Targeted and Tailored Messages to Enhance Depression Care

有针对性和量身定制的信息，以加强抑郁症护理

• 批准号: 8118900
• 负责人: RICHARD L KRAVITZ
• 金额: $ 53.56万
• 依托单位: UNIVERSITY OF CALIFORNIA AT DAVIS
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-27 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8118900
• 关键词: Address; Adherence; Adult; Affect; Age; Antidepressive Agents; Attention; Attitude; Behavior; Belief; Caring; Clinic; Clinical; Cognition; Cognitive; Communication; Control Groups; Counseling; Depressed mood; Diagnostic; Drug Prescriptions; Ethnic Origin; Evaluation; Feeling suicidal; Female; Focus Groups; Gender; Goals; Health; Health Status; Hygiene; Intervention; Interview; Major Depressive Disorder; Market Research; Marketing; Measures; Mental Depression; Mental Health; Minority; Minority Groups; National Institute of Mental Health; Outcome; Outcome Study; Patient Participation; Patient Self-Report; Patients; Perception; Pharmaceutical Preparations; Phase; Physicians; Primary Health Care; Process; Psychological Theory; Race; Randomized Controlled Trials; Readiness; Recommendation; Recording of previous events; Reporting; Research; Risk; Science; Self Efficacy; Services; Severities; Sleep; Stigmata; Subgroup; Surveys; Symptoms; Testing; Time; Toxic effect; Woman; Work; aged; base; care seeking; clinical care; comparative effectiveness; computer program; depressive symptoms; design; diagnostic accuracy; direct to consumer advertising; effective therapy; expectation; experience; group intervention; improved; information processing; interactive multimedia; male; men; post intervention; programs; prototype; social; social stigma

DESCRIPTION (provided by applicant): Surveys of patients and physicians show that direct-to-consumer advertising (DTCA) of prescription drugs influences public attitudes and patient behaviors. In a recent randomized controlled trial (RCT), MH64683, we showed that patients' requests for antidepressants increase depression-related history-taking, inquiry about suicidal thoughts, and delivery of appropriate initial treatment. But can messages designed to encourage patient participation reduce stigma and overcome barriers to optimal depression care in the clinic and beyond? Furthermore, what is the comparative effectiveness of communication strategies based on targeting vs. tailoring? In this application, we propose a two-phase study to enhance delivery of initial treatment for depression. First, using approaches informed by market research and psychological theory, we will develop two communication interventions aimed at working age adults at risk for depression: (1) demographically targeted Public Service Announcements (PSAs) and (2) a social-psychologically tailored interactive multimedia computer program (IMCP). Second, we will conduct a RCT in primary care offices to compare the two interventions with each other and with an "attention control" (video on sleep hygiene). This project has two specific aims. The first is to develop and test targeted PSAs and a tailored IMCP designed to reduce stigma and promote effective participation in care among working- aged adults at risk for depression. Enhanced participation in care will be measured as an increase in the likelihood of: a) seeking care for depressive symptoms and b) making explicit requests for depression treatment. The second aim is to compare effects of targeted PSAs, a tailored IMCP, and a sleep hygiene video (control) on patients' attitudes towards depression care-seeking, patients' treatment requests, physicians' history-taking and treatment recommendations, and patients' clinical outcomes. As exploratory sub-aims, we will also examine effects on MD diagnostic accuracy and treatment disparities. In this project, formative research will be used to develop and test targeted public service announcements (PSAs) and a tailored interactive multimedia computer program (IMCP) designed to enhance depression care seeking, encourage appropriate depression treatment requests, and reduce depression-related stigma. Then, in a randomized controlled trial conducted in primary care offices, the effects of the two programs on depression care and outcomes will be compared with each other and with a control group.

描述（由申请人提供）：对患者和医师的调查表明，处方药的直接面向消费者广告（DTCA）会影响公众的态度和患者行为。在最近的一项随机对照试验（RCT）MH64683中，我们表明患者对抗抑郁药的要求增加了与抑郁症相关的历史记录，对自杀思想的询问以及提供适当的初始治疗。但是，旨在鼓励患者参与的消息可以减少污名并克服诊所及其他地区最佳抑郁症护理的障碍吗？此外，基于目标与裁缝的沟通策略的比较有效性是什么？在此应用中，我们提出了一项两阶段的研究，以增强抑郁症初始治疗方法的递送。首先，使用市场研究和心理理论告知的方法，我们将开发两种旨在促进抑郁症风险的成年人的交流干预措施：（1）人口统计学针对性的公共服务公告（PSA）和（2）社交心理量身定制的互动互动的多媒体计算机计划（IMCP）。其次，我们将在初级保健办公室进行RCT，以将两种干预措施与“注意力控制”进行比较（有关睡眠卫生的视频）。该项目有两个具体的目标。首先是开发和测试针对目标的PSA和量身定制的IMCP，旨在减少污名并促进有效的抑郁症风险的成年人的护理。加强对护理的参与将被衡量，以增加：a）寻求抑郁症状的护理和b）提出明确的抑郁症治疗请求。第二个目的是比较目标PSA，量身定制的IMCP以及睡眠卫生视频（对照）对患者对抑郁症护理的态度，患者的治疗要求，医生的病史和治疗建议以及患者的临床结果的影响。作为探索性子AIM，我们还将研究对MD诊断准确性和治疗差异的影响。在该项目中，形成性研究将用于开发和测试目标公共服务公告（PSA）和量身定制的互动式多媒体计算机计划（IMCP），旨在增强寻求抑郁症的护理，鼓励适当的抑郁症治疗请求并减少与抑郁症相关的污名。然后，在初级保健办公室进行的随机对照试验中，这两个计划对抑郁症护理和结果的影响将与对照组进行比较。

项目成果

The effect of targeted and tailored patient depression engagement interventions on patient-physician discussion of suicidal thoughts: a randomized control trial.

有针对性和量身定制的患者抑郁参与干预措施对患者与医生自杀想法讨论的影响：一项随机对照试验。

• DOI: 10.1007/s11606-014-2843-8
• 发表时间: 2014
• 期刊: Journal of general internal medicine
• 影响因子: 5.7
• 作者: Shah,Ruby;Franks,Peter;Jerant,Anthony;Feldman,Mitchell;Duberstein,Paul;FernandezyGarcia,Erik;Hinton,Ladson;Strohecker,Lorrie;Kravitz,RichardL
• 通讯作者: Kravitz,RichardL

Do antidepressant advertisements educate consumers and promote communication between patients with depression and their physicians?

• DOI: 10.1016/j.pec.2010.01.014
• 发表时间: 2010-11
• 期刊: PATIENT EDUCATION AND COUNSELING
• 影响因子: 3.5
• 作者: Bell, Robert A.;Taylor, Laramie D.;Kravitz, Richard L.
• 通讯作者: Kravitz, Richard L.

Targeted versus tailored multimedia patient engagement to enhance depression recognition and treatment in primary care: randomized controlled trial protocol for the AMEP2 study.

有针对性的与定制的多媒体患者参与以增强初级保健中抑郁症的识别和治疗：AMEP2 研究的随机对照试验方案。

• DOI: 10.1186/1472-6963-13-141
• 发表时间: 2013
• 期刊: BMC health services research
• 影响因子: 2.8
• 作者: Tancredi,DanielJ;Slee,ChristinaK;Jerant,Anthony;Franks,Peter;Nettiksimmons,Jasmine;Cipri,Camille;Gottfeld,Dustin;Huerta,Julia;Feldman,MitchellD;Jackson-Triche,Maja;Kelly-Reif,Steven;Hudnut,Andrew;Olson,Sarah;Shelton,Janie;Kr
• 通讯作者: Kr

Depression treatment preferences of Hispanic individuals: exploring the influence of ethnicity, language, and explanatory models.

西班牙裔个体的抑郁症治疗偏好：探索种族、语言和解释模型的影响。

• DOI: 10.3122/jabfm.2011.01.100118
• 发表时间: 2011-01
• 期刊: Journal of the American Board of Family Medicine : JABFM
• 作者: Fernandez Y Garcia E;Franks P;Jerant A;Bell RA;Kravitz RL
• 通讯作者: Kravitz RL