Mediators of Intervention Effects on Depressive Symptoms Among People Living With HIV: Secondary Analysis of a Mobile Health Randomized Controlled Trial Using Latent Growth Curve Modeling
Mediators of Intervention Effects on Depressive Symptoms Among People Living With HIV: Secondary Analysis of a Mobile Health Randomized Controlled Trial Using Latent Growth Curve Modeling
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HIV 感染者抑郁症状干预效果的中介因素：使用潜在生长曲线模型对移动健康随机对照试验进行二次分析
DOI：
10.2196/15489
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发表时间：
2019-11
影响因子：
5
通讯作者：
Liu C
中科院分区：
文献类型：
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作者：
Zhu M;Guo Y;Li Y;Zeng C;Qiao J;Xu Z;Zhang H;Zeng Y;Cai W;Li L;Liu C
背景虽然有几项研究调查了移动的健康（mHealth）干预措施对艾滋病毒感染者抑郁症的影响，但很少有研究探讨基于mHealth的干预措施的中介，以改善艾滋病毒感染者的心理健康。确定有影响力的调解人可以加强和完善移动健康干预措施的有效组成部分，以改善艾滋病毒感染者的心理健康。目的本研究旨在使用4个时间点的测量数据来检查移动健康干预效果的中介因素，Run 4Love，旨在减少艾滋病毒感染者的抑郁症。方法本研究使用的数据来自一项随机对照试验，该试验在中国广州的HIV感染者中进行了mHealth干预，并伴有抑郁症状。共有300名患者通过计算机生成的区组随机分配接受mHealth干预（n=150）或等待列表对照组（n=150）。在基线、3个月、6个月和9个月随访时测量抑郁症状、应对方式和艾滋病毒相关耻辱感。采用潜伏生长曲线模型考察干预对抑郁症状的影响。使用偏倚校正的95%自举CI（BCI）估计介导效应，其中resolution为5000。结果积极应对的增强和艾滋病相关污名的减少是移动健康干预的有效治疗中介。特别是，通过积极应对的斜率，移动健康干预对抑郁症状的斜率有显著的间接影响（β =-2.86; 95%BCI-4.78至-0.94）。通过艾滋病毒相关污名的斜率，移动健康干预对抑郁症状斜率的间接影响也具有统计学意义（β =-1.71; 95%BCI-3.03至-0.40）。这些研究结果表明，积极应对的增强和艾滋病毒相关的耻辱感的减少是重要的中介因素的mHealth干预，减少艾滋病毒感染者的抑郁症。结论本研究采用潜伏生长曲线模型和4个时间点的纵向测量数据，揭示了移动健康干预降低HIV感染者抑郁的潜在介质。研究结果强调了在移动健康干预措施中提高积极应对技能和减轻艾滋病毒相关污名的重要性，以减少艾滋病毒感染者的抑郁症。
Background Although several studies have investigated the effects of mobile health (mHealth) interventions on depression among people living with HIV, few studies have explored mediators of mHealth-based interventions to improve mental health in people living with HIV. Identifying influential mediators may enhance and refine effective components of mHealth interventions to improve mental health of people living with HIV. Objective This study aimed to examine mediating factors of the effects of a mHealth intervention, Run4Love, designed to reduce depression among people living with HIV using 4 time-point measurement data. Methods This study used data from a randomized controlled trial of a mHealth intervention among people living with HIV with elevated depressive symptoms in Guangzhou, China. A total of 300 patients were assigned to receive either the mHealth intervention (n=150) or a waitlist control group (n=150) through computer-generated block randomization. Depressive symptoms, coping, and HIV-related stigma were measured at baseline, 3-, 6-, and 9-month follow-ups. The latent growth curve model was used to examine the effects of the intervention on depressive symptoms via potential mediators. Mediating effects were estimated using bias-corrected 95% bootstrapped CIs (BCIs) with resampling of 5000. Results Enhanced positive coping and reduced HIV-related stigma served as effective treatment mediators in the mHealth intervention. Specially, there was a significant indirect effect of the mHealth intervention on the slope of depressive symptoms via the slope of positive coping (beta=–2.86; 95% BCI –4.78 to –0.94). The indirect effect of the mHealth intervention on the slope of depressive symptoms via the slope of HIV-related stigma was also statistically significant (beta=–1.71; 95% BCI –3.03 to –0.40). These findings indicated that enhancement of positive coping and reduction of HIV-related stigma were important mediating factors of the mHealth intervention in reducing depression among people living with HIV. Conclusions This study revealed the underlying mediators of a mHealth intervention to reduce depression among people living with HIV using latent growth curve model and 4 time-point longitudinal measurement data. The study results underscored the importance of improving positive coping skills and mitigating HIV-related stigma in mHealth interventions to reduce depression among people living with HIV.
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影响因子：
3.6
作者：
Price M;Yuen EK;Goetter EM;Herbert JD;Forman EM;Acierno R;Ruggiero KJ
通讯作者：
Ruggiero KJ
影响因子：
2
作者：
R. Dmochowski
通讯作者：
R. Dmochowski
DOI：
10.1016/j.respe.2020.09.004
发表时间：
2020-10-10
期刊：
Revue D'Epidemiologie et De Sante Publique
影响因子：
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作者：
La rédaction
通讯作者：
La rédaction
影响因子：
9.3
作者：
通讯作者：
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