Feasibility, acceptability, and preliminary efficacy of a telehealth supported self-management intervention for adults with depression symptoms in Vietnam: a mixed-method pre-post study.

backgroundTelehealth has been proven to be an effective means of delivering psychotherapy, yet there is a lack of evidence in Vietnam where access to psychotherapy is limited. We conducted a study to evaluate the feasibility, acceptability, and preliminary efficacy of Tele-SSM-a mobile health-supported self-management intervention for depression in Vietnam.

methodsThis was a pre-post, mixed-methods study. Adults aged between 18 and 64 years old with symptoms of depression were recruited and participated in 10 individual weekly sessions delivered remotely by mental health para-professionals. Feasibility was assessed by recruitment capacity, retention, and participant compliance; acceptability by participant satisfaction ratings and in-depth interviews; and preliminary efficacy by changes in depression, anxiety, stress, suicidal ideation, self-esteem, and perceived social support scores from baseline to endline.

resultsSeventy-five adults with depression were enrolled and 58 of those completed the intervention. Feasibility was adequate as recruitment, retention, and compliance all exceeded the predefined progression criteria. Recruitment reached 93.75% (progression criterion of ≥70%), retention was 77% (progression criterion of ≥75%), and compliance was high, with 93.1% of participants completing the intervention within the expected number of sessions (progression criterion of ≥80%). The intervention was well-accepted by participants with 96% of participants reporting satisfaction with the materials and coaching sessions. The average number of coaching calls required to deliver 10 sessions was 10.81, suggesting that the intervention may need to be implemented over 11 calls. Additional emphasis should be placed on realistic thinking and non-violent communications skills as participants reported more difficulties with these components. Exploratory pre-post analyses suggested potential improvements across depression, anxiety, stress, suicidal ideation, self-esteem, and perceived social support; however, these findings should be interpreted cautiously given that the study was not powered to assess efficacy.

conclusionsThese results provide promising evidence for the adequate feasibility, acceptability and preliminary efficacy of Tele-SSM on depression. The intervention also has the potential to address anxiety and stress. These preliminary insights can inform the design of a future randomized hybrid effectiveness-implementation study, particularly with regard to recruitment, retention, adherence, and potential outcome trends.

trial registrationClinicaltrials.gov, NCT06456775. Registered June 13, 2024 - Retrospectively registered, https://clinicaltrials.gov/study/NCT06456775?cond=depression&intr=Tele-SSM&rank=1 .