Examining the Feasibility of Wysa in Hindi

A Feasibility Study of a Digital Mental Health Intervention (Wysa in Hindi) in Improving Mental Health Distress in Adolescents and Young Adults with Type 1 Diabetes in Low Resource Settings

The principal objective of this study is to investigate the feasibility of including a digital mental health intervention (Wysa in Hindi) within pre-existing usual care to support adolescents and young adults with Type 1 Diabetes (T1D) who have mild and above mental health distress (operationalized as Patient Health Questionnaire-9: 5-14 scores; or Diabetes Distress Scale-17: >2.0 mean score) with their mental health distress. This will be conducted through an exploratory randomized control study comparing Wysa in Hindi plus usual care with a control arm that just has usual care. The study further explores the effectiveness of the digital mental health intervention using the Patient Health Questionnaire (PHQ-9) and Diabetes Distress Scale (DDS-17).

Study Overview

• Status: Completed
• Conditions: Mental Health Issue; Diabetes Distress
• Intervention / Treatment: Behavioral: Wysa in Hindi; Behavioral: Individual and group sessions on topics like motivation, coping, wellbeing

Detailed Description

Participants (13-25 years) with Type1 Diabetes are invited into the study. The intervention being studied is the Wysa in Hindi app. Participants will be recruited from Udaan (a Non-Governmental Organization (NGO) supporting individuals with Type1 diabetes). They will complete baseline research procedures and be randomly allocated to one of two groups.

Participants in the intervention arm will get access to the Wysa in Hindi app as well as access to usual care (individual and group sessions on motivation, mental health, and coping). The control arm will only have access to the usual care i.e. the individual and group sessions. At the end of 2 months, participants will be invited for follow-up to complete the endline assessments.

• Study Type: Interventional
• Enrollment (Actual): 79
• Phase: Not Applicable

Contacts and Locations

Study Locations

• India
  • Maharashtra
    • Aurangabad, Maharashtra, India, 431003
      • Udaan

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age between 13-25 years
• Diagnosis of Type1 diabetes
• Access to a smartphone with internet connection
• Can read and understand Hindi
• Mental health distress as demonstrated by elevated scores on any of the scales: Mild -moderate symptoms (between 5-14 score) on Patient Health Questionnaire (PHQ-9), moderate and above diabetes distress (mean score 2.0 and higher) on the Diabetes Distress Scale (DDS-17)

Exclusion Criteria:

• Do not own or have access to a mobile device
• Are identified to have risk of harm/ suicidality (as identified on PHQ-9)
• Are currently undergoing or have received psychiatric support
• Experience any mental or physical impairments that create accessibility barriers to the use of a smartphone or access to a digital mental health intervention

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention arm: Wysa in Hindi + usual care; The intervention arm will receive Wysa in Hindi and the usual care. Wysa in Hindi is a digital mental health intervention that combines Artificial Intelligence-led conversational chatbot support and human therapy in the Hindi language. The Artificial Intelligence (AI) chatbot acts as a companion, and understands, empathizes, and guides users through exercises grounded in cognitive behavioral therapy (CBT) techniques, written by qualified psychologists and clinicians. Usual care includes access to individual and bi-weekly group sessions focused on building coping, wellbeing, and motivation by the diabetes educator team.	Behavioral: Wysa in Hindi; Wysa in Hindi is a blended digital mental health intervention; Behavioral: Individual and group sessions on topics like motivation, coping, wellbeing; Individual and group sessions on wellbeing, coping, and motivation with the diabetes educator team
Active Comparator: Usual care arm; Participants in the control group will only have access to usual care (which will remain the same as that for the intervention arm). This includes access to individual sessions and bi-weekly group sessions with the diabetes education team on motivation, wellbeing, and coping.	Behavioral: Individual and group sessions on topics like motivation, coping, wellbeing; Individual and group sessions on wellbeing, coping, and motivation with the diabetes educator team

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility - Recruitment rate (Proportion of participants who completed consent procedures)	Proportion of participants who completed consent procedures versus those who were invited to participate in the study via awareness activities.	Measured at the end of the recruitment period (3 weeks, or if recruitment is extended at the end of 2 months)
Feasibility - Retention rate (Proportion of participants who remained enrolled within the study for the entire study duration)	Proportion of recruited participants who completed endline assessments i.e. those who remained enrolled for the study duration.	Measured after the 2 month intervention during follow-up endline assessments
Feasibility - Wysa Engagement (Proportion of recruited participants who engaged in at least 1 interaction with the Wysa app)	Proportion of recruited participants who interacted with Wysa at least once after onboarding to the app. Information will also collected on average numbers of days the app was used.	Measured at the end of the 2 month intervention
Feasibility - App therapist engagement rate (Proportion of recruited participants who completed at least one therapist session within the Wysa app)	Proportion of recruited participants who completed at least one session with the therapist available on Wysa app.	Measured at the end of the 2 month intervention
Satisfaction with the app which is collected through 3 quantitative questions and 1 free text qualitative question on the app	Feedback is collected through 4 questions wherein 3 questions ask participants to provide a quantitative rating of the app features' usability and satisfaction. Participants can provide ratings on a 5 point likert scale with higher ratings denoting higher satisfaction. 1 qualitative question invites participant to use free text format to provide any additional feedback. All feedback is collected twice on the app i..e. Day 2 and Day 45 from onboarding.	This is collected twice; on day 2 and day 45 from onboarding on the app
Therapist Satisfaction feedback collected through 3 quantitative questions and 1 free text qualitative question on the app	Participants provide feedback about their app therapist sessions through 3 questions asking for a quantitative rating of their satisfaction, and 1 question where participant can provide a free text response with their overall feedback. The quantitative rating is on a 5 point Likert scale with higher ratings indicating higher satisfaction. Feedback will be collected at the end of each therapist session.	Collected post every therapist session during the intervention period of 2 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in mental health distress as measured by the Patient Health Questionnaire (PHQ-9)	PHQ-9, a 9 item self report scale will be to ask about the presence of depressive symptoms. Participants are asked to rate the frequency of symptoms on a scale of 0-3. It gives a score between 0-27, with higher scores indicating more severe symptoms.	Baseline assessment, and then at the 2 month follow-up endline assessment
Change in mental health distress as measured by the Diabetes Distress Scale (DDS-17)	Diabetes Distress Scale (DDS-17) is a 17 item self report questionnaire on diabetes distress. Participants have to respond to how much a problem has affected their lives on a scale of 1-6. The scoring yields a mean score range between 1-6, wherein higher scores indicate higher levels of distress.	Baseline assessment, and then at the 2 month follow up assessment

Collaborators and Investigators

• Sponsor: Wysa
• Collaborators: Udaan
• Investigators: Principal Investigator: Archana Sarda, M.D, Udaan; Principal Investigator: Tejaswi Shetty, M.A., Touchkin eServices Pvt. Ltd.; Principal Investigator: Chaitali Sinha, M.A., Touchkin eServices Pvt. Ltd.

Publications and helpful links

General Publications

• Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13. doi: 10.1046/j.1525-1497.2001.016009606.x.
• Polonsky WH, Fisher L, Earles J, Dudl RJ, Lees J, Mullan J, Jackson RA. Assessing psychosocial distress in diabetes: development of the diabetes distress scale. Diabetes Care. 2005 Mar;28(3):626-31. doi: 10.2337/diacare.28.3.626.

Study record dates

Study Major Dates

• Study Start (Actual): February 23, 2024
• Primary Completion (Actual): May 28, 2024
• Study Completion (Actual): May 28, 2024

Study Registration Dates

• First Submitted: February 23, 2024
• First Submitted That Met QC Criteria: March 12, 2024
• First Posted (Actual): March 20, 2024

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: December 18, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Keywords: digital mental health
• Other Study ID Numbers: 24-WYSA-101

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared with any external party as it does not comply with the terms of consent.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No