Understanding how digital mental health interventions can be optimised to improve longer term sustainability: Findings from a causal mediation analysis of the CONEMO trials.

ABSTRACT: Two CONEMO trials in Lima, Peru and São Paulo, Brazil evaluated a digital mental health intervention (DMHI) based on behavioural activation (BA), that demonstrated improved symptoms of depression at three, but not six-months. To understand how we can optimize features of the DMHI to improve outcomes for longer-term effectiveness and eventually scale-up, we investigated mediators through which the intervention improved symptoms of depression, separately for the two trials and then using a pooled dataset. Trial data included adults with depression (Patient Health Questionnaire - 9 (PHQ-9) score ≥10) and comorbid hypertension and/or diabetes. Interventional effects, a robust causal inference based approach to mediation, was used to decompose the total effect of DMHI on improved symptoms of de

SUBMITTER: Seward N 

PROVIDER: S-EPMC12212485 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature