Development and testing of a behavioral activation mobile therapy for elevated depressive symptoms

针对抑郁症状加重的行为激活移动疗法的开发和测试

基本信息

批准号：
8979241
负责人：
JULIA W FELTON
金额：
$ 22.46万
依托单位：
MOUNTAINPASS TECHNOLOGY, LLC
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-09-01 至 2018-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8979241
关键词：
Address Adherence Adult Antidepressive Agents Area Beck depression inventory Behavioral Car Phone Cognitive Therapy Conflict (Psychology)Data Development Effectiveness Evidence based intervention Evidence based treatment Funding Funding Mechanisms Future Goals Health Care Costs Impairment Individual Intervention Life Light Major Depressive Disorder Marketing Measures Mental Depression Monitor Outcome Participant Patients Pharmaceutical Preparations Phase Physicians Population Positioning Attribute Primary Care Physician Primary Health Care Public Health Randomized Randomized Clinical Trials Reporting Research Resources Risk Small Business Technology Transfer Research Symptoms Technology Testing Training Work base behavioral study clinical practice cost depressed patient depressive symptoms evidence base experience meetings mobile application mortality phase 2 study product development public health relevance research clinical testing research study subthreshold depression tool

项目摘要

DESCRIPTION (provided by applicant): Approximately 20-40% of the population experiences elevated depressive symptoms (Kubik et al., 2003). Despite recent research suggesting that overall population mortality would be reduced by 6.5% if the effects of subthreshold depression could be blocked completely, the majority of individuals with elevated depressive symptoms never receive evidence-based treatment (Cuijpers et al., 2013). Elevated depressive symptoms are most frequently reported to primary care physicians (PCPs; Mitchell et al., 2009), who lack evidence-based resources for the treatment of subthreshold depression. This lack of evidence-based resources leads to a number of negative outcomes for patients including: 1) the majority not receiving appropriate treatment (Kessler et al., 2005), 2) a decreased likelihood of reporting depressive symptoms again in the future (Bell et al., 2011), and 3) heightened mortality risk (Cuijpers et al., 2004). As the most likely initial contact for patients with elevated depressive symptoms, PCPs are in a unique position to provide evidence-based interventions (McDowell et al., 2011). In light of factors that deter use of evidence-based strategies by PCPs, including the necessity of additional training to support implementation and/or excessive costs to patients, mobile technologies such as mobile apps offer an ideal strategy to meet widespread treatment needs. However, there are currently no mobile apps for depressive symptoms available to PCPs that are both evidence-based and straightforward enough to be recommended to their patients. One treatment for elevated depressive symptoms that is particularly amenable to a mobile platform and could easily be recommended by PCPs is brief Behavioral Activation (brief BA; Lejuez et al., 2011). Across studies, brief BA has demonstrated effectiveness for reducing depressive symptoms among individuals with elevated depressive symptoms (Gawrysiak et al., 2009; Hopko et al., 2003; Reynolds et al., 2011). Despite this clear fit between brief BA, mobile platforms, and PCPs, such a tool has yet to be developed. The purpose of the proposed project is to customize BA for a mobile platform by creating a BA mobile application (Behavioral Apptivation) to be marketed to individuals with elevated depressive symptoms through their PCPs in order to address the currently unmet needs of PCPs and their patients with elevated depressive symptoms. We expect that via product development, acceptability and feasibility testing, and refinement consistent with the STTR Phase I funding mechanism, we will create a marketable product for which we will pursue larger scale clinical testing in an STTR Phase II study.

描述（由申请人提供）：尽管最近的研究表明，如果阈下抑郁的影响能够得到缓解，那么总体人口死亡率将降低 6.5%，但大约 20-40% 的人口会出现抑郁症状（Kubik 等，2003）。如果完全受阻，大多数抑郁症状加重的人从未接受过基于证据的治疗（Cuijpers 等，2013）。大多数症状都是向初级保健医生报告的（PCP；Mitchell 等，2009），他们经常缺乏治疗阈下抑郁症的循证资源，这种缺乏循证资源会导致患者出现许多负面结果，包括：：1）大多数人没有接受适当的治疗（Kessler等人，2005），2）未来再次报告抑郁症状的可能性降低（Bell等人，2011），以及3) 死亡风险（Cuijpers 等，2004）。作为抑郁症状加重患者最有可能的初次接触者，PCP 处于提供循证干预措施的独特地位（McDowell 等，2011）。由于存在阻碍 PCP 使用循证策略的因素，包括需要额外培训来支持实施和/或患者成本过高，移动应用程序等移动技术提供了满足广泛治疗需求的理想策略。目前还没有可供 PCP 使用的针对抑郁症状的移动应用程序，这些应用程序既基于证据又足够简单，可以向患者推荐一种特别适合移动平台且可以很容易地由 PCP 推荐的针对抑郁症状的治疗方法。行为激活（简短的 BA；Lejuez 等人，2011）多项研究表明，简短的 BA 可以有效减少抑郁症状加重的个体的抑郁症状（Gawrysiak 等人，2011）。 2009；Hopko 等人，2003；Reynolds 等人，2011）尽管简单的 BA、移动平台和 PCP 之间存在明显的契合，但该项目的目的是定制 BA。通过创建 BA 移动应用程序（行为 Apptivation），通过 PCP 向抑郁症状加重的个人推销，以解决 PCP 及其患者当前未满足的需求我们预计，通过产品开发、可接受性和可行性测试以及与 STTR 一期资助机制一致的改进，我们将创造出一种适销对路的产品，我们将在 STTR 二期研究中进行更大规模的临床测试。