Developing and Testing Tele-Support Psychotherapy Using Mobile Phones for Depression Among Youth in Kampala District, Uganda: Study Protocol for a Pilot Randomized Controlled Trial

Background: In the post-COVID-19 era, there has been a concerning rise in depressive disorders among youth, highlighting the urgent need for accessible and effective mental health solutions. Our objective is to understand the specific mental health challenges faced by youth and leverage these insights to adapt the successful Group Support Psychotherapy (GSP) into a Tele-Support Psychotherapy (TSP) model using mobile phones. We aim to evaluate the feasibility, acceptability, and preliminary effectiveness of TSP in alleviating mild to moderate depressive symptoms among youth in central Uganda. Methods: Data on mental health issues affecting youth will be collected through focus group discussions and key informant interviews. This data will be analyzed using the grounded theory framework and ATLAS.ti 8 software. The findings, combined with the Ecological Validity and Culturally Sensitive Framework, will guide the adaptation of GSP into a TSP model tailored for youth. The study will enroll 300 youth aged 15-30 with mild to moderate depression from Naguru, Kamwokya, and Makerere in Kampala district. Participants will be randomly assigned to two groups: one receiving TSP via mobile phones in addition to standard mental health services (SMHS), and a comparison group receiving SMHS alone. The study will assess the cost-effectiveness of TSP, identify barriers and facilitators to its access, and evaluate changes in outcomes using intention-to-treat analysis with generalized structural equation modeling. Results: The study has received approval from the ethical boards of Makerere College of Health Sciences and the Uganda National Council of Science and Technology. Recruitment commenced in May 2023. The dissemination of findings is planned across various scholarly and professional platforms, including conferences, academic publications, and reports to sponsors. Conclusions: This pilot study aims to provide critical information on the initial effectiveness and economic viability of Tele-Support Psychotherapy (TSP) delivered via mobile phones for youth with depression in Kampala. The findings will offer valuable insights into the delivery of mental health services in similar resource-limited settings.