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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.contributor.author Brandt, Lena R.
dc.contributor.author Hidalgo Padilla, Liliana Milagros
dc.contributor.author Diez-Canseco Montero, Francisco
dc.contributor.author Araya, Ricardo
dc.contributor.author Mohr, David C.
dc.contributor.author Menezes, Paulo R.
dc.contributor.author Miranda, J. Jaime
dc.date.accessioned 2019-07-04T16:59:18Z
dc.date.available 2019-07-04T16:59:18Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/6715
dc.description.abstract BACKGROUND: 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. en_US
dc.language.iso eng
dc.publisher JMIR Publications
dc.relation.ispartofseries JMIR Mental Health
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject depression en_US
dc.subject Depression en_US
dc.subject developing countries en_US
dc.subject Developing countries en_US
dc.subject mental health en_US
dc.subject Mental health en_US
dc.subject mHealth en_US
dc.subject MHealth en_US
dc.subject noncommunicable diseases en_US
dc.subject Noncommunicable diseases en_US
dc.subject smartphone en_US
dc.subject Smartphone en_US
dc.title 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 en_US
dc.type info:eu-repo/semantics/review
dc.identifier.doi https://doi.org/10.2196/11701
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.24
dc.relation.issn 2368-7959


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