Telephone IPT Intervention for HIV-Infected Rural Persons

农村艾滋病病毒感染者电话IPT干预

基本信息

批准号：
7853753
负责人：
Timothy Glenn Heckman
金额：
$ 38.84万
依托单位：
OHIO UNIVERSITY ATHENS
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-12-01 至 2013-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7853753
关键词：
AIDS/HIV problem Acquired Immunodeficiency Syndrome Adherence Agriculture Antidepressive Agents Area Cessation of life Client Clinical Trials Code Communication Communities Conflict (Psychology)County Data Data Collection Diagnosis Disease Disputes Divorce Drug abuse Dysthymic Disorder Eligibility Determination Enrollment Epidemic Feeling suicidal Goals Grief reaction HIV Health Professional Individual Intervention Interview Life Linear Models Loneliness Major Depressive Disorder Mental Depression Mental Health Mental disorders Methodology Modeling Nature Occupations Outcome Measure Partial Remission Participant Pattern Perception Persons Pharmaceutical Preparations Psychiatric Social Work Psychotherapy Public Health Randomized Randomized Clinical Trials Recruitment Activity Reporting Research Role Rural Screening procedure Self-Administered Series Services Social support Support Groups Surveys System Technology Telemedicine Telephone Telephone Interviews Testing Therapeutic Time United States Visit Voice active method base clinically significant comparison group depressive symptoms eligible participant expectation experience follow-up health care service organization improved loved ones meetings post intervention primary outcome programs public health relevance response rural area secondary outcome treatment as usual

项目摘要

DESCRIPTION (provided by applicant): Compared to their urban counterparts, HIV-rural persons are more likely to be diagnosed with depression, less likely to seek assistance from mental health professionals, and appear to have shorter periods of survival. This application responds to PA-07-103 ("Research on Rural Mental Health and Drug Abuse Disorders") and the PA's stated need for research that will "Study whether individuals with various mental disorders can be treated effectively via telemedicine." A pilot RCT recently completed by our team showed that a 6-session telephone-delivered, interpersonal psychotherapy (IPT) intervention reduced depressive symptoms in 79 HIV- infected rural persons (Ransom, Heckman, et al., 2008, Psychiatric Services). This follow-up RCT will enroll 180 persons living with HIV/AIDS in rural counties in the United States who are diagnosed with depression via telephone interviews. Participants will complete self-administered surveys at pre-intervention, post- intervention, and 4- and 8-month follow-up that assess depressive symptoms (the primary outcome measure), interpersonal problems, social support, and ART adherence. Participants will also provide weekly data (for 41 weeks) via interactive voice response (IVR) systems that assess depressive symptoms (41 weeks) and therapeutic alliance (9 weeks). Ninety (n=90) participants will be randomly assigned to a 9-session, one-on- one, telephone-delivered, IPT intervention and 90 will be assigned to a usual care comparison group. Linear mixed models (LMM) will test if IPT participants report greater reductions in depressive symptoms compared to usual care controls. Analyses of reliable change will test if a greater proportion of IPT participants report clinically-significant reductions in depressive symptoms compared to usual care controls. Using weekly data collected via IVR systems, time series analyses will test if IPT participants report greater decreases in depressive symptoms over a 41-week follow-up period compared to usual care control. Mixed models analyses will assess the importance of therapeutic alliance in telephone-delivered IPT. Public Health Significance: This study will test if nine sessions of telephone-administered interpersonal psychotherapy can reduce depressive symptoms in HIV-infected rural persons, a group that is increasing in size and that experiences great difficulty accessing mental health support services. PUBLIC HEALTH RELEVANCE: HIV-infected rural persons are 1.3 times more likely than their urban counterparts to be diagnosed with depression. This randomized clinical trial will test if a nine-session, telephone-administered, interpersonal psychotherapy intervention can reduce depressive symptoms in HIV-infected persons living in rural counties of the United States who are diagnosed with depression.

描述（由申请人提供）：与他们的城市同行相比，艾滋病毒农村人士更有可能被诊断出患有抑郁症，不太可能向精神卫生专业人员寻求援助，并且似乎较短的生存期。该申请对PA-07-103（“农村心理健康和药物滥用障碍的研究”）和PA所指出的研究需求将“研究是否可以通过远程医疗有效治疗各种精神疾病的人”。我们的团队最近完成的一名飞行员RCT显示，有6次介绍，人际心理治疗（IPT）干预措施减少了79名HIV感染的农村人士的抑郁症状（Ransom，Heckman等，2008，2008，精神病学）。此后续行动RCT将在美国的农村县招募180名患有艾滋病毒/艾滋病的人，他们通过电话采访被诊断出患有抑郁症。参与者将在干预前，干预后以及4个月和8个月的随访中完成自我管理的调查，以评估抑郁症状（主要的结局指标），人际交往问题，社会支持和艺术依从性。参与者还将通过评估抑郁症状（41周）和治疗联盟（9周）的交互式语音反应（IVR）系统提供每周的数据（41周）。九十（n = 90）参与者将被随机分配给9条，一对一，电话交付，IPT干预和90个分配给通常的护理比较组。线性混合模型（LMM）将测试IPT参与者是否报告与通常的护理对照相比，抑郁症状的减少更大。可靠变化的分析将测试是否有更大比例的IPT参与者报告与常规护理对照相比，抑郁症状的临床降低。使用IVR系统收集的每周数据，时间序列分析将测试IPT参与者在41周的随访期内与通常的护理控制相比，在41周的随访期内，抑郁症状是否更大。混合模型分析将评估在电话传递IPT中治疗联盟的重要性。公共卫生的意义：这项研究将测试9次通过电话管理的人际心理治疗可以减少艾滋病毒感染的农村人群的抑郁症状，该小组的规模越来越大，并且在获得心理健康支持服务方面遇到了很大的困难。公共卫生相关性：艾滋病毒感染的农村人士的可能性是被诊断出患有抑郁症的城市同行的1.3倍。这项随机临床试验将测试是否有9条经验，电话管理，人际心理治疗干预可以减少居住在美国农村县的艾滋病毒感染者的抑郁症状。