TY - JOUR
T1 - Can Mobile Health Improve Depression Treatment Access and Adherence Among Rural Indian Women? A Qualitative Study
AU - Bhat, A.
AU - Goud, B. Ramakrishna
AU - Pradeep, J. R.
AU - Jayaram, G.
AU - Radhakrishnan, R.
AU - Srinivasan, K.
N1 - Funding Information:
The study was supported by the Yale Global Mental Health program (RR). Maanasi project is supported by grants from the Rotary Clubs of Bangalore, Midtown and Howard West, USA.
Funding Information:
We would like to acknowledge the efforts of staff and community health workers of St. John’s Medical College’s Community Health Training Centre, Mugalur and Members of the Rotary Clubs of Bangalore Midtown, India and Howard West, USA. RR is supported by Dana Foundation David Mahoney program and CTSA Grant Number UL1 TR001863 from the National Center for Advancing Translational Science (NCATS), components of the National Institutes of Health (NIH), and NIH roadmap for Medical Research. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official view of NIH.
Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Major Depressive Disorder (MDD) is associated with low rates of treatment and medication non-adherence, more so in low- and middle-income countries (LMICs). Mobile mental health (mHealth) interventions offer promise as a tool to address these problems. However, the feasibility and acceptability of mHealth interventions among rural women in LMICs is unknown. We examined barriers to accessing mental health treatment, reasons for non-adherence, and attitudes towards mHealth solutions among women with MDD in rural south India. Six focus groups were conducted among women with MDD (n = 69) who had been in treatment at a rural community health center. The discussion was transcribed and analyzed using a modified grounded-theory approach. Women perceived limited autonomy within their family structure, and experienced financial and systemic barriers as contributing to poor treatment access and non-adherence. Illiteracy, limited personal access to mobile phones, and preference for in-person clinical consultation were identified as barriers to use of mHealth. This is the first qualitative study, to our knowledge, that examines attitude towards mHealth among women with MDD in a rural setting in India. The study identified contextual barriers that will be important to address before implementing mHealth interventions.
AB - Major Depressive Disorder (MDD) is associated with low rates of treatment and medication non-adherence, more so in low- and middle-income countries (LMICs). Mobile mental health (mHealth) interventions offer promise as a tool to address these problems. However, the feasibility and acceptability of mHealth interventions among rural women in LMICs is unknown. We examined barriers to accessing mental health treatment, reasons for non-adherence, and attitudes towards mHealth solutions among women with MDD in rural south India. Six focus groups were conducted among women with MDD (n = 69) who had been in treatment at a rural community health center. The discussion was transcribed and analyzed using a modified grounded-theory approach. Women perceived limited autonomy within their family structure, and experienced financial and systemic barriers as contributing to poor treatment access and non-adherence. Illiteracy, limited personal access to mobile phones, and preference for in-person clinical consultation were identified as barriers to use of mHealth. This is the first qualitative study, to our knowledge, that examines attitude towards mHealth among women with MDD in a rural setting in India. The study identified contextual barriers that will be important to address before implementing mHealth interventions.
KW - Depression
KW - Global mental health
KW - Mobile mental health
KW - Non-adherence
KW - Qualitative study
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U2 - 10.1007/s11013-019-09664-3
DO - 10.1007/s11013-019-09664-3
M3 - Article
C2 - 31916181
AN - SCOPUS:85078594160
VL - 44
SP - 461
EP - 478
JO - Culture, Medicine and Psychiatry
JF - Culture, Medicine and Psychiatry
SN - 0165-005X
IS - 4
ER -