Single-Session Digital Intervention for Adolescent Depression, Anxiety and Well-being: Outcomes of a Randomized Controlled Trial with Kenyan Adolescents

View/ Open
Date
2020-03-24Author
Osborn, Tom L.
Rodriguez, Micaela
Wasil, Akash R.
Venturo-Conerly, Katherine E.
Gan, Jenny
Alemu, Rediet G.
Roe, Elizabeth
G, Susana Arango
Otieno, Benny H.
Wasanga, Christine M.
Shingleton, Rebecca
Weisz, John R.
Metadata
Show full item recordAbstract
Background: Adolescent depression and anxiety symptoms are prevalent in Sub-Saharan
African countries, yet treatment options are scarce, and stigma limits help-seeking. Brief,
computerized single-session interventions (SSIs) that contain empirically supported stigmareducing elements may help expand access to treatment. We developed and evaluated such an
intervention for Kenyan adolescents.
Method: High school students (N=103, age 13-18) were randomized to a digital SSI ShamiriDigital (Shamiri means “thrive” in Kiswahili) or a study-skills control intervention. ShamiriDigital consisted of reading and writing activities about three concepts: growth mindset,
gratitude, and value affirmation. Both Shamiri-Digital and the study-skills control condition
were delivered electronically in schools.
Results: Compared to the control, Shamiri-Digital produced greater reduction in adolescent
depression symptoms in both the full sample (p = 0.028, d = 0.50) and a sub-sample of youths
with moderate-to-severe depression symptoms (p = 0.010, d = 0.83) from baseline to two-week
follow-up. The effects exceed the mean effects reported in meta-analyses of full-length, face-toface psychotherapy for youth depression. There were no significant effects on anxiety symptoms,
well-being, or happiness.
Conclusion: This is the first report that a brief, computerized SSI may reduce depressive
symptoms in adolescents in Sub-Saharan Africa. Replication trials with extended follow-ups will
help gauge the strength and durability of these effects.
Trial Registration Number: PACTR201906810558181. Pan African Clinical Trials Registry
(PACTR).
Public Health Significance: This study provides evidence that a brief single-session positivepsychology intervention may help reduce depressive symptoms of adolescents living in Sub
Saharan Africa, where there are few mental health professionals, and stigma limits help-seeking
Keywords: Depression, Anxiety, Adolescents, Global Mental Health, Digital Mental
Health, Sub-Saharan Africa, Growth Mindset, Gratitude, Value Affirmation