Dissemination of Computer-assisted Cognitive-behavior Therapy for Depression in Primary Care

初级保健中抑郁症计算机辅助认知行为疗法的传播

• 批准号: 8934425
• 负责人: Jesse H. Wright
• 金额: $ 25万
• 依托单位: UNIVERSITY OF LOUISVILLE
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8934425
• 关键词: Dissemination; Computer; assisted; Cognitive; behavior

 DESCRIPTION (provided by applicant): Dissemination of Computer-assisted cognitive-behavior therapy (CCBT) for depression in primary care will be evaluated in a trial with 320 patients randomly assigned to CCBT or treatment as usual (TAU). The study will disseminate a therapy method found to be effective in psychiatric settings into primary care - a setting where there have been significant problems in delivery of adequate, evidence-based treatment for depression. The study will include a high percentage of disadvantaged patients - a population that has been largely ignored in previous research in CCBT. There have been no previous studies of CCBT for depression in primary care that have enrolled large numbers of disadvantaged patients. The form of CCBT used in this study is designed to increase access to effective therapy, provide a cost-effective method, and be a sustainable model for wide-spread use in primary care. In order to deliver therapy in a practical manner that can be replicated in other primary care practices, patients with significant symptoms of depression will receive treatment with an empirically supported computer program that builds cognitive-behavior therapy skills. Support for CCBT will be provided by telephone and/or e-mail contact with a care coordinator instead of the face-to-face treatment with a cognitive-behavior therapist that has been a part of CCBT delivery in mental health settings. Novel features of this treatment program include: 1) fully detailed and replicable method for integrating clinician support with CCBT in primary care; 2) delivery of CCBT to a population with high percentage of disadvantaged patients; 3) integration of CCBT into the primary care delivery model; 4) highly interactive, multimedia computer program with adaptations for persons who may have lower levels of education or computer experience; 5) advanced cost-benefit analysis including data on actual health care utilization and costs; 6) exploration of moderators and predictors of treatment outcome. Outcome will be assessed by measuring CCBT completion rate, comprehension of CBT concepts, and satisfaction with treatment; in addition to ratings of depressive symptoms, negative thoughts, and quality of life. The cost-effectiveness analysis and exploration of possible predictors of outcome should help clinicians, health care organizations, and others plan further dissemination of CCBT in primary care.

 描述（由适用提供）：将在一项试验中评估计算机辅助的认知行为疗法（CCBT）针对初级保健抑郁症的抑郁症，将在一项试验中评估320名患者，随机分配给CCBT或像往常一样（TAU）。该研究将传播一种在精神病环境中有效到初级保健的治疗方法 - 在这种情况下，在提供足够的基于证据的抑郁症治疗方面存在重大问题。这项研究将包括高灾的患者比例很高 - 在CCBT的先前研究中，这一人群在很大程度上被忽略了。以前尚无对CCBT在初级保健中抑郁症的研究，这些研究已经招募了大量灾害患者。本研究中使用的CCBT的形式旨在增加获得有效治疗的机会，提供一种具有成本效益的方法，并成为在初级保健中广泛使用的可持续模型。为了以实用方式进行治疗，可以在其他初级保健实践中复制，抑郁症状症状的患者将通过紧急支持的计算机计划接受治疗，以建立认知行为治疗技能。将通过电话和/或电子邮件联系与护理协调员的联系，而不是通过认知行为治疗师的面对面治疗提供的支持，这是心理健康环境中CCBT交付的一部分。该治疗计划的新功能包括：1）将临床支持与CCBT在初级保健中集成的完全详细且可复制的方法； 2）将CCBT交付给有灾难准备的患者比例高的人群； 3）将CCBT集成到初级保健输送模型中； 4）高度互动的多媒体计算机计划，适应可能具有较低教育水平或计算机经验的人； 5）先进的成本效益分析，包括有关实际医疗保健利用和成本的数据； 6）探索主持人和治疗结果的预测指标。结果将通过测量CCBT完成率，CBT概念的理解以及对治疗的满意度来评估结果；除了抑郁症状，负面思想和生活质量的评分。成本效益分析和对结果可能预测因素的探索应有助于临床医生，卫生保健组织和其他人计划进一步在初级保健中传播CCBT。