Technology Facilitated Behavioral Intervention for Depression among Diverse Patients in Ambulatory Oncology

技术促进了门诊肿瘤科不同患者抑郁症的行为干预

• 批准号: 10577738
• 负责人: BETINA YANEZ
• 金额: $ 62.03万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-01 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10577738
• 关键词: Address; Adherence; Adoption; American Society of Clinical Oncology; Anxiety; Area; Behavior Therapy; Behavioral; Behavioral Model; Cancer Patient; Caring; Characteristics; Chicago; Clinic; Clinical; Clinical Management; Clinical Oncology; Cognitive; Combined Modality Therapy; Data; Depression screen; Diagnosis; Disease; Distress; Effectiveness; Electronic Health Record; Emergency department visit; Ethnic Origin; Evaluation; Evidence based intervention; Evidence based treatment; General Population; Goals; Guidelines; Health; Health Benefit; Health Personnel; Health system; Home; Income; Individual; Information Systems; Information Technology; Internet; Intervention; Language; Maintenance; Major Depressive Disorder; Malignant Neoplasms; Measurement; Measures; Mediator; Medicine; Mental Depression; Mental Health; Modeling; Oncology; Outcome; Outcome Study; Patient Care; Patient Outcomes Assessments; Patient Triage; Patients; Population; Prevalence; Process; Race; Recommendation; Recording of previous events; Self Efficacy; Severities; Severity of illness; Site; Specificity; Symptoms; System; Technology; Testing; Time; Training; United States Preventative Services Task Force; Universities; Work; behavioral health; cancer therapy; comorbidity; computerized; depressive symptoms; diagnostic criteria; effectiveness evaluation; effectiveness/implementation trial; ethnic diversity; evidence base; experience; health information technology; health related quality of life; health service use; implementation evaluation; implementation framework; improved; individualized medicine; instrument; metropolitan; mortality; operation; patient portal; primary outcome; programs; psychologic; racial diversity; recruit; screening; secondary outcome; sex; standard care; standard of care; suicidal risk; symptomatology; technology platform; tool; treatment as usual

Abstract Depressionis one of the most common psychological comorbidities experienced throughout the cancercontinuum. Elevated depressive symptoms in oncology patients is a major concern as unmanaged depressive symptoms in cancer patients is associated with poor health-related quality of life (HRQoL), poor adherence to cancer treatments, delayed return to work and baseline function, greater emergency department visits, greater risk of suicide, and higher all-cause mortality. Behavioral interventions for the management of depression are efficacious, but scalability and implementation of these evidence-based interventions in oncology is limited. Health interpretation capture behavioral populations. information technologies (HIT) provide an ideal opportunity t o expedite the administration, scoring, and of depression screening with well-validated, brief and precise measurement tools that can actionable data to screen for depression, and deliver pragmatic and scalable evidence-based interventions that are proven to reduce depressive symptomatology across various other Despite the benefits of these HITs,use of technology-based models to screen and deliver evidence-based behavioral treatments that address the depressive symptoms in cancer remains underdeveloped and poorly implemented. We will evaluate the effectiveness and the implementation of an evidence-based HIT behavioral treatment for cancer patients with elevated depressive symptoms. This HIT treatment combines systematic, electronic health record-integrated screening for depressive symptoms with an individually-tailored HIT interventions to address gaps in the treatment of depression among cancer patients. The study takes place across two distinct health systems in two major metropolitan areas—Chicago and Miami (Northwestern Medicine and University of Miami Health System). We aim to conduct a pragmatic Type I effectiveness-implementation hybrid trial of My Cancer Support—an evidence-based, tailored behavioral HIT program for the management of elevated depressive symptoms—in ambulatory oncology care settings within two large health systems. We will establish the effectiveness of My Cancer Support on depressive symptoms(i.e., primary outcome) and anxiety, HRQoL, and health services use (i.e. secondary outcomes) compared to usual care. We will evaluate the process of implementing My Cancer Support and its impact on patient and system-level outcomes, including reach, adoption, maintenance, and acceptability. Next, we will identify facilitators and barriers to wide-scale implementation of My Cancer Support beyond Northwestern Medicine and University of Miami Health System. Finally, we will explore whether the effects of My Cancer Support vary across SES, language, disease severity, severity of depressive symptoms, recruitment sites, and other patient and clinical characteristics.

抽象的 抑郁症是整个癌症过程中最常见的心理合并症之一，肿瘤患者的抑郁症状升高是一个主要问题，因为抑郁症得不到控制。 癌症患者的症状与健康相关的生活质量 (HRQoL) 较差、依从性较差有关 癌症治疗、延迟返回工作岗位和基线功能、更多的急诊就诊、更多的 自杀风险和更高的全因死亡率是治疗抑郁症的行为干预措施。 这些循证干预措施虽然有效，但可扩展性和实施有限。 健康 解释 捕获 行为的 人口。 信息技术（HIT）提供了探索管理、评分和管理的理想机会 使用经过充分验证的、简短且精确的测量工具进行抑郁症筛查 用于筛查抑郁症的可操作数据，并提供务实且可扩展的基于证据的数据 经证明可以减少其他各种抑郁症状的干预措施 尽管这些 HIT 有很多好处，但使用基于技术的模型来筛选和交付 解决癌症抑郁症状的基于证据的行为治疗仍然存在 不发达且执行不力。 我们 将要 评估一项措施的有效性和实施情况 针对抑郁症状加重的癌症患者的基于证据的 HIT 行为治疗。 治疗结合了系统的、电子健康记录集成的抑郁症状筛查和 个性化定制的 HIT 干预措施可弥补癌症患者抑郁症治疗方面的差距。 该研究在两个主要大都市地区（芝加哥和迈阿密）的两个不同的卫生系统中进行 （西北医学和迈阿密大学卫生系统）我们的目标是进行务实的 I 类研究。 My Cancer Support 的有效性与实施混合试验——基于证据的定制行为 HIT 管理抑郁症状加重的计划——在门诊肿瘤护理机构中 我们将确定“我的癌症支持”对抑郁症的有效性。 症状（即主要结果）和焦虑、HRQoL 和卫生服务使用（即次要结果） 与常规护理相比，我们将评估实施“我的癌症支持”的过程及其对患者的影响。 患者和系统级结果，包括覆盖范围、采用、维护和可接受性。 确定西北大学以外地区大规模实施“我的癌症支持”的促进因素和障碍 最后，我们将探讨“我的癌症”是否有影响。 支持因社会经济地位、语言、疾病严重程度、抑郁症状的严重程度、招募地点和 其他患者和临床特征。