Thinking Healthy (digital version)

To maintain the integrity of the session content, key therapeutic messages are delivered through the app in short segments by ‘avatar therapists’ or animated characters through contextually-appropriate illustrations and voiceover videos, while the peer provides empathy and support. The peer pauses between segments to facilitate a discussion on the relevance of the message on the mother’s own life and offers encouragement.

The app also has brief animated videos that depict stories from the lives of women from the community who experienced depression and how they overcame it. Peers also help mothers set a goal related to their health (e.g., diet, relaxation exercises) and can track its progress on the app through a ‘progress tree’ that flowers when a goal is achieved. In case the mother has not been able to make progress towards the goal, the peer helps develop a solution to address it by utilizing a pre-populated list of challenges and solutions located in the app.

Validated screening and evaluation tools for maternal depression have been integrated into the app to help peers identify women experiencing depression and track improvement in their symptoms over time. Peers also have access to referral guidelines through the app to support mothers who do not show improvement or are at a risk of self harm or interpersonal violence.

The app can also be used by peer trainers to conduct group trainings and supervision sessions for the peers. The training modules feature ‘avatar trainers’ who deliver the core messages that focus on the use of technology, developing counseling skills, and dealing with challenging situations. Peer trainers pause after each message to facilitate practice through role plays. The app also has modules on supervision and provides access to peers’ attendance, session duration, and progress made by their clients. During monthly supervision meetings, peer trainers can access this data to discuss challenges, brainstorm solutions, and if needed, revise training content.

The app was co-developed and user-tested with the end users using principles of human centered design (see case study)

In the future, there will also be a mobile app for mothers so they can refer back to session content on demand. Further, on completion of the ongoing evaluation, the program will be translated to English and content will be tweaked to be context-agnostic so it can be used in other settings.