Web-Based Cognitive Behavioral Intervention for Women with Postpartum Depression

针对产后抑郁症女性的基于网络的认知行为干预

• 批准号: 8049655
• 负责人: Brian G. Danaher
• 金额: $ 34.84万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-02 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8049655
• 关键词: Address; Area; Attitude; Australia; Behavior Therapy; Behavioral; Clinic; Clinical; Cognitive; Cognitive Therapy; Data; Depressed mood; Development; Educational Intervention; Elements; Family; Feedback; Feeling; Focus Groups; Health; Health Services; Health behavior; Home environment; Infant Development; Information Technology; International; Internet; Intervention; Iowa; Left; Life; Measures; Mental Depression; Mental Health; Methods; Mothers; NIH Program Announcements; National Institute of Mental Health; Newborn Infant; Online Systems; Oregon; Participant; Postpartum Depression; Postpartum Period; Postpartum Women; Pregnancy; Process; Protocols documentation; Public Health; Randomized; Relative (related person); Research; Research Institute; Research Personnel; Schedule; Seasons; Source; Stigmata; Structure; Symptoms; Technology; Telephone; Testing; Time; Universities; Woman; Work; base; coping; cost; depressive symptoms; design; efficacy testing; evidence base; follow-up; innovation; intervention program; novel; peer; programs; public health relevance; response; skills; social stigma; success; therapy design; tool; treatment program; uptake; usability; web site

DESCRIPTION (provided by applicant): Background: The postpartum period offers uniquely important public health challenges and opportunities. It is a time that many women find stressful, and unexpected depressive symptoms occur in what would otherwise be a positive time of life. Postpartum depression (PPD) afflicts many women. If left untreated, it has serious consequences for maternal mental health and infant development. Most research in this area has focused on clinic-based PPD treatment programs. But recent evidence for significantly poor uptake of this treatment is related to women's concerns about stigma, limited availability of treatment programs targeted to their needs, program costs, and/or the fact that coping with a newborn makes it impossible to find the time to schedule trips outside of the home. The proposed research is innovative: 1) it tests a new Web-based approach that integrates existing data and treatments; and b) it has the potential to increase uptake of PPD treatment by offering a viable (effective, available) treatment option accessible to a large number of women. The proposed intervention builds on an established record of successfully using a cognitive behavioral intervention (CBT) to treat many types of depression and it extends the rapidly-growing evidence base for Web-based health behavior interventions. Finally, the proposed research brings together a very strong International team (US and Australia) that contributes critically important components to make the project a success. Objectives: We propose to follow appropriate formative steps to develop an interactive, Web-based treatment program targeted to women suffering with PPD and then to perform a feasibility test evaluating its efficacy relative to a control website. Methods: In the proposed study, 100 women with PPD will be randomized (50 women per condition) to one of two Web-based conditions. The cutting-edge Enhanced Intervention Condition offering an online CBT intervention targeted to PPD includes engaging content with interactivity, guided behavioral strategies for a personalized depression treatment, online videos of women who have used the recommended strategies, Web forums (peer and "Ask an Expert"), and periodic phone coaching. The Basic Control Condition will present information about PPD that women could obtain through a typical Google search (e.g., relatively detailed information about PPD including what research-based information says about its sources and treatment). Measures: We propose to measure: a) each Web programs' ameliorating effects on PPD symptoms at a 6-week posttest and a 3-month follow-up; b) how much participants use the program; and c) how well the program is received by women with PPD. Benefits: This proposed research addresses a key theme identified by the NIMH: namely, the impact of Internet-based psycho-educational interventions on health-related problems. And we believe it is vital to NIMH's initiatives on women's mental health in pregnancy and the postpartum. Our proposed research has the potential of developing a viable tool that can reach a large number of postpartum women and can help relieve their immediate and long-term suffering. PUBLIC HEALTH RELEVANCE: Postpartum depression (PPD) afflicts many women and, if left untreated, it has serious consequences for maternal mental health and infant development. Recent evidence shows that significantly poor uptake of clinic-based PPD treatment is related to women's concerns about stigma, limited availability of treatment programs targeted to their needs, program costs, and/or the fact that coping with a newborn makes it impossible to find the time to schedule trips outside of the home. The proposed research will provide a feasibility test of an alternative approach - a Web-based cognitive behavioral PPD treatment - designed to reduce depressive symptoms measured at a 6-week posttest and a 3-month follow-up.

背景：产后时期提供了独特的重要的公共卫生挑战和机遇。这是一个许多女性感到压力的时期，意想不到的抑郁症状出现在本来是积极的生活时期。产后抑郁症（PPD）折磨着许多女性。如果不及时治疗，它会对产妇的心理健康和婴儿的发育造成严重后果。这一领域的大多数研究都集中在基于临床的PPD治疗方案上。但最近有证据表明，这种治疗的接受程度明显较低，这与妇女对耻辱的担忧、针对其需求的治疗方案的可获得性有限、方案成本和/或应对新生儿使其无法抽出时间安排外出旅行的事实有关。拟议的研究具有创新性：1)它测试了一种新的基于网络的方法，该方法集成了现有的数据和治疗方法；b)通过为大量妇女提供可行的（有效的，可用的）治疗选择，它有可能增加PPD治疗的接受度。提出的干预建立在成功使用认知行为干预（CBT）治疗多种类型抑郁症的既定记录之上，并扩展了基于网络的健康行为干预快速增长的证据基础。最后，拟议的研究汇集了一个非常强大的国际团队（美国和澳大利亚），为项目的成功做出了至关重要的贡献。目的：我们建议采取适当的形成步骤，针对患有产后抑郁症的女性开发一个交互式的、基于网络的治疗方案，然后进行可行性测试，评估其相对于对照网站的疗效。方法：在拟议的研究中，100名患有PPD的妇女将被随机分配（每种情况50名妇女）到两种基于网络的情况之一。尖端的强化干预条件提供针对产后抑郁症的在线CBT干预，包括互动内容，个性化抑郁症治疗的指导行为策略，使用推荐策略的女性的在线视频，网络论坛（同伴和“询问专家”），以及定期电话指导。基本控制条件将提供关于产后抑郁症的信息，女性可以通过典型的谷歌搜索获得这些信息（例如，关于产后抑郁症的相对详细的信息，包括基于研究的信息对其来源和治疗的说明）。测量方法：我们建议测量：a)每个网络项目在6周后测试和3个月随访时对PPD症状的改善效果；B)有多少参与者使用该计划；c)产后抑郁症女性对该项目的接受程度。好处：这项拟议的研究解决了NIMH确定的一个关键主题：即基于互联网的心理教育干预对健康相关问题的影响。我们认为，这对NIMH在怀孕和产后妇女心理健康方面的倡议至关重要。我们提出的研究有潜力开发一种可行的工具，可以达到大量的产后妇女，可以帮助减轻他们的即时和长期的痛苦。