Primary Care-Based Depression Prevention for Adolescents

基于初级保健的青少年抑郁症预防

• 批准号: 7145475
• 负责人: BENJAMIN W VAN VOORHEES
• 金额: $ 17.03万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-01 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7145475
• 关键词: Internet; adolescence (12-20); behavioral /social science research tag; child behavior; child psychology; clinical research; cognitive behavior therapy; culture; depression; dosage; drug administration rate /duration; family structure /dynamics; health care model; human subject; human therapy evaluation; mental disorder prevention; mental health epidemiology; motivation; patient care management; population survey; therapy design /development

DESCRIPTION (provided by applicant): Dr. Van Voorhees' long-term research objective is to reduce the morbidity of depression during the adolescence through early, preventive intervention in primary care. Primary care physicians (PCP) currently lack a defined, efficacious behavioral intervention for adolescents with sub-threshold depressive symptoms who are at risk for progressing to major depression. The proposed training program will provide him with knowledge/skills to develop/evaluate preventive interventions. Dr. Van Voorhees (Principal Investigator) has already completed a pilot study of a prototype primary care/Web-based depression prevention intervention with late adolescents (age 18-24) that demonstrated favorable trends in three risk factors. This K-08 application proposes a three-step process to systematically redesign and evaluate the potential efficacy of each component of the intervention for younger adolescents age 14-18 in preparation for an anticipated efficacy study (RO-1). Results of a stakeholder marketing survey (Study I) will inform (motivation and feasibility factors) intervention redesign for younger adolescents (Study II) leading to a pilot randomized pilot efficacy evaluation of each component. Study I will identify the key motivation (attitudes, social norms and behavioral factors) and process (dose and socio-cultural relevance) factors that will influence feasibility and efficacy in the target age group. Informed by the survey results, Study II will revise the intervention to include a comprehensive approach to reducing modifiable risk factors including parent education/engagement and behavioral activation approaches (more suited to younger adolescents). Study will evaluate the potential efficacy of each of the components of the intervention. We will recruit and randomize the 100 participants into one of two study groups: (1) control group that will be given only the address of the Internet site and receive follow-up phone call to evaluate safety, and (2) full intervention (motivational program, Ml before and after internet components and 4 motivational phone calls). We will conduct intention to treat and completer analyses of three outcomes: 1) process (dose, time on site, exercise completion), 2) post-intervention mood (CES-D score) and post-intervention risk factor/resiliency measures. These results will lead directly to an RO-1 application.

描述（由申请人提供）：Van Voorhees 博士的长期研究目标是通过初级保健的早期预防性干预来降低青春期抑郁症的发病率。初级保健医生 (PCP) 目前缺乏针对具有阈下抑郁症状、有可能发展为重度抑郁症风险的青少年的明确、有效的行为干预措施。拟议的培训计划将为他提供制定/评估预防干预措施的知识/技能。 Van Voorhees 博士（首席研究员）已经完成了一项针对青少年晚期（18-24 岁）的原型初级保健/基于网络的抑郁症预防干预的试点研究，该研究显示了三个风险因素的有利趋势。该 K-08 申请提出了一个三步流程，系统地重新设计和评估干预措施每个组成部分对 14-18 岁青少年的潜在功效，为预期功效研究 (RO-1) 做准备。利益相关者营销调查（研究 I）的结果将为年轻青少年的干预重新设计（研究 II）提供信息（动机和可行性因素），从而对每个组成部分进行试点随机试点功效评估。研究一将确定影响目标年龄组可行性和有效性的关键动机（态度、社会规范和行为因素）和过程（剂量和社会文化相关性）因素。根据调查结果，研究二将修改干预措施，以包括减少可改变风险因素的综合方法，包括家长教育/参与和行为激活方法（更适合年轻的青少年）。研究将评估干预措施每个组成部分的潜在功效。我们将招募 100 名参与者并将其随机分为两个研究组之一：(1) 对照组，仅提供互联网站点的地址并接听后续电话以评估安全性，以及 (2) 全面干预（激励性干预）程序、互联网组件之前和之后的机器学习以及 4 个励志电话）。我们将对三个结果进行意向治疗和完整分析：1）过程（剂量、现场时间、锻炼完成），2）干预后情绪（CES-D 评分）和干预后风险因素/弹性测量。这些结果将直接导致 RO-1 申请。