Reducing the Burden of Depression on Employment: Improving function and work

减轻抑郁症对就业的负担：改善功能和工作

• 批准号: 9248814
• 负责人: DAVID W. OSLIN
• 金额: --
• 依托单位: PHILADELPHIA VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-01 至 2018-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9248814
• 关键词: Absenteeism; Address; Aftercare; Caring; Chronic; Clinical Research; Communities; Consent; Cost Analysis; Cost Savings; Costs and Benefits; Counseling; DSM-V; Data; Depressed mood; Depressive disorder; Diagnosis; Disease; Economics; Effectiveness; Eligibility Determination; Employee; Employment; Enrollment; Family; Goals; Grant; Guidelines; Gulf War; Health; Health Care Costs; Health Services Research; Home environment; Hour; Human; Informed Consent; Intervention; Investments; Literature; Major Depressive Disorder; Measures; Medical center; Mental Depression; Mental Health; Mental Health Services; Methodology; Modality; Modeling; Names; Occupations; Outcome; Outcome Measure; Participant; Performance at work; Persons; Population; Post-Traumatic Stress Disorders; Prevention; Primary Health Care; Productivity; Professional counselor; Questionnaires; Randomized Controlled Trials; Recovery; Rehabilitation therapy; Reporting; Research; Research Design; SF-12; Science; Services; Severities; Symptoms; Telephone; Testing; Time; Unemployment; United States Department of Veterans Affairs; Veterans; Vulnerable Populations; Work; Workplace; base; clinical Diagnosis; cost; depressive symptoms; disability; evidence base; experience; follow-up; functional improvement; health care service utilization; health difference; health related quality of life; improved; improved functioning; innovation; post intervention; productivity loss; programs; psychologic; public health relevance; research study; screening; therapy design; treatment as usual; treatment group

DESCRIPTION (provided by applicant): PI: David Oslin, MD Title: Reducing the Burden of Depression on Employment: Improving Function and Work Abstract 1. Objective(s): Depression is a prevalent, often chronic condition that frequently limits ability to function at work, at home and in the community. In veteran and civilian populations, depression has been associated with excess unemployment, job loss, turnover, work absences and at-work performance deficits. Among Gulf War veterans, major depression and PTSD are leading reasons for service-connected disability benefits granted at the 100% level. Among OEF/OIF veterans with depression who are employed, at-work performance deficits and absences are four times higher than rates for depressed employees in the civilian population. At minimum, depression costs this nation $24 billion annually in lost productivity. With the goal of helping employed veterans with depression to participate fully in the labor market, this study has two objectives: test the effectiveness of a new evidence-based, vocationally-focused telephonic counseling program for employed veterans with depression, the Veterans -Work and Health Initiative (V-WHI), which was developed by this study's research partners from the Tufts Medical Center; and 2) if the V-WHI is effective, quantify its return on investment (ROI). The V-WHI will provide veterans with eight telephone counseling sessions to address barriers to effective functional performance at work. This study will test the impact of the V-WHI in combination with the VA's program of Integrated Care (IC) for depression. The V-WHI is based on two bodies of scientific literature. First, clinical research indicates that providng evidence-based depression diagnosis and treatment is helpful but not sufficient to reduce depression's negative employment and related functional deficits. Second, research on disability (and work disability specifically) suggests the potential benefits to both functioning and recovery by improving the "fit" between the employed person with depression and his or her work context. Thus, used in combination with the VA's IC services, which reflect VA/DOD Depression Guidelines for primary care, the V-WHI's functional improvement interventions are expected to improve veteran outcomes. 2. Research Design: A randomized controlled trial (RCT) will test the hypothesis that the V- WHI added to the IC will be superior to IC services alone. The primary endpoints are pre/post changes in at-work performance and productivity scores based on the validated Work Limitation Questionnaire (WLQ). Secondary endpoints include changes in depression symptom severity (measured with the validated PHQ-9) and healthcare utilization and costs. 3. Methodology: After eligibility screening and informed consent, subjects will be assigned to a combined program or IC only group. Initially, 250 employed veterans with depression and work limitations will be enrolled (half per group). Questionnaires will be administered at baseline, month four to five (post-intervention) and month nine. An ROI analysis will assess costs and benefits. This study will potentially benefit the VA and veterans by advancing the science and practice of functional improvement.

描述（由申请人提供）： PI：大卫·奥斯林（David Oslin），医学博士标题：减轻抑郁症的负担：就业负担：提高功能和工作摘要1。目标：抑郁症是一种普遍的，通常是慢性病，通常会限制在工作，在家和社区中工作的能力。在资深人口和平民中，抑郁症与失业，失业，营业额，工作缺勤和工作表现不足有关。在海湾战争退伍军人中，重度抑郁症和PTSD是100％授予服务连接残疾福利的主要原因。在受雇的抑郁症的OEF/OIF退伍军人中，在平民人口中，沮丧的雇员的劳动表现不足和缺勤高四倍。至少，抑郁症每年损失生产力损失，抑郁症每年损失240亿美元。 为了帮助雇用抑郁症的退伍军人充分参与劳动力市场的目的，这项研究具有两个目标：测试针对抑郁症，退伍军人和健康计划的老兵（V-WHI）的新的基于循证的，以职业为中心的电话咨询计划（V-WHI），该研究是由该研究研究伙伴从Tufts医疗中心开发的； 2）如果V-WHI有效，请量化其投资回报率（ROI）。 V-WHI将为退伍军人提供八次电话咨询会议，以解决工作中有效功能性能的障碍。这项研究将测试V-WHI与VA综合护理计划（IC）对抑郁症的影响。 V-WHI基于两种科学文献。首先，临床研究表明，基于证据的抑郁诊断和治疗是有帮助的，但不足以减少抑郁症的负面就业和相关功能缺陷。其次，残疾研究（和工作残疾）提出了功能和恢复的潜在益处 通过改善抑郁症患者与他或她的工作环境之间的“合身”。因此，与VA的IC服务结合使用，该服务反映了VA/DOD抑郁症的初级保健指南，V-WHI的功能改进干预措施有望改善退伍军人的结果。 2。研究设计：一项随机对照试验（RCT）将检验以下假设：添加到IC中的V WHI将仅优于IC服务。主要终点是基于经过验证的工作限制问卷（WLQ）的AT-WORK绩效和生产率得分的验/验证更改。次要终点包括抑郁症状严重程度的变化（用经过验证的PHQ-9衡量）以及医疗保健利用和成本。 3.方法论：资格筛选和知情同意后，将分配给组合程序或IC组。最初，将招募250名具有抑郁症和工作局限性的退伍军人（每组一半）。问卷将在基线，第四至第五个月（干预后）和第九月进行管理。 ROI分析将评估成本和收益。这项研究将通过推进功能改进的科学和实践来使VA和退伍军人受益。