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Table 5 Overview of intervention

From: A digital mental health intervention to reduce depressive symptoms among overseas Filipino workers: protocol for a pilot hybrid type 1 effectiveness-implementation randomized controlled trial

Content Content overview
  (Session 1)
Story 1 The session starts with information on the program and how to use it.
Story 2 There is a psychoeducation element to Session 1, that is explaining that experiencing adversity can lead to low mood or anxiety and physical symptoms.
Story 3 The next part of session one, and in the interactive part, is about the theory of change, so how positive actions help us to feel better. We briefly mention that actions, mood and body are linked, and we mention exercise particularly triggering a naturally occurring reaction in our brains.
Interactive 1 After the recap of the session, there is the exercise to try doing something to make oneself feel better.
  (Session 2)
Story 1 Recap the character says that doing a small activity helped a little, but it did not last. Some users may relate to the small activity not being very helpful.
Story 2 Psychoeducation - cycle of sadness. This may be hard for some people to understand, so be prepared for either questions on this part, or for the user to not acknowledge it.
Story 3 Also, in this session, the younger character wants to do something more complex and so the older and younger characters break a larger activity into steps.
Interactive 1 In session two interactive activity part, first the older OFW character asks if the user did the activities.
Interactive 2 Next the older OFW character suggests that the user do something more complex, requiring steps.
Interactive 3 Finally, the older OFW character suggests making a reminder to do their activity or steps of an activity.
  (Session 3)
Story 1 After the recap of the previous session content, we hear of how the younger character got nervous or anxious about doing some activities.
Story 2 There is some psychoeducation about anxiety symptoms and about how slow breathing can help.
Story 3 Next, there is some psychoeducation and an example of a cognitive element of low mood (self-criticizing) and that self-affirmative statements can help.
Story 4 The character reflects on how they wanted to give up.
Interactive 1 Relaxation activities.
Interactive 2 Next the user is asked to write down some positive self-talk by imagining what they may say to a friend and a confidence booster.
Interactive 3 The user is again asked to think of a complex activity and break it into steps.
Interactive 4 Then, the user is asked to write some things that may prevent them for doing the activity then the solutions for that.
  (Session 4)
Story 1 After the recap of the previous session, there is some psychoeducation on the impact of depressive symptoms on social relationships and how that impacts the tired cycle.
Story 2 The younger character uses the techniques they learned in Session 2 (breaking activities into steps) and 3 (relaxation and positive self-talk) to help with their social activities.
Interactive 1 First the older OFW character asks if the user did the activities.
Interactive 2 After the recap of the session, the older OFW character asks the user to make a list of social activities and break it into steps.
Interactive 3 Similarly, to before, the older OFW character asks the user to identify any problems and solutions they may come up against.
  (Session 5)
Story 1 Throughout the session, the SbS skills and knowledge are reiterated and used to help the user recognize and prevent relapse.
There is lots of praise for completing the intervention and some recognition that mood goes up and down, so to keep up the practice, even if we do not always feel good.
Story 2 In the session, after the recap, the younger character encourages the user to reflect on the positive change they have experienced.
Story 3 The character tells of how their mood did go up and down but that s/he kept up the practice, even if s/he did not always feel good.
Interactive 1 The first part of the interactive session is to identify personal signs that mood is worsening.
Interactive 2 The last part of the session reminds users that all their inputs in the “my activities” section can be saved for the user to remind themselves of their activities and what they have learned.