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）：对患者和医生的调查表明，处方药的直接面向消费者的广告 (DTCA) 会影响公众的态度和患者的行为。在最近的一项随机对照试验 (RCT) MH64683 中，我们发现患者对抗抑郁药物的需求增加了抑郁相关病史采集、自杀想法询问以及适当初始治疗的提供。但是，旨在鼓励患者参与的信息能否减少耻辱并克服临床内外最佳抑郁症护理的障碍？此外，基于目标与定制的沟通策略的相对有效性如何？在本申请中，我们提出了一项两阶段研究，以加强抑郁症初始治疗的实施。首先，利用市场研究和心理学理论的方法，我们将针对有抑郁风险的工作年龄成年人制定两种沟通干预措施：（1）针对人口的公共服务公告（PSA）和（2）根据社会心理量身定制的交互式多媒体计算机程序（IMCP）。其次，我们将在初级保健办公室进行随机对照试验，以比较这两种干预措施以及“注意力控制”（有关睡眠卫生的视频）。该项目有两个具体目标。第一个是开发和测试有针对性的 PSA 和量身定制的 IMCP，旨在减少有抑郁风险的工作年龄成年人的耻辱并促进有效参与护理。护理参与度的提高将通过以下可能性的增加来衡量：a) 就抑郁症状寻求护理；b) 明确请求抑郁症治疗。第二个目的是比较有针对性的 PSA、定制的 IMCP 和睡眠卫生视频（对照）对患者寻求抑郁症护理的态度、患者的治疗要求、医生的病史采集和治疗建议以及患者的治疗效果的影响。临床结果。作为探索性的子目标，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有针对性的公共服务公告（PSA）和定制的交互式多媒体计算机程序（IMCP），旨在加强抑郁症护理寻求，鼓励适当的抑郁症治疗请求，并减少与抑郁症相关的耻辱。然后，在初级保健办公室进行的随机对照试验中，将比较这两个项目对抑郁症护理和结果的影响以及与对照组的影响。

项目成果

Suffering in silence: reasons for not disclosing depression in primary care.

沉默地受苦：在初级保健中不披露抑郁症的原因。

• 发表时间: 2011-09
• 影响因子: 4.4
• 作者: Bell, Robert A;Franks, Peter;Duberstein, Paul R;Epstein, Ronald M;Feldman, Mitchell D;Fernandez y Garcia, Erik;Kravitz, Richard L
• 通讯作者: Kravitz, Richard L

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

抗抑郁广告是否能够教育消费者并促进抑郁症患者与其医生之间的沟通？

• 发表时间: 2010-11
• 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。

• 发表时间: 2013-04-17
• 影响因子: 2.8
• 作者: Tancredi, Daniel J;Slee, Christina K;Jerant, Anthony;Franks, Peter;Nettiksimmons, Jasmine;Cipri, Camille;Gottfeld, Dustin;Huerta, Julia;Feldman, Mitchell D;Jackson;Kelly;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。

• 发表时间: 2011-01
• 作者: Fernandez Y Garcia, Erik;Franks, Peter;Jerant, Anthony;Bell, Robert A;Kravitz, Richard L
• 通讯作者: Kravitz, Richard L

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。

• 发表时间: 2014-08
• 影响因子: 5.7
• 作者: Shah, Ruby;Franks, Peter;Jerant, Anthony;Feldman, Mitchell;Duberstein, Paul;Fernandez y Garcia, Erik;Hinton, Ladson;Strohecker, Lorrie;Kravitz, Richard L
• 通讯作者: Kravitz, Richard L