StandStrong Dissemination Program in Chitwan
TPO Nepal organized a dissemination program on 30th September 2019 at Bharatpur Garden Resort, Chitwan to mark the completion of ‘SensingTechnology to personalize Adolescent maternal DepreSsion TReatment in lOw resource settiNGs’ project. This project was implemented in 7 health facilities of Bharatpur Metropolitan City of Chitwan district from October 2018 to September 2019, to understand the feasibility and acceptability of a mobile-based sensing technology to study the mental health of young adolescents mothers with post-partum depression. The dissemination program was attended by 48 participants which included representatives of health facilities, Bharatpur metropolitan city, related NGOs, research staffs, TPO staffs and other stakeholders.
The program started with a welcome note by Dr. Kamal Gautam, executive manager of TPO Nepal. He also gave an overview of TPO’s work various districts of Nepal and its impact/results. Dr. Mita Rana, clinical psychologist, talked about women and mental health in Nepal. She highlighted how gender is a risk factor and suicide is a leading cause of death among women in Nepal.
Following that, Dr. Brandon Kohrt, Principal Investigator of the study, and professor of Psychiatry in George Washington University gave a presentation on global mental health and the use of sensing technology to study mental health. He highlighted that 1 in 10 women in Southern Chitwan suffered from post-partum depression according to preliminary results of the study. He also explained that women suffering from pre-natal depression tend to get better with time after the childbirth however, in case of women with post-partum depression, the situation often tends to get worse after childbirth and it needs attention for the well-being of both mother and child.
Mr. Sujen Man Maharjan, Project Coordinator and country principal investigator, presented the preliminary findings of the study. He briefed about overall research activities and outcomes. He emphasized how the team was able to utilize participant’s information on timely basis to incorporate in the intervention provided to them. The goal was to research and implement this tool in low-resource settings in Nepal so that personalized psychological treatments can be provided in areas that lack these vital services. The tool is comprised of a mobile phone, for the mother, and a small attachable bluetooth beacon for the baby. It records GPS location, distance to the beacon, and sound. This data from the mobile phone sensor was used to construct reliable models that can associate specific activity with perinatal depression such as the length of time spent with the child, the level of vocal interactions, and frequency of outings. A community advising board, which comprised of both young and old mothers, their families, and healthcare providers in the area evaluated and provided feedback on the effectiveness of the tools and this approach.
A total of 1356 adolescent mothers were approached in seven health facilities in Chitwan, Nepal. Among them, 559 mothers met the inclusion criteria (mother’s age between 15-25 years; infant <12 months). We consented 559 mothers and administered PHQ-9. Among these mothers, 62 mothers were screened positive (PHQ > 8) for depression. Among 559 mothers, 33 mothers who met criteria for maternal depression and 27 mothers without depression participated in the study after family consent. Four mothers dropped out of the study for various reasons.
Ms. Bhagwati Sapkota, the member of the research team talked about her experience on Acceptability & Feasibility of the technologies, the challenges she faced during field work and how she overcame them often finishing the work with close relation built with participant and her family over time. At beginning, community is often doubtful about the research. But as they understand it, they become very supportive and helpful to the participant.
Ms. Bindu Aryal, a psychosocial counselor, shared her experiences of using StandStrong App developed for the purpose of incorporating sensing data in HAP delivery during the intervention. She explained how the use of sensing data facilitated her HAP sessions and was helpful for behavioral intervention. The total of 28 mothers received weekly 5 session HAP counseling support during the study.
Research participants (both mothers with depression and without) also shared their personal experience of participating in this study. The event was also covered by local media.