Effectiveness of Selected Cbt-Based Self-Management Mobile Applications in Reducing Depression Among University Students in Kenya: A Case Of South-Eastern Kenya University in Kitui County, Kenya

Abstract

Depression is a highly prevalent mental health concern among university students. The accessibility of smartphones in this population grants a promising opportunity for providing mental health interventions. This study covered five objectives which explored the effectiveness, feasibility, user experiences, and applicability of Cognitive Behavioural Therapy (CBT) based self-management mobile apps in reducing depression symptoms in university students in Kenya. The study used the Cognitive Behavioural Theory and was complemented by the Technology Acceptance Model. The study was a quasi-experimental study of South-Eastern Kenya University (SEKU) in Kitui County. The study used a mixed-methods approach, where quantitative data involved pre-intervention and post-intervention surveys to measure variations in depression levels before and after using self-management mobile apps for a period of eight weeks. The qualitative survey was designed to gather data on participants’ user experiences, challenges, and perceptions regarding the self-management apps. The target population was SEKU undergraduate students aged 18-25 years who were proportionally sampled in the six schools within the university, based on the overall population of undergraduate students. The study sample consisted of 107 undergraduate students. The participants were selected using simple random sampling. Participants were randomly grouped into two where one was the mobile app intervention group and the other the control group with no intervention. The groups sample included the SEKU University students who responded to the questionnaires, who met the criteria for depression based on the standardised PHQ-9 screening tool and consented to participate. This study established a high prevalence of depression among SEKU students, with 35.7% reporting moderate depressive symptoms and 5.6% severe symptoms based on initial PHQ-9 scores. CBT-based self-management mobile applications were found to be feasible and acceptable, with 78% of the participants rating the applications as practical mental health tools. Usability of the CBT-based mobile applications feature was found to be helpful by 80% of the participants as it received favourable ratings, with an average score of 8.1 out of 10. The mobile applications significantly reduced depressive symptoms, with PHQ-9 scores decreasing from an average of 15.3 (moderately severe) to 8.9 (mild depression) after the eight-week intervention period. Quantitative data was analysed using statistical methods, including Statistical Package for Social Sciences (SPSS) 20.0. Qualitative data was analysed based on the themes emanating from the research questions. These findings highlight the potential of CBT-based apps to address mental health challenges, including depression, in low-resource settings. The findings prove the possibility of utilising CBT-based self-management mobile applications as potential tools that richly contribute to accessible, culturally relevant, and cost- effective mental health solutions that enhance student well-being and academic performance.