Internet-based Intervention Culturally Adapted for Treatment of Depression in the Ecuadorian Population

Cultural Adaptation of the Smile is Fun Program for the Treatment of Depression in the Ecuadorian Public Health Care System: A Study Protocol for a Randomized Controlled Trial

Internet-Based Interventions are increasingly relevant as an alternative for reducing the gap in treatment of metal disorders such as depression, especially in resource-limited regions.

In this study the investigators will try to evaluate the effectiveness of an Internet-Based Intervention culturally adapted to the Ecuadorian population for treatment of depression.

Our participants will be randomized to one of the following three conditions: 1) Internet-Based intervention (IBI) with automated support (e.g. e-mails or text messages), 2) IBI plus human support by phone calls (automated + human support), 3) Waiting list control group .

The corresponding evaluations of the outcomes will be carried out at different moments of the process: baseline, three, six and twelve months.

This study will use the Smile is Fun program for the treatment of depression previously adapted to the Ecuadorian context.

Inclusion Criteria:

• Ability to understand and read Spanish and access to Internet and having an email address
• Access to a computer or smart phone with internet at home
• Criteria for diagnosis of depression disorder according to the MINI interview and score between 5 to 9 (mild) 10 to 14 (moderate) and 15 to 19 (Moderate/severe) on PHQ-9

Exclusion Criteria:

• Scores 20-27 (severe depression) on PHQ-9
• Suicidal risk
• Severe psychiatric disorders (schizophrenia, substance dependence, bipolar disorder, psychotic illness)
• Receiving psychological treatment for depression at the time of recruitment