Development, evaluation, and implementation of a tablet device-based depression screening and management tool for rural womens self-help groups

Depression is a critical public health issue among women in rural India, with diagnosis and treatment rates being very low. The paper summarizes the development of MITHRA, a user-centred mobile app for depression screening and treatment among women in self-help groups (SHGs) of rural India. The predevelopment phase involved situation analysis and forming participatory design groups of prospective users. The app development phase used an Agile approach for flexibility and rapid adaptation. The post-development phase involved user acceptance testing, training on app usage, data synchronization, accuracy testing and usability evaluation. The study found that only 25% of the women in the participatory design group were digitally literate, despite 63% smartphone ownership. On assessing the cellular connectivity, the average download speed across the eight study sites was 9.81 Mbps, and the average upload speed was 4.6 Mbps. The user tests showed improvement in the task success rate between user testing session 1 and session 2 for all the tested tasks. The app successfully passed user acceptance testing (UAT) and data accuracy testing, demonstrating its readiness for deployment. Heuristic evaluation identified 52 violations with a mean score of 2.3, indicating minor usability issues to be addressed. This description of app development underscores the potential of mHealth apps in addressing mental health issues in underrepresented populations.