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）：该提案寻求对有效性试验的支持，以评估抑郁症外展治疗对工作相关行为的影响。该试验在四个方面与其他试验不同：（1）我们将通过健康风险评估（HRA）调查对就业人员样本进行筛查，而不是通过抑郁症筛查量表在初级保健中进行筛查。 (2) 治疗将由联合行为健康 (UBH) 的专家提供 而不是由初级保健医生进行。 (3) 对因病缺勤、工伤事故、工作数量、工作质量、工作人际关系、工作流动率等的详细评估将作为主要结果，而不是次要结果。 (4) 成本效益分析将用于估计该计划给雇主带来的净效益。该试验在外展和护理监测方法以及质量保证方面将与其他试验相同。五家雇主将合作：美国航空、达美航空、马萨诸塞州雇员协会、东北公用事业公司和雷神公司。有两个设计变更：（1）团体健康合作社（GHC）护理经理外展监测模型现在是干预的核心，而不是之前提交的混合 GHC-UBH 模型； (2) APA 循证实践指南将用于质量保证，而不是先前提交的混合指南。这项研究对于回答提出的一个关键问题具有重要意义 雇主：使用现实水平的质量保证对抑郁工人进行外展和符合指南的治疗是否会降低工作场所抑郁症的成本，足以对雇主来说具有成本效益？同样重要的是我们的传播计划。(1) 区域健康业务小组和行为健康管理顾问将与我们合作传播结果，以创造购买者对加强抑郁症外展治疗的需求。向雇主传达的信息是，抑郁症外展监测护理 经理干预是具有正投资回报的投资机会。 (2) UBH 将提供这种外展监测干预措施作为特殊的附加疾病管理计划，可以以高于标准计划的溢价购买。对于积极成果的传播传统上一直是一个严重问题的研究领域来说，这是快速和广泛传播的一个极其重要的机会。