Assessing the efficacy of a culturally adapted cognitive behavioural internet-delivered treatment for depression: protocol for a randomised controlled trial

Alicia Salamanca-Sanabria, Derek Richards, Ladislav Timulak, Leónidas Castro-Camacho, Mónica Mojica-Perilla, Yamilena Parra-Villa, Alicia Salamanca-Sanabria, Derek Richards, Ladislav Timulak, Leónidas Castro-Camacho, Mónica Mojica-Perilla, Yamilena Parra-Villa

Abstract

Background: Depression is the principal cause of disability in the world. High prevalence rates of depression in general populations and college students have been found worldwide and in various cultural groups. Low-intensity cognitive behavioural internet-delivered treatment has demonstrated efficacy in high-income-countries (HICs). However little is known of their potential for adaptation and efficacy in low and middle-income countries.

Methods: Study (1) involves the cultural adaptation of the Space from Depression cognitive-behaviour internet-delivered programme with an asynchronous support for depressive symptoms. This includes initial researcher/clinician adaptation and the integration of cultural assessment feedback of the programme by a panel of experts and users through the theoretically-based Cultural Relevance Questionnaire (CRQ). Study (2) describes the implementation of the culturally adapted intervention using a randomised controlled trial methodology. The efficacy trial will include an active treatment group and a waiting-list control group of participants meeting eligibility criteria (mild to moderate depression symptoms). The active condition will consist of 7 weekly modules of internet-delivered cognitive behavioural therapy (iCBT) Space from Depression, with post-session feedback support. The primary outcome will be the Patient Health Questionnaire (PHQ-9). The study also involves collection of client reported significant events and client satisfaction with the internet-delivered treatment. Data will be collected at baseline and at post-treatment (week 7), and at follow-up (week 20/3 months). Analysis will be conducted on the intention-to-treat basis.

Discussion: The study seeks to establish a theoretically robust methodology for culturally adapting internet-delivered interventions for mental health disorders and to evaluate the efficacy of a culturally adapted internet-delivered treatment for depression in Colombia, with support. The study will be a first contribution to a method for culturally adapting internet-delivered interventions and also a first to examine the efficacy of such an adapted intervention in Latin America.

Trial registration: Clinical trials NCT03062215. Retrospectively registered 14th February 2017.

Keywords: CBT; College students; Culturally adapted psychotherapy; Depressive symptoms; Internet-delivered treatment; Randomised trial.

Conflict of interest statement

Consent for publication

Not applicable.

Competing interests

Alicia Salamanca is the recipient of an Irish Research Council (IRC) scholarship award [EPSPG/2014/98] under the Enterprise/ Academia collaboration scheme. The scholarship is funded by the IRC and SilverCloud Health. Dr. Derek Richards is Director of Clinical Research at SilverCloud Health. Dr. Ladislav Timulak provides a research consultancy for SilverCloud Health.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

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Fig. 1
Participant flow CONSORT

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