Adaptation of an internet-based depression prevention intervention for Jordanian youth
| ISRCTN | ISRCTN14751844 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN14751844 |
- Submission date
- 08/03/2024
- Registration date
- 12/03/2024
- Last edited
- 05/03/2025
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Mental and Behavioural Disorders
Plain English summary of protocol
Background and study aims
Depression is frequently identified as the leading factor behind the thoughts, planning, and attempts of suicide, as well as the act itself, among adolescents. Remarkably, over 88% of the world's adolescent population resides in developing nations, including those in the Arab region, where a staggering 97% of adolescent mortality cases are reported. Mental and behavioral disorders, with depression being the most prominent, are responsible for almost a quarter of the disability experienced by Arab youths. The prevalence of depression is expected to escalate, fueled by increasing socio-political turmoil within the Arab countries. This situation is exacerbated by notable deficiencies in mental healthcare infrastructure and various structural factors such as poverty, the decline in the quality of education, lack of employment opportunities, and shifts in family dynamics.
This study introduces 'Al-Khaizuran', a novel internet-based initiative designed to combat depression, and seeks to evaluate its effectiveness and cultural appropriateness among Jordanian adolescents and youth. This program is a modification of CATCH-IT (Competent Adulthood Transition with Cognitive-behavioral, Humanistic, and Interpersonal Training), an existing web-based depression prevention program that integrates primary care with online activities. Focusing on strategies to enhance resilience, Al-Khaizuran has been tailored to align with the specific cultural and ethical contexts of Jordanian society.
Who can participate?
Youth aged 18 -24 years who have mild to moderate depressive symptom. Al-Khaizuran program also has another version for school adolescents that is currently under development.
What does the study involve?
Participants will be randomly assigned to receive one of three treatments: Al-Khaizuran, CBT, or Treatment As Usual (TAU). The study will utilize several measurements including the Connor-Davidson Resilience Scale (to assess resilience), Center for Epidemiological Studies-Depression Scale (to assess depressive symptoms), the Usefulness and Ease of use Questionnaire (to assess usefulness, ease of use, ease of learning, and satisfaction), the Socio-Cultural Relevance Scale (to assess perceived change with the intervention), the Trans-Theoretical Model Scale (to assess self-efficacy and intention to seek help for depressive symptoms), and the Dysfunctional Attitude Scale (to assess dysfunctional attitudes).
What are the possible benefits and risks of participating?
The Al-Khaizuran program, tailored for Jordanian adolescents and youth, presents a culturally sensitive, internet-based intervention designed to improve mental health and resilience. By incorporating cognitive-behavioral, humanistic, and interpersonal training, it aims to reduce depressive symptoms, enhance coping mechanisms, and foster positive thinking within a framework that respects and integrates Jordanian cultural nuances and ethical considerations. The convenience and accessibility of this online platform allow participants to engage with the program flexibly and privately, offering a promising approach to depression management and prevention that is both innovative and attuned to the specific needs of its target demographic. The study assures minimal risk, emphasizing mental health support and participants' rights to withdraw without consequences
Where is the study run from?
University of Jordan
When is the study starting and how long is it expected to run for?
April 2018 to March 2025
Who is funding the study?
University of Jordan
Who is the main contact?
Dr Latefa Ali Dardas, L.dardas@ju.edu.jo
Contact information
Public, Scientific, Principal Investigator
http://eacademic.ju.edu.jo/l.dardas/default.aspx
Amman
11942
Jordan
 ORCID ID |
0000-0001-5437-4778 |
|---|---|
| Phone | +962 790797521 |
| l.dardas@ju.edu.jo |
Study information
| Study design | Interventional cluster randomized controlled trial |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Cluster randomised trial |
| Study setting(s) | University/medical school/dental school |
| Study type | Prevention |
| Participant information sheet | https://noor-project.org/ |
| Scientific title | Adaptation of an internet-based depression prevention intervention for Jordanian youth: from 'CATCH-IT' to 'Al-Khaizuran' |
| Study acronym | Arabic CATCH-IT |
| Study objectives | Aim 1: Evaluate the feasibility and cultural acceptability of 'Al-Khaizuran' program among Jordanian youth. We hypothesize that Al-Khaizuran will demonstrate more favorable acceptability ratings than traditional cognitive behavioral therapy (CBT), and will be more potentially scalable and transformative within the Jordanian context. Aim 2: Evaluate the comparative effectiveness of Al-Khaizuran, CBT, and treatment as usual (TAU) in youth (aged 18-23 years) in preventing onset of depressive episodes and improving other patient-centered outcomes (symptoms, function, and resiliency). We hypothesize that Al-Khaizuran is comparably effective to CBT, but superior to TAU in preventing depressive episodes and improving other patient centered outcomes. Secondary Aim 1: Examine mediators and moderators of intervention risk factors (elevated CES-D score, prior depressive episodes, parent CES-D, other mental behavioral emotional symptoms), geographic location, gender, and academic achievement). We hypothesize that Al-Khaizuran may be more effective for those with parental depressed mood compared to CBT and TAU, but that CBT may be more effective for groups preferring face-to-face intervention. |
| Ethics approval(s) |
Approved 11/04/2018, The University of Jordan (Queen Rania Street, Amman, 11942, Jordan; +962 65355000; nur.dean@ju.edu.jo), ref: No. 19/2018/1106 |
| Health condition(s) or problem(s) studied | Youth with mild to moderate depression |
| Intervention | CATCH-IT is a primary care/Internet-based behavioral 'vaccine' intended for adolescents and youth at elevated risk for depression. It teaches resiliency skills to at-risk groups through teen-friendly, interactive web-based modules. The intervention consists of 14 Internet-based information modules based on cognitive behavioral therapy (CBT), interpersonal therapy (IPT), behavioral activation (BA), and resiliency theory. CATCH-IT incorporates both motivational support by primary care professionals and an Internet-based parental behavioral change course, and it employs a multi-channel learning process with culturally relevant lessons, stories, and graphics to increase personal relevance and multi-modal learning opportunities. CATCH-IT teaches adolescents and youth how to reduce behaviors that are associated with increased vulnerability for depressive disorders (e.g., procrastination, avoidance, rumination, pessimistic appraisals, indirect communication style) and increase behaviors that are thought to protect against depressive disorder (e.g., behavioral scheduling countering pessimistic thoughts, activating social networks, strengthening relationship skills). Studies of the intervention in the US showed high levels of user engagement and favorable outcomes in lowering depressed moods and strengthening protective factors for depression. Al-Khaizuran is an adapted Arabic version that will be tested for the first time among Arab participants. We will conduct a three-arm comparative effectiveness trial to evaluate if three interventions (Al-Khaizuran, CBT, and TAU) of varying time commitment, cultural acceptability, and implementation cost are comparably effective in preventing the onset of depressive episodes and improving other patient-centered outcomes among Jordanian youth. Participants with mild to moderate depressive symptoms (on the Center for Epidemiologic Studies Depression Scale (CES-D) will be randomized to receive either Al-Khaizuran, CBT, or TAU. The sample will include N=180 university students from all public and private universities in Jordan. |
| Intervention type | Behavioural |
| Primary outcome measure | 1. The Connor-Davidson Resilience Scale (CD-RISC, 10-item, self-report) will be used to assess resilience at baseline, 2 and 6 months 2. Center for Epidemiological Studies-Depression Scale (CES-D, 20 items, self-report) will be used to assess depressive symptoms at baseline, 2 and 6 months 3. USE Questionnaire: Usefulness, Satisfaction, and Ease of use. We will measure usefulness, ease of use, ease of learning, and satisfaction after completing the intervention 4. The Socio-Cultural Relevance Scale (10-item and 14-item versions, self-report) will assess perceived change and satisfaction with the intervention after completing the intervention at 2 and 6 months 5. The Trans-Theoretical Model Scale (10-item, self-report) will assess self-efficacy and intention to seek help for depressive symptoms at baseline |
| Secondary outcome measures | The Dysfunctional Attitude Scale (DAS, 9-item, self-report) will be used to assess dysfunctional attitudes at baseline, 2 and 6 months |
| Overall study start date | 11/04/2018 |
| Completion date | 10/03/2025 |
Eligibility
| Participant type(s) | Learner/student |
|---|---|
| Age group | Adult |
| Lower age limit | 18 Years |
| Upper age limit | 24 Years |
| Sex | Both |
| Target number of participants | 600 |
| Total final enrolment | 180 |
| Key inclusion criteria | Youth (targeted through universities) who have mild to moderate depressive symptoms |
| Key exclusion criteria | 1. Participants diagnosed with severe depression or severe suicidal symptoms 2. Participants having difficulty viewing internet-based content 3. Participants undergoing other psychological therapies |
| Date of first enrolment | 20/03/2024 |
| Date of final enrolment | 01/06/2024 |
Locations
Countries of recruitment
- Jordan
Study participating centres
Amman
11942
Jordan
Irbid
22110
Jordan
Salt
19117
Jordan
Sponsor information
University/education
Queen Rania Street
Amman
11942
Jordan
| Phone | +962 65355000 |
|---|---|
| Admin@ju.edu.jo | |
| Website | https://ju.edu.jo/Home.aspx |
"ROR" |
https://ror.org/05k89ew48 |
Funders
Funder type
University/education
Government organisation / Local government
- Alternative name(s)
- UJ
- Location
- Jordan
Results and Publications
| Intention to publish date | 01/03/2025 |
|---|---|
| Individual participant data (IPD) Intention to share | Yes |
| IPD sharing plan summary | Published as a supplement to the results publication |
| Publication and dissemination plan | The study protocol is planned to be sent for publication in March, 2024. The RCT results are planned to be published after completing the three assessment points. Both papers will be sent to high-impact peer-reviewed journals. |
| IPD sharing plan | The datasets associated with the study will be published as a supplement to the results publications |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Results article | 12/02/2025 | 05/03/2025 | Yes | No |
Editorial Notes
05/03/2025: Publication reference added.
12/03/2024: Trial's existence confirmed by The University of Jordan
