Añuapp

Añuapp is a bilingual Spanish-Guarani mental health app for teenagers and young people.

It's a bilingual Spanish-Guarani mobile app focused on preventing and coping with stress, anxiety, depression, increasing hope, finding psychological help, and preventing suicide. To do that, it uses strategies based on evidence and gamified learning.

The app has four main sections:

• Selfcare: it has resources of prevention and coping with stress, anxiety and depression based on evidence. It uses the cognitive-behavioural model. It has three parts:
  • Think good, feel good: based on the ABC model. Has comics, infographics, short stories and motivational testimonies.
  • Gratitude jar: a daily plan the user makes with a list of things they like to do and a jar to say thanks for the good moments.
  • I want to relax: with guided deep breathing technique and a relaxing music playlist.
• Support network: contains a guide to make a support network. The user is able to put their trusted contacts when they need to talk and has shortcuts to make calls and messages.
• Emergency hotlines: contains emergency hotlines and a button to schedule for therapeutic attention. 
• Mental health map: contains a map with mental health services and a directory with the free mental health services.

The main problems we identified are: 1) the unsatisfied demand for mental health services in populations from vulnerable sectors; 2) the lack of digital mental health solutions for Guarani-speaking people, who constitute a majority in Paraguay (80%); 3) the high incidence of suicides and preventable mental health problems in young population; 4) the need to include generational, ethnic, gender and non-discrimination perspectives in mental health resources.

The neglect of mental health problems has serious effects on the population, since it constitutes the third cause of violent death in Paraguay and most frequently affects people between 18 and 29 years old (3). Suicide attempts are more frequent in women, although there are more men among suicides because they use more lethal methods (3). One of the main causes of morbidity and disability among adolescents (1) is suicidal behavior, adolescent women register a greater number of suicide attempts than men, which is significantly related to sexual abuse (1).

A study with adolescents reports that among high school students who made suicide attempts, serious situations of mental health disorders were found that were not detected in time (1). Most patients with suicidal behavior had no diagnosis and had a family history of mental disorders and a previous suicide attempt (3). Access to mental health services is limited for economic reasons, in Paraguay the poorest regions and with the largest Guarani-speaking population have higher suicide rates (2), and speaking Guarani is related to factors of discrimination.

The COVID-19 pandemic had an impact on the increase in mental health problems and suicides, directly linked to mental health problems that were not treated (1). Violence against women also increased, calls to SOS Mujer increased by 78% (2). There is an unmet need for mental health services, especially in low-income populations (2), and a study that tested the use of Apps with women from vulnerable areas reported the acceptance, demand, and use of digital solutions (2). For this reason, we identified young people between the ages of 15 and 24 who speak Guarani as a target for AñuApp, with specific attention to gender-based violence. In addition, we will adjust the target in consultation with potential users to develop the prototype to be tested.

Public mental health services are scarce, and private services are very expensive. The existing services are little known, although the MSPyBS launched a directory of mental health services, but its dissemination is scarce, and they are not georeferenced. AñuApp will have direct access to existing services and will be mapped on GoogleMaps, so that people can easily find help. AñuApp will have psychoeducational resources on self-care based on the cognitive behavioral model, which has evidence in the prevention of mental health problems. A study with high school students reported that learning the ABC model was effective in strengthening the mental health of adolescents: it reduced symptoms of depression and anxiety, increased hope and self-esteem.

Part of the team that is part of the Interact Club has been researching since 2020 about mental health, discrimination, and sexual abuse in the context of the pandemic. They made virtual discussion meetings and awareness materials. In addition, Letizia was a logistical support volunteer for the main researcher for a study on mental health, technology, and women in the context of the pandemic (1). 

To define the concept, we made interviews with specialized people, Moli Molinas and José Britos (mentors of this project), both authors of the mentioned research. We reviewed specialized literature, papers on the problem and made a map of actors and stakeholders we need to involve.

Since the target is young people from vulnerable sectors who speak Guarani, we sought to connect with people and organizations with that profile. That’s how we contacted Ivana Castillo, an activist from the Bañados of Asuncion, and we invited her to be part of the team. Ivana had previously worked with our mentor on a research and social experiment on prevention of sexual violence in an emergency context supported by Oxfam (2). She is part of the Guerrilla Verde youth group, and we are currently in the process of negotiating an alliance with this group to involve the participation of potential users in the co-creation and participative testing of the app so it is appropriate to the needs and characteristics of the target audience.

AñuApp is an idea that we developed in consultation with specialists and stakeholders, and right now we are starting consultations to develop the prototype and test a pilot with potential users. In this matter, we contacted the Guerrilla Verde group from Bañado de Asunción as potential users of the app.

 We invited Ivana, who is part of Guerrilla Verde, to the AñuApp team to facilitate the link with community participation and have a more active participation in the design and validation of the app.

 With the support of our mentors, we are also planning the construction of a business model, which is in the preliminary phase.

The solution has as core technologies software, mobile applications, behavioural technology, including biofeedback. As the development of the app progresses, the technologies used to make it will be defined with more precision. We want to make a free mobile application to facilitate access to mental health services and psychological help for people with limited resources. That's why we need to explore models that suit low and mid-range devices, and consult with potential users. 

The app will use geospatial technology through Google Maps to georeference the mental health services. This is important so that people can easily find mental health services near their community.

It is also proposed to use social networks to disseminate the app so that users have a space to interact, learn and participate in forums, psychoeducational LIVEs and opinion polls. We will also use metrics to measure the usability of the App.

AñuApp is in the creation phase and the next step will be the elaboration of the prototype to be tested.

Once the solution has been launched, we estimate that in a first stage we will reach some 2,000 people, within the first year.

Our impact goals are:

Increase coping skills: people use AñuAPP and learn skills for self-care, prevention and coping with stress, anxiety, depression

Increase hope and psychological well-being: AñuAPP users increase their support networks, feel more empowered, motivated, and hopeful.

Find psychological help: users know how to find psychological help and form a support network

Help prevent suicide: people can find psychological help in emergency situations

The mission of AñuApp team is:

Contribute to the mental health of young people between the ages of 15 and 24.

Position mental health as a right for all people without discrimination.

Build collaborative networks and learning communities.

We surpass ourselves in the use of technology and the creation of digital solutions to serve the community.

 Our vision is:

Collaborative work. Build a team where people feel respected and inspired to give their best every day.

Community service. Offer a quality product adapted to the needs, culture, language, and characteristics of the target groups.

Digital inclusion. Contribute to the reduction of the digital gap and the leadership of women in ICT. Sustainable development. Help build and support sustainable communities in line with the SDGs

Based on this we will develop our work plan, with activities, products and budget, including community participation approach, collaborative work, the development of alliances with specialized organizations and stakeholders. In all our work we have in mind gender approaches, non-discrimination, as well as evidence-based technologies and knowledge.

The AñuApp objectives can contribute to the fulfillment of the SDGs, more specifically SDG 3) Good health and well-being , 5) Gender equality  and 10) Reduced inequalities.

3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.

5.b Enhance the use of enabling technology, in particular information and communications technology, to promote the empowerment of women.

10.2 By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status

We will develop a MEL (Monitoring, Evaluation & Learning) plan with specific SMART indicators and metrics on the usability of the App, as well as for measuring its effects and impacts on AñuApp users. This may include conducting opinion polls, focus groups and other strategies.

Financial: we lack financial resources for the development of AñuApp, but we are in the process of defining the budget and formulating a fundraising strategy that identifies a mapping of possible donors. 

Techniques: most of the team has a strong background in STEM skills, but we consider it necessary to strengthen our specific abilities to build Apps and to measure their influence. Additionally, several team members are applying to universities to study engineering.

Social: the digital divide mainly affects women and populations from vulnerable sectors, although the context of the pandemic has increased the use of smartphones, the cost of Internet access continues to be a problem. For this reason, a challenge that AñuApp has is to develop a light app with low data consumption.

Cultural: there are stigmas about mental health and the need for psychological care, although the context of the Covid-19 pandemic has positioned the importance of mental health and the prevention approach in public debate.

Policies: in Paraguay there are limited mental health services, for which we consider it necessary to incorporate an advocacy component in public policies for the expansion of psychological services.

The members of the team are Letizia, CEO; Gabriela, Fundraising Officer; Abril, Digital Solutions Officer; Alejandro, Programming Officer; Bruno, Graphic Design Officer and Ivana, Community Engagement. We are used to work together, passionate about technology and community service, since almost all of us are part of the Interact Club of the Rotary Club, a volunteer organization. We joint the global campaign #generationequality with awareness videos on equality for women (1), prevention of sexual abuse (2) and interviews (3). Letizia is the director of international relations, Gabriela is the director of finances and treasurer, Abril is past-president, Bruno is a member and Alejandro is the director of community service.

Abril and Letizia were founders of the Interact Club Asunción Sajonia and schoolmates since kindergarten. They are both passionate about technology. As a final project for high school, they co-created JSLearn, an e-learning website about JavaScript. They participated in Hackerfem and TEDIC hackathons. Alejandro is from the same high school and with Letizia they participated in the OMAPA programming Olympiads and were selected for the Young Talents Scientific Initiation Program (JT). Bruno also participated in the OMAPA Olympiads, he is also an actor and cartoonist.

Ivana is an activist for the right to the city, gender equality and Afro identity. She is a member of the Guerrilla Verde organization. She lives in the Bañado of Asunción, a flood and poor zone. Ivana participated in the co-creation of campaigns against sexual harassment and social experiments with the support of Oxfam. We connected with her through our mentor, Moli Molinas, who was Oxfam's Gender and MEAL Officer. This connection is essential for the successful creation and testing of the app with the participation of people representative of the target groups: young Guarani speakers from vulnerable populations.

We’re partnering with the Centro de Ciencias del Comportamiento (Behavioural Sciences Centre). This will help us have all the information we need about psychology to make the app work and be useful to people. This can also help with getting the contacts for the mental health services. 

We started conversations with members of Guerrilla Verde, an ecologist youth group. We want to conect with the group to facilitate the community participation for the cocreation and testing of the app with people from the Bañado.

We also had conversations with Po Paraguay, an NGO that makes 3D printed prostheses that are economic, for people with scarce resources. They showed interest to work with us.

We plan on working with other organizations that will help us get the information we need about psychology, have the contacts for the mental health services and the hotlines. 

AñuApp is a digital solution for mental health, which focus is the application of the perspective of human rights, non-discrimination and gender equality and takes into account the specific needs of women. The leader of the team and the AñuApp team is made up mostly of girls between 15 and 18 years old. AñuApp is a project that can strengthen the STEM skills of the team leaders, and its impact objective is to contribute to the digital equity.

AñuApp is a digital solution for mental health, which focus is the application of the perspective of human rights, non-discrimination and gender equality and takes into account the specific needs of women. The leader of the team and the AñuApp team is made up mostly of girls between 15 and 18 years old. AñuApp is a project that can strengthen the STEM skills of the team leaders, and its impact objective is to contribute to the digital equity.