Artículos Instituto de Psicología FH

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Browsing Artículos Instituto de Psicología FH by Author "Angelina Sosa Lovera"

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    A feasibility study of a mental health mobile app in the Dominican Republic: the untold story
    (2018) Angelina Sosa Lovera; Patricia Reyna
    Mobile health (mHealth) interventions include mental health apps (MHapps). There are hundreds of MHapps, which have been touted as a means of revolutionizing mental health care delivery. In spite of the rosy outlook and promise of MHapps, there are challenges to implementation in Low and Middle Income Countries (LMICs). We report on several domains of implementation: acceptance, appropriateness, engagement, and work processes assessed in two samples of clinicians and patients designed to develop and test the feasibility of a Spanish language Cognitive Behavioral VoiceThread® app for Dominican primary care patients with depression. Results indicated that feasibility of our eMH intervention was compromised by appropriateness of the target audience and the eligibility criteria used, including language, age, access to phones, and access to the internet. Both participants and clinical providers had varying degrees of engagement in the MHapp. Clinical providers had a desire for increased knowledge and capacity building, but also unspoken expectations and misaligned incentives. For participants, there were logistical and emotional barriers to use, some of which could not be fully determined in this study due to a lack of feasibility in terms of a low retention rate. Corresponding to these issues, we identified four potential solutions: 1) understanding of characteristics of end-users; 2) engagement of key stakeholders; 3) working within the existing infrastructure; and 4) addressing the social determinants of health. Unforeseen strengths also emerged as a result of our investigations. The challenges encountered in this pilot study can be viewed as evidence of failure or part of the incremental steps necessary to build future success.
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    A Mobile App to prevent depression among low-income primary care patients in the Dominican Republic: sociocultural adaptations
    (2020) Angelina Sosa Lovera
    Introduction: Mental health mobile apps (MHapps) can provide depression treatment to people worldwide who do not have access to care, but few apps are culturally targeted to the population. In this series of studies, we described sociocultural considerations of MHapp development, and we explored participants’ perceptions of acceptability, usability, and cultural relevance of the MHapp. Method: Individual interviews were conducted in three separate primary care sites in the Dominican Republic among convenience samples of staff and patients (n = 23, 18, and 21, respectively), using mixed methods of data collection. Results: Modifications were made during the iterative design process to reflect user preferences, which included a female gendered voice, the addition of animations, and changes to the psychoeducational content. Discussion: Primary care patients reported strong interest in MHapps due to its convenience, privacy, and affordability. Our findings support the necessity of detailed examination of user preferences to develop culturally congruent MHapp psychoeducation.
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    Comparison of patient versus trained observer assessments of Healthcare provider’s use of motivational interviewing techiques for patients experiencing depresión and anxiety in the Dominican Republic
    (2021) Angelina Sosa Lovera
    In settings with limited mental health system capacity, integrated care and the improvement of patient-provider communication surrounding common mental disorders is critical to advancing treatment outcomes. We trained primary care providers in the Dominican Republic in motivational interviewing (MI) to improve communication with patients experiencing depression and anxiety. Providers were randomized to an intervention group, which received MI training, or a control group. To evaluate the training’s effectiveness, patients assessed their clinical encounters using the Motivational Interviewing Measure of Staff Interaction (MIMSI). Trained research assistants (RAs) rated a sub-set of those interactions using an adapted MIMSI instrument. Overall, patients (n = 36) perceived their interactions with providers (n = 10) very positively; however, the RAs’ ratings strongly indicated that providers’ application of MI behaviors was insufficient. Patients generally could not distinguish between intervention and control providers. Findings underscore the need to carefully consider optimal training delivery and cultural influences surrounding the implementation of MI mental health interventions in settings where directive communication is highly valued.
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    Effectiveness of El Buen Consejo Movil (EBCM; the mobile Sound Advice), to reduce symptoms of depression, anxiety, loneliness and social isolation among users in the Dominican Republic
    (2023-02-25) Angelina Sosa Lovera
    The availability of mental health services in the Dominican Republic is limited and mental health needs have increased since the onset of the COVID-19 pandemic. Mobile mental health apps may be a feasible response to this increased demand for services, but few have been tested in Spanish speaking low- and middle-income countries. The objective of this study was to evaluate the effectiveness of a mobile app, El Buen Consejo Movil (EBCM) to reduce symptoms of anxiety, depression, social isolation and loneliness. Of the twenty-seven participants who screened eligible to use EBCM, twenty participants logged in and used the app (users). The PHQ-9 results were clinically and statistically significant. A decrease in PHQ-9 score was sustained in 75% of users over 12 weeks. Results of the pre and post NIH Toolbox Adult Social Relationship Scales indicated that there was a statistically significant difference in score (p = .011). Our study is one of the few studies to trial a mobile app in a Spanish speaking Caribbean LMIC. The EBCM app was a useful and effective resource to support the therapeutic process for participants with symptoms of depression
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    Psychological helpline in response to the COVID-19 pandemic in the Dominican Republic
    (2021-10-29) Ana Jacqueline Ureña; Angelina Sosa Lovera; Josefina Arias; Amarilis Araujo Rodríguez; Julio Arturo Canario
    The global health emergency due to COVID-19 is a disruptive event that has had various effects on mental health. Given this emergency, the Dominican Republic intervened to mitigate the negative impact of the pandemic, considering the physical isolation decreed in the country. In this context, the Autonomous University of Santo Domingo and the School of Psychology designed the UASD COVID-19 Psychological Helpline. The objective of this article is to describe the development, implementation and evaluation of a programme of psychological first aid. The programme aimed to attenuate the impact of morbidity and mortality due to mental health issues associated with the COVID-19 pandemic through mobile technology. There were 62 psychologists involved and trained to provide care, and a protocol was developed, implemented, monitored and evaluated. Over the course of four months, the programme assisted 497 people. The average age of the participants was 32 years, and 73% were women. The reasons for contacting the helpline included anxiety, stress, depression, domestic violence, suicidal behaviours and other behavioural problems. Following the intervention, most users reported feeling satisfied and having improved emotions. The first psychological aid in the country developed through telephone and chat messaging was an optimal resource since face-to-face interaction was not possible. It also reached more people and reduced the attention gap.