Digital psychosocial intervention for depression among older adults in socioeconomically deprived areas in Brazil (PRODIGITAL-D): protocol for an individually randomised controlled trial

Carina Akemi Nakamura, Marcia Scazufca, Felipe Azevedo Moretti, Thiago Vinicius Nadaleto Didone, Mariana Mendes de Sá Martins, Luara Aragoni Pereira, Caio Hudson Queiroz de Souza, Gabriel Macias de Oliveira, Marcelo Oliveira da Costa, Marcelo Machado, Evelyn da Silva Bitencourt, Monica Souza Dos Santos, Jamie Murdoch, Pepijn van de Ven, Nadine Seward, William Hollingworth, Tim J. Peters, Ricardo Araya

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1 Citation (Scopus)


BACKGROUND: Depression in older adults is a challenge for health systems in most low- and middle-income countries (LMICs). Digital strategies for the management of this condition have been emerging worldwide, but the effectiveness of most of them is still unclear, especially among older adults. Thus, we aim to assess the effectiveness and cost-effectiveness of a digital psychosocial intervention to treat depression among older adults living in socioeconomically deprived areas in Guarulhos, Brazil. METHODS: We will conduct a two-arm individually randomised controlled trial with 1:1 allocation ratio. Five hundred older adults aged 60 years or over with depressive symptomatology (9-item Patient Health Questionnaire score, PHQ-9 ≥ 10) and registered with one of the primary care clinics will be recruited to participate in this study. A 6-week digital psychosocial programme, named Viva Vida, will be delivered via WhatsApp to participants allocated to the intervention arm. The Viva Vida will send psychoeducational and behavioural activation audio and visual messages 4 days a week for 6 weeks. The control arm will only receive a single message with general information about depression. The primary outcome will be the proportion of depression recovery (PHQ-9 < 10) assessed at 3 months. The cost-effectiveness of the intervention will be assessed at 5 months. A detailed process evaluation will be used to explore context and important implementation outcomes. DISCUSSION: This programme was based on the PROACTIVE intervention and designed to be delivered without face-to-face contact. If effective, it could be a simple treatment option, appropriate not only when social distancing is required, but it could also be included as a regular public health programme to initiate depression treatment, particularly in LMICs where resources allocated to mental health are scarce. TRIAL REGISTRATION: Registro Brasileiro de Ensaios Clínicos (ReBEC), RBR-4c94dtn. Registered on 22 October 2021 (submitted on 03 August 2021).

Original languageEnglish
Article number761
Pages (from-to)761
Number of pages1
Issue number1
Publication statusPublished - Dec 2022


  • Behavioural activation
  • Brazil
  • Depression
  • Digital intervention
  • Low- and middle-income countries
  • Process evaluation
  • Psychoeducation
  • Psychosocial intervention
  • Randomised controlled trial


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