Depression Self-Management and Women with Disabilities

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DESCRIPTION (provided by applicant): Depression is a common secondary condition associated with a primary disability. Disproportionately high among women compared to men, depression appears to be even more prevalent among women with disabilities. Although the risk for depression among all persons with disabilities appears to be higher than that among people in general, women with disabilities may be at even greater risk comparied to their male counterparts, yet the literature fails to report on a therapeutic modality that is responsive to the unique needs of depressed women with functional limitations. The purpose of this project is to develop and test an innovative, targeted, and theory-driven group intervention designed to ameliorate depression in women with physical disabilities. It is hypothesized that (a) women with disabilities who participate in a depression self-management group intervention will report lower levels of depression and higher levels of self- management of depression, self-efficacy, and social connectedness after the intervention and at a three-month follow-up, compared to those who participate in a depression education-only intervention; and, (b) self-management of depression, self-efficacy, and social connectedness will mediate the relation of disability to depression outcomes among women with physical disabilities. This study uses a randomized with-groups and between-groups pre/post-test design with a three-month follow-up. The intervention will be implemented at local public and private chronic care clinics with 154 women with physical disabilities who will randomly be assigned to participate in either the self- management intervention or education-only comparison workshop. The scores of the two groups on measures of self-management of depression, self-efficacy, social connectedness, and depression will be compared. These assessments will be conducted at three time points, before and after the intervention period and at a three-month follow-up. Formative and summative evaluations, using qualitative and quantitative methodologies, will be conducted. This study is designed to be generalizable for clinical practice in physical medicine and rehabilititation, for mental health services for women with disabilities, and for public health policy governing the delivery of mental health services to people with disabilities.