AzTrials
AzTrials

DepressionNCT06295250

ASHA Bangladesh--An Integrated Intervention to Address Poverty and Depression

A study testing Manualized Group Based Psychotherapy and Poverty Alleviation in people with Depression and Economic Vulnerability, run by University of Massachusetts, Worcester at 1 site in Bangladesh.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

The goal of this randomized controlled trial is to compare the impact of an integrated intervention combining poverty alleviation and depression treatment to depression treatment alone, in low income rural Bangladeshi women with depression. Read more about this study

Who is it for?
Ages 18 to 45 years, women only
Conditions the study is for
Depression, Economic Vulnerability, Anxiety
What is being tested?
Manualized Group Based Psychotherapy and Poverty Alleviation
Could I receive a placebo?
No, everyone receives an active treatment
How many people
600 participants
Where
1 siteBangladesh
Study dates
1 Mar 2024to Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 45 years
  • Women only
  • No healthy volunteers
  • Adult

Who may be able to join

  • Age 18-45
  • Meets criteria for Economic Vulnerability as measured by: household income <= 15000 Taka per month; food insufficiency in household over previous six months; OR owning <= 10 decimals of land
  • Family willingness to participate in the program
  • Basic literacy as measured by ability to read a simple sentence;
  • A score >=10 on the Patient Health Questionnaire (PHQ-9 Depression Scale) at baseline

Who cannot join

  • Pregnancy at screen;
  • Cognitive or physical impairment precluding participation
  • Plans to relocate or to travel for > 1 month during 18 M period.
  • Household debt greater than 70,000 Taka

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Alison Karasz, PhD contact

3478435652

alison.karasz@umassmed.edu

Bangladesh1 site, 1 recruiting
  • International Centre for Diarrhoeal Disease Research

    Dhaka, Dhaka Division

    Fahmida Tofail, MBBS, PhD, ftofail@icddrb.org

    Recruiting

Other trials in Bangladesh

About this study

Official title: ASHA Bangladesh--An Integrated Intervention to Address Depression in Low Income Rural Women

The goal of this randomized controlled trial is to compare the impact of an integrated intervention combining poverty alleviation and depression treatment to depression treatment alone, in low income rural Bangladeshi women with depression. The main question[s] it aims to answer are whether adding poverty alleviation to depression treatment in an integrated intervention: 1) improves depression outcomes at 6 months post baseline as measured by changes in the PHQ-9 from baseline--compared to depression treatment alone; 2) reduces the chance of relapse (PHQ-9 >=5) at 18 months among patients who remitted (PHQ-9<5) at six months--compared to depression treatment alone; and 2) whether adding poverty alleviation to depression treatment improves implementation outcomes including treatment uptake and retention--compared to depression treatment alone. Other outcomes that will be studied include economic vulnerability and psychosocial variables such as anxiety, culturally specific symptoms, quality of life, and function. Participants in both arms will participate in research interviews at 6,12 and 18 months. The project also includes a mixed methods implementation evaluation. Quantitative implementation outcomes to be examined include adoption/uptake; retention in the intervention, and fidelity of intervention delivery. A qualitative process evaluation will include interviews with 80 study participants and approximately 40 staff members, including research staff, agricultural officers, and interventionist staff.

Being tested
Manualized Group Based Psychotherapy, Poverty Alleviation
Keywords
Depression treatment, Cash Transfer, Problem Management Plus, Poverty Alleviation
Medical subject headings
Depression, Anxiety Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Manualized Group Based PsychotherapyBehavioural

    Participants in the control group will receive a 10-session 6-month manualized group based psychotherapy treatment. The treatment is adapted from a WHO program called Problem Management Plus (PM+). PM+ includes 4 evidence based strategies: 1) problem solving; 2) increasing social support; 3) behavioral activation; and 4) relaxation through deep breathing. The intervention is delivered by trained non professional peers.

  • Poverty AlleviationOther

    In addition to the psychotherapy intervention described above, participants in the experimental group will receive a poverty alleviation intervention adapted from the well-known Graduation Program--a poverty alleviation intervention widely used in low income countries. The poverty alleviation intervention includes a) 4 sessions of financial literacy education; b) savings accounts; c) consumption support equal to the cost of 1kg of rice per day for six months; d) productive asset transfer of 3 goats; e) 12 months of animal feed and veterinary care; f) gardening supplies; g) agricultural skill building.

Study groups in NCT06295250
Study groupRoleWhat they receive
Depression Treatment (DT)Active comparatorParticipants in the control group will receive: 1) 6-sessions of a manualized group based psychotherapy treatment. The treatment is adapted from a WHO program called Problem Management Plus (PM+). PM+ includes 4 evidence based strategies: problem solving; increasing social support; behavioral activation; and relaxation through deep breathing; 2) 4 support group meetings. The intervention is delivered by trained non professional peers.
Receives: Behavioral: Manualized Group Based Psychotherapy
Integrated InterventionExperimentalThe experimental arm includes 2 elements: 1. The 6-ssesion psychotherapy intervention described above. 2. A poverty alleviation intervention that includes a) 4 sessions of financial literacy education; b) savings accounts; c) consumption support equal to the cost of 1kg of rice per day for six months; d) productive asset transfer of 3 goats; e) 12 months of animal feed and veterinary care; f) gardening supplies; g) agricultural skill building.
Receives: Behavioral: Manualized Group Based Psychotherapy; Other: Poverty Alleviation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Depressive symptoms at 6 Months

    Change in Symptoms from Baseline to 6 months post baseline, as measured by the Patient Health Questionnaire, a 9 item questionnaire designed to assess depressive symptoms. The minimum score is 0; the maximum score is 27.

    Measured: 6 Months

Secondary outcomes (7)
  1. 18-Month Relapse

    Relapse is defined as a score of Patient Health Questionnaire>= 5 among participants who achieved remission at Time 2: 6 months. To assess relapse, at each data collection point (6, 12, and 18 month) the investigators will ask participants about the experience of depressive symptoms at any time since the previous data collection point. Data collection will focus on 18 month relapse, or the presence of relapse at any time since Time 2.

    Measured: 18 months

  2. Depression at 12 and 18 months

    Changes between PHQ-9 and Baseline at other time points: 12 and 18 months

    Measured: 12 and 18 months

  3. Economic vulnerability Index

    A composite index of economic vulnerability including a variety of indicators such as income, debt, and food insecurity.

    Measured: Baseline, 12, and 18 Months

  4. Anxiety

    Anxiety symptoms as measured on the General Anxiety Disorder scale - a seven item questionnaire with scores from 0-21. Higher scores indicate more anxiety.

    Measured: Baseline, 6 Months, 12 Months, and 18 Months

  5. Function

    Function and disability as measured by the World Health Organization Disability Assessment Schedule, a 12 item questionnaire that is scored from 12-60 with higher scores indicating greater disability.

    Measured: Baseline, 6 Months, 12 Months, and 18 Months

  6. Change in Quality of Life

    Quality of life measure that includes five dimensions: mobility, self care, usual activities, pain/discomfort and anxiety/depression, scored from 0-100 with higher scores indicating better quality of life.

    Measured: Baseline, 6 Months, 12 Months, and 18 Months

  7. Tension Scale

    A questionnaire that measures both psychological symptoms as well as somatic cultural symptoms: a 39 item instrument measured from 0-3 with a minimum score of 0 and a maximum score of 117 with higher scores indicating higher levels of distress.

    Measured: Baseline, 6 Months, 12 Months, 18 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Mar 2024
  2. Study start1 Mar 2024
  3. Primary completionDec 2026 (estimated)
  4. Study completionDec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Outcomes assessor
Enrolment
600 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06295250
Sponsor's protocol ID
STUDY00001114
Other IDs
7R01MH127577
Status last verified
Jun 2026
First submitted
27 Feb 2024
Last updated
15 Jun 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: We will create a deidentified dataset and it is our intention that these data be readily accessible and used. We will collaborate with and make our data available to other researchers for additional/secondary analyses. Formal data sharing agreements will be developed to guide and encourage further data mining of the proposed datasets for various purposes. All such data requests will be approved though by the investigative team, including the International Center for Diarrhoeal Disease Research (ICDDRB), to help ensure ethical use of the data.

Publications

  • Greenberg PE, Kessler RC, Birnbaum HG, Leong SA, Lowe SW, Berglund PA, Corey-Lisle PK. The economic burden of depression in the United States: how did it change between 1990 and 2000? J Clin Psychiatry. 2003 Dec;64(12):1465-75. doi: 10.4088/jcp.v64n1211.

    PubMed 14728109
  • Kessler RC, Akiskal HS, Ames M, Birnbaum H, Greenberg P, Hirschfeld RM, Jin R, Merikangas KR, Simon GE, Wang PS. Prevalence and effects of mood disorders on work performance in a nationally representative sample of U.S. workers. Am J Psychiatry. 2006 Sep;163(9):1561-8. doi: 10.1176/ajp.2006.163.9.1561.

    PubMed 16946181
  • Heflin CM, Iceland J. Poverty, Material Hardship and Depression. Soc Sci Q. 2009 Dec 1;90(5):1051-1071. doi: 10.1111/j.1540-6237.2009.00645.x.

    PubMed 25530634
  • Haushofer J, Fehr E. On the psychology of poverty. Science. 2014 May 23;344(6186):862-7. doi: 10.1126/science.1232491.

    PubMed 24855262
  • Patel V, Araya R, de Lima M, Ludermir A, Todd C. Women, poverty and common mental disorders in four restructuring societies. Soc Sci Med. 1999 Dec;49(11):1461-71. doi: 10.1016/s0277-9536(99)00208-7.

    PubMed 10515629
  • Lerman S. The syndemogenesis of depression Concepts and examples. depression. 2018.

  • Lund C, De Silva M, Plagerson S, Cooper S, Chisholm D, Das J, Knapp M, Patel V. Poverty and mental disorders: breaking the cycle in low-income and middle-income countries. Lancet. 2011 Oct 22;378(9801):1502-14. doi: 10.1016/S0140-6736(11)60754-X. Epub 2011 Oct 16.

    PubMed 22008425
  • Lund C, Breen A, Flisher AJ, Kakuma R, Corrigall J, Joska JA, Swartz L, Patel V. Poverty and common mental disorders in low and middle income countries: A systematic review. Soc Sci Med. 2010 Aug;71(3):517-528. doi: 10.1016/j.socscimed.2010.04.027. Epub 2010 May 12.

    PubMed 20621748
  • Program UND. Human development report 2019: Beyond income, beyond averages, beyond today: Inequalities in human development in the 21st century. 2019.

  • Buckshee K. Impact of roles of women on health in India. Int J Gynaecol Obstet. 1997 Jul;58(1):35-42. doi: 10.1016/s0020-7292(97)02887-7.

    PubMed 9253664
  • Jambunathan J. Sociocultural factors in depression in Asian Indian women. Health Care Women Int. 1992 Jul-Sep;13(3):261-70. doi: 10.1080/07399339209516001.

    PubMed 1399866
  • Rani M, Bonu S. Rural Indian women's care-seeking behavior and choice of provider for gynecological symptoms. Stud Fam Plann. 2003 Sep;34(3):173-85. doi: 10.1111/j.1728-4465.2003.00173.x.

    PubMed 14558320
  • Rodrigues M, Patel V, Jaswal S, de Souza N. Listening to mothers: qualitative studies on motherhood and depression from Goa, India. Soc Sci Med. 2003 Nov;57(10):1797-806. doi: 10.1016/s0277-9536(03)00062-5.

    PubMed 14499506
  • Ullrich HE. A study of change and depression among Havik Brahmin women in a south Indian village. Cult Med Psychiatry. 1987 Sep;11(3):261-87. doi: 10.1007/BF00048516.

    PubMed 3677776
  • Karasz A. Marriage, Depression and Illness: Sociosomatic Models in a South Asian Immigrant Community. Psychology and Developing Societies. 2005;17(2):161-180.

Questions about this trial

What is this clinical trial studying?

A study testing Manualized Group Based Psychotherapy and Poverty Alleviation in people with Depression and Economic Vulnerability, run by University of Massachusetts, Worcester at 1 site in Bangladesh.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 15 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Bangladesh. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Alison Karasz, PhD (3478435652, alison.karasz@umassmed.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Depressive symptoms at 6 Months (time frame: 6 Months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06295250, which also lists 163 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jun 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in