Sensing Technology to personAlize materNal DepreSsion TReatment in lOw resource settiNGs (StandStrong 3)

Background:

Maternal depression is quite common worldwide. Evidence shows that 12-15% of women suffer from depression in the perinatal period. According to the Nepal Demographic Health Survey (NDHS) 2016, suicide is one of the leading causes of death of women of reproductive age in Nepal accounting for 16% of the total maternal mortality.  

Under this context, TPO Nepal is implementing the StandStrong research project in partnership with the George Washington University, Yale University, and the University of the Witwatersrand to improve community-level treatment of maternal depression in Nepal through the use of innovative digital technologies. Our interdisciplinary team of experts in mHealth interventions, psychiatry, anthropology, implementation science, biostatistics, psychology, and health economics from Nepal, South Africa, and the U.S. has been developing and testing a passive data collection suite and app interface for non-specialist counselors to treat mothers with postpartum depression in Nepal. The StandStrong suite consists of a participant application and a counselor mobile application. The devices for passive sensing consist of a smartphone for the mother and a small attachable Bluetooth beacon for the baby. It will record physical activity, GPS location (movement), proximity to the baby, and sound (social interactions). This passive sensing data from mobile technology sensors will be used to construct reliable models that can associate specific activity with postnatal depression, such as the length of time spent with the child, types of vocal interactions, physical activity, and frequency of outings. The participant app will utilize the sensors in smartphones to monitor mothers who are suffering from postpartum depression. The counselor app platform will incorporate passive sensing data collected from the mothers and babies (through electronic devices) to tailor the psychological interventions they receive from the counselor. The goal is to evaluate the suite of digital technologies in resource-constrained settings like Nepal so that personalized psychological treatments can be provided in areas that lack the capacity for quality mental healthcare services.

Objectives:

Aim 1: To conduct a pilot randomized controlled trial (RCT) to establish parameters for treatment engagement, safety, and change over time through StandStrong implementation (experimental arm) vs. standard psychological treatment (control arm).

Aim 2: To identify parameters for sustainability and scalability by engaging policy, healthcare, and telecom stakeholders, costing the intervention, and building research capacity. 

​Implementation area:

Pokhara Metropolitan City, Kaski, Gandaki Province

 Time Frame: December 2023- August 2026

Supported by: US National Institute of Mental Health (NIMH) via the George Washington University