaptation, we first adapted BA (to fit the linguistic, cultural, and resource context) for delivery in India. The intervention was also adapted for potential remote delivery by telephone. In a randomized controlled trial, we will be testing the acceptability, feasibility, and implementation of the adapted BA intervention (BIP). We shall also test if a randomized controlled feasibility trial can be delivered effectively and estimate important parameters (eg, recruitment and retention rates and completeness of follow-up) needed to design a future definitive trial.
Results:
Following the receipt of approval from all the relevant agencies, the development of the BIP was started on November 28, 2020, and completed on August 18, 2021, and the quantitative data collection was started on August 23, 2021, and completed on December 10, 2021. Process evaluation (qualitative data) collection is ongoing. Both the qualitative and quantitative data analyses are ongoing.
Conclusions:
This study may offer insights that could help in closing the gap in the treatment of common mental illness, particularly in nations with limited resources, infrastructure, and systems such as India. To close this gap, BEACON tries to provide BA for depression in NCDs through qualified NCD (BA) counselors integrated within the state-run NCD clinics. The results of this study may aid in understanding whether BA as an intervention is acceptable for the population and how feasible it will be to deliver such interventions for depression in NCD in South Asian countries such as India. The BIP may also be used in the future by Indian community clinics as a brief intervention program.
Published in: JMIR Research Protocols
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