Melissa Joanne Harper Shehadeh|Jinane Abi Ramia|Pim Cuijpers|Rabih El Chammay|Eva Heim|Wissam Kheir|Khalid Saeed|Mark van Ommeren|Edith van’t Hof|Sarah Watts|Andreas Wenger|Edwina Zoghbi|Kenneth Carswell
Step-by-Step, an E-Mental Health Intervention for Depression: A Mixed Methods Pilot Study From Lebanon
World Health Organization|University of Geneva|Ministry of Public Health|World Health Organization|Vrije Universiteit Amsterdam|Ministry of Public Health|University of Zurich|Ministry of Public Health|World Health Organization Regional Office for the Eastern Mediterranean|World Health Organization - Egypt|World Health Organization|World Health Organization|World Health Organization|Addiction Switzerland|University of Zurich|World Health Organization - Lebanon|World Health Organization
background emental health established mode delivering treatment common mental disorders many high income countries however evidence effectiveness lower income countries lacking mixed methods study presents preliminary data feasibility minimally guided emental health intervention lebanon aim pilot test stepbystep guided emental health intervention prior future controlled testing methods participants recruited using social media advertisements primary care clinics participants completed baseline postintervention questionnaires depression symptoms primary outcome phq8 anxiety symptoms wellbeing disability selfperceived problem severity client satisfaction questionnaire addition seven completers four dropouts eleven study staff four clinic managers interviewed responses thematically analyzed website analytics used understand participant behavior using website results total 129 participants signed via stepbystep website 74 participants started session 1 completing pretest questionnaires 26 completed baseline post intervention data among completed postassessments depression symptoms improved phq8 scores t562 p0001 2 tailed df25 wilcoxon signed ranks tests showed significant difference baseline poststepbystep scores secondary outcome measures client satisfaction data positive interview responses suggested intervention could made appropriate younger single people motivating easier use utilised support element intervention happy relationship nonspecialist support person ehelper though participants would preferred specialist support ehelpers would liked training complex cases website analytics showed many users dropped intervention start reentered screening data excluded study conclusion stepbystep skills techniques model service integration nonspecialist support element acceptable though sample small noncontrolled dropout high results suggest may effective reducing depression anxiety symptoms increasing wellbeing lessons learned inform content revision development app version stepbystep research methodology upcoming effectiveness studies