Development and testing of a behavioral activation mobile therapy for elevated depressive symptoms

针对抑郁症状加重的行为激活移动疗法的开发和测试

• 批准号: 8979241
• 负责人: JULIA W FELTON
• 金额: $ 22.46万
• 依托单位: MOUNTAINPASS TECHNOLOGY, LLC
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8979241
• 关键词: Address; Adherence; Adult; Antidepressive Agents; Area; Beck depression inventory; Behavioral; Car Phone; Cognitive Therapy; Conflict (Psychology); Data; Development; Effectiveness; Evidence based intervention; Evidence based treatment; Funding; Funding Mechanisms; Future; Goals; Health Care Costs; Impairment; Individual; Intervention; Life; Light; Major Depressive Disorder; Marketing; Measures; Mental Depression; Monitor; Outcome; Participant; Patients; Pharmaceutical Preparations; Phase; Physicians; Population; Positioning Attribute; Primary Care Physician; Primary Health Care; Public Health; Randomized; Randomized Clinical Trials; Reporting; Research; Resources; Risk; Small Business Technology Transfer Research; Symptoms; Technology; Testing; Training; Work; base; behavioral study; clinical practice; cost; depressed patient; depressive symptoms; evidence base; experience; meetings; mobile application; mortality; phase 2 study; product development; public health relevance; research clinical testing; research study; subthreshold depression; tool

 DESCRIPTION (provided by applicant): Approximately 20-40% of the population experiences elevated depressive symptoms (Kubik et al., 2003). Despite recent research suggesting that overall population mortality would be reduced by 6.5% if the effects of subthreshold depression could be blocked completely, the majority of individuals with elevated depressive symptoms never receive evidence-based treatment (Cuijpers et al., 2013). Elevated depressive symptoms are most frequently reported to primary care physicians (PCPs; Mitchell et al., 2009), who lack evidence-based resources for the treatment of subthreshold depression. This lack of evidence-based resources leads to a number of negative outcomes for patients including: 1) the majority not receiving appropriate treatment (Kessler et al., 2005), 2) a decreased likelihood of reporting depressive symptoms again in the future (Bell et al., 2011), and 3) heightened mortality risk (Cuijpers et al., 2004). As the most likely initial contact for patients with elevated depressive symptoms, PCPs are in a unique position to provide evidence-based interventions (McDowell et al., 2011). In light of factors that deter use of evidence-based strategies by PCPs, including the necessity of additional training to support implementation and/or excessive costs to patients, mobile technologies such as mobile apps offer an ideal strategy to meet widespread treatment needs. However, there are currently no mobile apps for depressive symptoms available to PCPs that are both evidence-based and straightforward enough to be recommended to their patients. One treatment for elevated depressive symptoms that is particularly amenable to a mobile platform and could easily be recommended by PCPs is brief Behavioral Activation (brief BA; Lejuez et al., 2011). Across studies, brief BA has demonstrated effectiveness for reducing depressive symptoms among individuals with elevated depressive symptoms (Gawrysiak et al., 2009; Hopko et al., 2003; Reynolds et al., 2011). Despite this clear fit between brief BA, mobile platforms, and PCPs, such a tool has yet to be developed. The purpose of the proposed project is to customize BA for a mobile platform by creating a BA mobile application (Behavioral Apptivation) to be marketed to individuals with elevated depressive symptoms through their PCPs in order to address the currently unmet needs of PCPs and their patients with elevated depressive symptoms. We expect that via product development, acceptability and feasibility testing, and refinement consistent with the STTR Phase I funding mechanism, we will create a marketable product for which we will pursue larger scale clinical testing in an STTR Phase II study.

 描述（由申请人提供）：大约20-40%的人群经历升高的抑郁症状（Kubik等人，2003年）。尽管最近的研究表明，如果阈下抑郁症的影响可以被完全阻断，则总体人群死亡率将降低6.5%，但大多数抑郁症状升高的个体从未接受循证治疗（Cuijpers等人，2013年）。最常向初级保健医生报告的抑郁症状升高（PCP; Mitchell等人，2009年），缺乏用于治疗阈下抑郁症的循证资源。这种缺乏循证资源导致患者的许多负面结果，包括：1）大多数人没有接受适当的治疗（Kessler等人，2005），2）未来再次报告抑郁症状的可能性降低（Bell等人，2011），以及3）死亡风险升高（Cuijpers等人，2004年）。作为抑郁症状加重患者最有可能的初始接触者，PCP处于提供循证干预的独特地位（McDowell等人，2011年）。考虑到阻碍PCP使用循证策略的因素，包括需要额外培训以支持实施和/或患者成本过高，移动的技术（如移动的应用程序）提供了满足广泛治疗需求的理想策略。然而，目前还没有移动的应用程序可用于PCP的抑郁症状，这些应用程序既基于证据又足够简单，可以推荐给他们的患者。一种特别适合于移动的平台并且可以容易地被PCP推荐的针对升高的抑郁症状的治疗是简短的行为激活（brief Behavioral Activation）（简短的BA; Lejuez等人，2011年）。在所有研究中，简短的BA已经证明了在具有升高的抑郁症状的个体中减少抑郁症状的有效性（Gawrysiak等人，2009; Hopko等人，2003; Reynolds等人，2011年）。尽管在简短的BA、移动的平台和PCP之间存在这种明显的匹配，但这样的工具还有待开发。拟议项目的目的是通过创建BA移动的应用程序（行为应用程序），为移动的平台定制BA，通过其PCP向抑郁症状加重的个人销售，以解决PCP及其抑郁症状加重的患者目前未满足的需求。我们预计，通过产品开发、可接受性和可行性测试以及与STTR I期资助机制一致的改进，我们将创造一种可销售的产品，我们将在STTR II期研究中进行更大规模的临床测试。