1/2 - Online Collaborative Learning Intervention to Prevent Perinatal Depression

1/2 - 预防围产期抑郁症的在线协作学习干预

• 批准号: 8619545
• 负责人: Jennifer L Duffecy
• 金额: $ 30.9万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-12-16 至 2014-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8619545
• 关键词: Accountability; Accounting; Adherence; Aftercare; Behavior Therapy; Breast Feeding; Childbirth; Clinical Research; Clinical Trials; Clinical assessments; Cognitive; Control Groups; Cost Analysis; Depressed mood; Development; Distress; Educational Curriculum; Educational process of instructing; Electronic Mail; Ethnic Origin; Funding; General Population; Goals; Health; Human; Impairment; Incidence; Individual; Infant Care; Infant Development; Internet; Intervention; Iowa; Lead; Learning; Life; Major Depressive Disorder; Manuscripts; Medicine; Mental Depression; Mental Health Services; Meta-Analysis; Modeling; Monitor; Moods; Online Systems; Outcome; Parenting behavior; Participant; Patients; Perinatal; Personal Satisfaction; Persons; Pharmaceutical Preparations; Population; Postpartum Depression; Postpartum Period; Postpartum Women; Pregnancy; Preventive; Preventive Intervention; Process; Protocols documentation; Publications; Quality of life; Race; Randomized; Randomized Controlled Trials; Recruitment Activity; Relative (related person); Research; Risk; Rural; Sample Size; Sampling; Self Management; Services; Site; Stress; Support Groups; Technology; Teleconferences; Telemedicine; Telephone; Testing; Time; Training Programs; Training and Infrastructure; Universities; Woman; base; caregiving; cost; cost effective; daily functioning; data management; depression prevention; depressive symptoms; design; design and construction; eHealth; effective intervention; effective therapy; emotional distress; flexibility; improved; innovation; meetings; novel; payment; peer; pilot trial; pregnant; prevent; programs; prototype; psychologic; public health relevance; secondary outcome; skill acquisition; skills; skills training; symposium; theories; tool; treatment site; usability

Postpartum major depression (PPMD) is common, occurring in approximately 7% of women in the first three months after childbirth. PPMD can have a profound impact for the woman, decreasing quality of life, increasing emotional distress and reducing caregiving capacity, and can increase the risk of disturbances in infant development. A growing number of studies have shown that psychological treatments are effective at reducing the incidence of PPMD. In addition, women overwhelmingly prefer psychological treatment to medication while pregnant or breast feeding. However, numerous barriers exist that prevent women from accessing face-to-face services. The Internet offers great potential in extending preventive services to women in the perinatal period. While such interventions have not been investigated in this population, two broad classes of internet interventions have been evaluated. Individual Internet Interventions (IIIs), which provide patients with access to web-based self- management skills training programs, have been shown to be effective in reducing depression in general populations, particularly when accompanied by some human support via email or telephone coaching. Internet Support Groups (ISGs) appear to be commonly used by women in the perinatal period. However, randomized controlled trials have found them ineffective at reducing depression. Theories on the use of accountability to improve adherence and the application of online collaborative learning to enhance skill acquisition suggest that a careful integration of III and ISG could have a synergistic effect in improving both adherence and outcomes in online treatments to prevent depression. Thus, use of networked peers to enhance adherence and outcomes, instead of therapists or coaches, would make this intervention highly scalable. We have designed, constructed, and piloted a prototype of an online intervention, which we call "Share"that functionally integrates an III and an ISG targeting skills to manage mood and prevent depression. Shared goal setting and supportive monitoring by networked peers is designed to increase adherence to the program. Shared learning tools are designed to enhance learning through group learning processes. Based on promising results in a pilot, we are proposing an RCT to evaluate Share. Women in weeks 20-28 of their pregnancy will be randomized to receive either Share or an III that will serve as a minimal treatment control. Share has the potential to provide a novel paradigm for the prevention of depression, one that is accessible, highly scalable and cost- effective.

产后重度抑郁症 (PPMD) 很常见，大约 7% 的女性在产后前三个月会出现这种情况 产后几个月。 PPMD 会对女性产生深远的影响，降低生活质量，增加 情绪困扰并降低护理能力，并可能增加婴儿受到干扰的风险 发展。越来越多的研究表明，心理治疗可以有效减少 PPMD 的发生率。此外，绝大多数女性更喜欢心理治疗而不是药物治疗 怀孕或哺乳。然而，存在许多障碍阻碍女性面对面接触 服务。 互联网在向围产期妇女提供预防服务方面具有巨大潜力。虽然这样 尚未对这一人群进行干预调查，已研究了两大类互联网干预措施 评价。个人互联网干预 (III)，为患者提供基于网络的自我干预 管理技能培训计划已被证明可以有效减少总体抑郁症 人群，特别是在通过电子邮件或电话指导提供一些人工支持的情况下。互联网 支持小组 (ISG) 似乎是围产期妇女常用的形式。然而，随机 对照试验发现它们对减少抑郁症无效。关于运用问责制的理论 提高依从性和应用在线协作学习来增强技能获取表明 III 和 ISG 的仔细整合可以在改善依从性和结果方面产生协同效应 预防抑郁症的在线治疗。因此，利用网络同伴来提高依从性和结果， 而不是治疗师或教练，将使这种干预具有高度可扩展性。 我们设计、构建并试点了一个在线干预的原型，我们称之为“分享” 在功能上整合了 III 和 ISG 目标技能来管理情绪和预防抑郁。共同目标 由联网同行进行设置和支持性监督旨在提高对该计划的遵守程度。共享 学习工具旨在通过小组学习过程加强学习。基于有希望的结果 作为试点，我们建议进行随机对照试验来评估份额。怀孕第 20 至 28 周的女性将 随机接受 Share 或 III，作为最低限度的治疗对照。分享有潜力 提供一种预防抑郁症的新范例，一种易于使用、高度可扩展且成本低廉的范例 有效的。