Validating a digital depression prevention program for adolescents in Jordan: cultural adaptation and user testing in a randomized controlled trial
Abstract
Purpose Digital health interventions (DHIs) offer scalable solutions for improving mental health care access in underserved settings. This study is part of a multi-phased project aimed at adapting a depression prevention DHI for Jordanian adolescents. It evaluated the feasibility, cultural acceptability, and effectiveness of the translated and culturally adapted DHI, named Al-Khaizuran, with comparisons to school-based group CBT. Methods A two-arm, single-blind randomized controlled trial with a mixed-methods design was conducted among 109 Jordanian adolescents aged 15–17 years experiencing mild to moderate depression. Participants were randomly assigned to either Al-Khaizuran DHI (n=55) or school-based group CBT (n=54). The adaptation of Al-Khaizuran DHI components was guided by the Ecological Validity Framework, while the procedural adaptation followed Barrera and Castro’s Heuristic Framework, incorporating iterative refinement based on user feedback and contextual considerations. Results Al-Khaizuran DHI was found to be a culturally relevant and acceptable intervention for Jordanian adolescent. Over half of the participants reported that the intervention was effective, empowering, and easy to use, with 51% expressing satisfaction and willingness to recommend it. However, challenges such as limited access to personal devices, privacy concerns, and participants’ reliance on shared family resources emerged as significant barriers to consistent engagement. Participants showed…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 109 participants or records.
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