Outreach and Treatment for Depression in the Labor Force

劳动力抑郁症的推广和治疗

• 批准号: 6475182
• 负责人: Philip S Wang
• 金额: $ 201.01万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-19 至 2006-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6475182
• 关键词: absenteeism; accidents; behavioral /social science research tag; clinical research; cost effectiveness; depression; employee; health care service evaluation; health insurance; health services research tag; health surveys; human subject; human therapy evaluation; information dissemination; interpersonal relations; job performance; longitudinal human study; managed care; medical outreach /case finding; mental disorder chemotherapy; mental health services; patient oriented research; psychotherapy; serotonin inhibitor; work site

DESCRIPTION (provided by applicant): This proposal seeks support for an effectiveness trial to evaluate the impact of depression outreach-treatment on work-related behaviors. The trial will differ from others in four ways: (1) We will screen in samples of employed people with Health Risk Appraisal (HRA) surveys rather than in primary care with depression screening scales. (2) Treatment will be provided by specialists working for United Behavioral Health (UBH) rather than by primary care doctors. (3) Detailed assessments of sickness absence, job-related accidents, quantity of work, quality of work, interpersonal relations at work and job turnover will be primary rather than secondary outcomes. (4) Cost-benefit analysis will be used to estimate the net benefit of the program to employers. The trial will be identical to others in outreach and care monitoring methods and in quality assurance. Five employers will collaborate: American Airlines, Delta airlines, the Massachusetts State Employees Association, Northeast Utilities, and Raytheon. There are two design changes: (1) The Group Health Cooperative (GHC) care manager outreach-monitoring model is now the core of the intervention rather than the hybrid GHC-UBH model proposed in the previous submission; (2) APA Evidence-Based Practice Guidelines will be used for quality assurance rather than the hybrid guidelines proposed in the previous submission. The study will be significant in answering a key question posed by employers: Will outreach and guideline-concordant treatment of depressed workers using realistic levels of quality assurance reduce the workplace costs of depression enough to be cost-effective to the employer? Also significant is our dissemination plan.(1) Regional Business Groups on Health and behavioral health management consultants will work with us to disseminate the results in order to create purchaser demand for enhanced depression outreach-treatment. The message to employers will be that depression outreach-monitoring care manager interventions are investment opportunities with positive returns on investment. (2) UBH will offer this outreach-monitoring intervention as a special add-on disease management program, which can be purchased for a premium over the standard plan. This is an extremely important opportunity for rapid and widespread dissemination in an area of research where dissemination of positive results has traditionally been a serious problem.

描述（由申请人提供）：该提案寻求支持有效试验，以评估抑郁症外展治疗对与工作相关行为的影响。该试验将以四种方式不同：（1）我们将在具有健康风险评估（HRA）调查的受雇人士的样本中进行筛查，而不是在具有抑郁症筛查量表的初级保健中进行筛选。 （2）将由联合行为健康（UBH）的专家提供治疗 而不是由初级保健医生。 （3）对疾病缺席，与工作有关的事故，工作数量，工作质量，工作中的人际关系和工作营业额的详细评估将是主要的，而不是次要结果。 （4）将使用成本效益分析来估算该计划的净益处给雇主。该试验将在外展和护理监测方法和质量保证方面与其他人相同。五个雇主将合作：美国航空，三角洲航空公司，马萨诸塞州雇员协会，东北公用事业和雷神公司。有两个设计变化：（1）集团健康合作社（GHC）护理经理外展监测模型现在是干预措施的核心，而不是上一篇文章中提出的混合GHC-UBH模型； （2）基于APA的循证实践指南将用于质量保证，而不是先前提交中提出的混合指南。这项研究将在回答一个关键问题方面具有重要意义 雇主：使用现实的质量保证对沮丧工人的宣传和指导方案治疗是否会降低抑郁症的工作场所成本，足以对雇主具有成本效益？我们的传播计划也很重要。（1）健康和行为健康管理顾问的区域业务团体将与我们合作，分发结果，以提高购买者对增强抑郁症外展治疗的需求。给雇主的信息将是抑郁症外展监测护理 经理干预是具有积极投资回报的投资机会。 （2）UBH将作为特殊的附加疾病管理计划提供这种外展监测干预措施，该计划可用于比标准计划的溢价购买。这是在研究积极成果传播传统上是一个严重的问题的研究领域中快速和广泛传播的一个极为重要的机会。