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A four-year experience with a Web-based self-help intervention for depressive symptoms in Mexico

dc.creatorLara, María Asunción
dc.creatorTiburcio, Marcela
dc.creatorAguilar Abrego, Araceli
dc.creatorSánchez-Solís, Alejandro
dc.date.accessioned2017-06-29T03:40:57Z
dc.date.available2017-06-29T03:40:57Z
dc.date.issued2014es_ES
dc.identifier2508es_ES
dc.identifier.issn1020-4989es_ES
dc.identifier.urihttp://repositorio.inprf.gob.mx/handle/123456789/4357
dc.identifier.urihttps://www.scielosp.org/article/rpsp/2014.v35n5-6/399-406/es_ES
dc.description.abstractes_ES
dc.language.isoenges_ES
dc.publisheres_ES
dc.relation35(5-6) 399-406p.es_ES
dc.relationversión del editores_ES
dc.rightsacceso cerradoes_ES
dc.subject.meshAdolescentes_ES
dc.subject.meshAdultes_ES
dc.subject.meshDepression/therapyes_ES
dc.subject.meshFemalees_ES
dc.subject.meshHumanses_ES
dc.subject.meshInternetes_ES
dc.subject.meshMalees_ES
dc.subject.meshMexicoes_ES
dc.subject.meshMiddle Agedes_ES
dc.subject.meshSelf-Help Groupses_ES
dc.subject.meshTime Factorses_ES
dc.subject.meshYoung Adultes_ES
dc.titleA four-year experience with a Web-based self-help intervention for depressive symptoms in Mexicoes_ES
dc.title.alternativees_ES
dc.typeartículoes_ES
dc.contributor.affiliationInstituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexicoes_ES
dc.contributor.emaillaracan@imp.edu.mxes_ES
dc.relation.jnabreviadoREV PANAM SALUD PUBLICAes_ES
dc.relation.journalRevista panamericana de salud públicaes_ES
dc.identifier.placeEstados Unidoses_ES
dc.date.published2014es_ES
dc.identifier.organizacionInstituto Nacional de Psiquiatría Ramón de la Fuente Muñizes_ES
dc.identifier.eissn1680-5348es_ES
dc.identifier.doies_ES
dc.description.monthMay-Junes_ES
dc.description.abstractotrodiomaObjective. To describe a four-year descriptive, naturalistic study monitoring the use of HDep (Help for Depression or Ayuda para depression (ADep) in Spanish), an openaccess/free Web-based, psycho-education, cognitive-behavioral intervention program produced in Mexico consisting of seven self-help modules that include feedback-generating assessments of depressive symptoms, vignettes, recorded messages, a relaxation exercise, a personal workbook, blogs, and user discussion forums. Methods. Data were collected on all individuals who entered the HDep site since the program’s launching in 2009. Those who entered the site two or more times and also registered as “users” or “participants.” The user data consisted of 1) user profiles; 2) scores for the CES-D (Center for Epidemiological Studies Depression Scale), for users who completed the feedback-generating assessments of depressive symptoms; 3) user evaluations of the usefulness of HDep; and 4) transcripts of HDep discussion forum posts. The raw user data were obtained through Moodle (Modular Object-Oriented Dynamic Learning Environment, a free software e-learning platform) and analyzed quantitatively (using SPSS) and qualitatively (using ATLAS.ti). Results. A total of 28 078 individuals accessed HDep and 17 318 of those (61.6%) qualified as users. Of all users, 84.4% were women, 64.6% used the workbook, and 60.9% entered the discussion forums (of whom 16.3% added a post). Depressive symptoms (CES-D score ≥ 16) were observed in 97.1% of the users who completed the feedback-generating assessment (n = 16 564). User retention dropped across the seven modules (from 12 366 users for Module 1 to 626 for Module 7). However, all seven modules were rated very high for “helpfulness/ usefulness,” with mean scores all above 4 on a 1–5 scale. The HDep discussion forums showed a rich social interaction. Predictors of entering at least one module (based on stepwise logistic regression analysis) included being a woman, being ≥ 30 years old, reporting disability, and having attempted suicide. Of the 72 participants who completed the final user evaluation of HDep, 97.5% said it had an enormous influence on helping them to identify and transform negative thoughts. Conclusions. Despite the high attrition among users, and the need for further structure adaptation, HDep can be considered a potentially useful mental health tool in Mexico for 1) detecting depression (via the CES-D assessments) and 2) providing a means of social support to those with depression. The high levels of depressive symptoms detected among users suggest that the role of free-access, self-help, Web-based interventions in public mental health programs should be further investigated. The effectiveness of HDep in reducing depressive symptoms and providing a support system has yet to be assessed and should be examined in future research.es_ES
dc.subject.meshmes_ES
dc.subject.kwes_ES
dc.subject.koDepressiones_ES
dc.subject.koInternetes_ES
dc.subject.koSocial supportes_ES
dc.subject.koCognitive therapyes_ES
dc.subject.koMexicoes_ES


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