TY - JOUR AU - Dambi, Jermaine AU - Norman, Clara AU - Doukani, Asmae AU - Potgieter, Stephan AU - Turner, Jean AU - Musesengwa, Rosemary AU - Verhey, Ruth AU - Chibanda, Dixon PY - 2022 DA - 2022/10/7 TI -针对津巴布韦成年人常见精神健康障碍的数字心理健康干预(Inuka)，以应对COVID-19大流行:可行性和可接受性试点研究JO - JMIR Ment Health SP - e37968 VL - 9 IS - 10 KW -可接受性KW - COVID-19 KW -可行性KW -友谊长凳KW - Inuka KW -试点KW -任务转移KW -津巴布韦AB -背景:常见精神健康障碍(CMDs)是全球残疾的主要原因。目前的COVID-19大流行进一步加重了疾病的负担。包括封锁在内的COVID-19遏制措施影响了人们获得亲自精神卫生保健的机会。因此，必须探索利用数字精神卫生干预措施来弥合治疗差距。移动保健技术是以较低成本增加获得治疗的有效工具。本研究探索了Inuka的实用性，这是一个基于聊天的应用程序，与友谊长凳解决问题的治疗干预相结合。Inuka应用程序提供双重匿名，客户可以在方便的时候预订或取消会话。Inuka的服务可以通过手机应用程序或网络访问。目的:探讨未来进行临床试验的可行性。 Additionally, we evaluated the feasibility, acceptability, appropriateness, scalability, and preliminary effectiveness of Inuka. Methods: Data were collected using concurrent mixed methods. We used a pragmatic quasiexperimental design to compare the feasibility, acceptability, and preliminary clinical effectiveness of Inuka (experimental group) and WhatsApp chat-based counseling (control). Participants received 6 problem-solving therapy sessions delivered by lay counselors. A reduction in CMDs was the primary clinical outcome. The secondary outcomes were health-related quality of life (HRQoL), disability and functioning, and social support. Quantitative outcomes were analyzed using descriptive and bivariate statistics. Finally, we used administrative data and semistructured interviews to gather data on acceptability and feasibility; this was analyzed using thematic analysis. Results: Altogether, 258 participants were screened over 6 months, with 202 assessed for eligibility, and 176 participants were included in the study (recruitment ratio of 29 participants/month). The participants’ mean age was 24.4 (SD 5.3) years, and most participants were female and had tertiary education. The mean daily smartphone usage was 8 (SD 3.5) hours. Eighty-three users signed up and completed at least one session. The average completion rate was 3 out of 4 sessions. Inuka was deemed feasible and acceptable in the local context, with connectivity challenges, app instability, expensive mobile data, and power outages cited as potential barriers to scale up. Generally, there was a decline in CMDs (F2,73=2.63; P=.08), depression (F2,73=7.67; P<.001), and anxiety (F2,73=2.95; P=.06) and a corresponding increase in HRQoL (F2,73=7.287; P<.001) in both groups. Conclusions: Study outcomes showed that it is feasible to run a future large-scale randomized clinical trial (RCT) and lend support to the feasibility and acceptability of Inuka, including evidence of preliminary effectiveness. The app’s double anonymity and structured support were the most salient features. There is a great need for iterative app updates before scaling up. Finally, a large-scale hybrid RCT with a longer follow-up to evaluate the clinical implementation and cost-effectiveness of the app is needed. SN - 2368-7959 UR - https://mental.www.mybigtv.com/2022/10/e37968 UR - https://doi.org/10.2196/37968 UR - http://www.ncbi.nlm.nih.gov/pubmed/35960595 DO - 10.2196/37968 ID - info:doi/10.2196/37968 ER -