Implementation and effectiveness of Mindfulness-Based Cognitive Therapy for mild depression in primary care: Protocol for a stepped-wedge cluster RCT
Caroline Krauser, Eduardo Jardim Simões, Chester Schmaltz, Luiz Roberto Ramos, Erika Blamires Santos Porto, Lucas Petri Damiani, Marcelo Demarzo
SSM - Mental Health June 16, 2026 DOI: 10.1016/j.ssmmh.2026.100608 (opens in new tab) via DOAJ
Summary
AI-generated from the abstractDepression and anxiety symptoms are a major cause of disability worldwide. Mindfulness-based interventions are proven treatments for mild-to-moderate cases, but evidence on their real-world feasibility and effectiveness is limited, especially in low- and middle-income countries. This paper describes a randomized stepped-wedge trial with qualitative analysis that will evaluate the implementation and effectiveness of Mindfulness-Based Cognitive Therapy for depression symptoms in primary care patients in Brazil. The study aims to generate context-sensitive evidence to improve public health strategies and inform sustainable depression treatments in low- and middle-income countries.
Study at a glance
| Characteristics | Randomized stepped-wedge design with qualitative analysis Peer reviewed |
|---|---|
| Population | Primary health care patients in a low- and middle-income country (Brazil) |
| Intervention | Mindfulness-Based Cognitive Therapy |
| Topics | Depression Meditation |
| Keywords | Primary health care Implementation science |
| Key finding | Describes a planned trial to evaluate the implementation and effectiveness of Mindfulness-Based Cognitive Therapy for depression symptoms in primary care patients in a low- and middle-income country. |
Abstract
Depressive and anxiety symptoms are one of the leading causes of years lived with disability worldwide. Mindfulness-based interventions (MBIs) have been shown to be one of the proven treatments for improving mild and moderate cases of depression and anxiety. However, there is still a gap regarding the feasibility and effectiveness of MBIs in the real world, especially in low- and middle-income countries. This study uses a randomized stepped-wedge design with qualitative analysis to evaluate the implementation and effectiveness of Mindfulness-Based Cognitive Therapy for symptoms of depression in primary health care patients in a LMIC. Through implementation research, we aim to bridge the gap between research and practice and advance mixed methods studies by generating actionable and context-sensitive evidence. This approach aims to improve public health strategies and inform more effective and sustainable treatments for depression in low- and middle-income countries. This trial is registered in the Brazilian Registry of Clinical Trials as “Implementation and Effectiveness of an Integrative Practice Protocol for Reducing Depression Symptoms in Primary Care” (RBR-4qv57kj), accessible at https://ensaiosclinicos.gov.br/rg/RBR-4qv57kj.