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Adapted Tele-Behavioral Activation Targeted to Increase Physical Activity in Depression

适应远程行为激活旨在增加抑郁症患者的体力活动

基本信息

批准号：
10194067
负责人：
MADHUKAR H. TRIVEDI
金额：
$ 24.58万
依托单位：
UT SOUTHWESTERN MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-06-23 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10194067
关键词：
Address Adherence Anhedonia Behavior Behavioral COVID-19 pandemic Clinic Clinical Communities Control Groups Data Depressed mood Depressive disorder Disease remission Dissemination and Implementation Distal Evaluation Evidence based intervention Exercise Fatigue Feeling hopeless Fitness Centers Focus Groups Goals Grant Health Services Accessibility Health behavior Home Individual Insurance Intervention Interview Knowledge Logistics Maintenance Measurement Measures Mediator of activation protein Medical Mental Depression Methods Modality Morbidity - disease rate Outcome Participant Patients Persons Physical activity Pilot Projects Population Positioning Attribute Primary Health Care Problem Solving Process Psychotherapy Public Health Quality of life Randomized Recreation Research Research Domain Criteria Resources Safety Sampling Structure Surveys Symptoms Telephone Teletherapy Testing Thinking Time Transportation Treatment Efficacy Treatment outcome Withdrawal Work acceptability and feasibility barrier to care base brief intervention care delivery clinical practice comorbidity control trial cost depressive symptoms disability disorder later incidence prevention effectiveness evaluation efficacy evaluation exercise intervention exercise program experience fitbit hybrid type 1 design implementation science improved interest low socioeconomic status mortality multidisciplinary physical conditioning primary care setting recruit research study rural area screening sedentary service delivery stem successful intervention telehealth uptake virtual delivery

项目摘要

Project Summary There is a fundamental gap in delivery of evidence-based interventions to improve the promotion of physical activity in individuals with depression. Despite its proven efficacy in randomized control trials, exercise (i.e., increasing physical activity) is rarely used as a treatment for depressive disorders in real-world clinical settings. Our proposed intervention addresses shortcomings in previous research by developing a briefer intervention and delivering the intervention via teletherapy, both of which aim to reduce barriers to intervention adherence. The long-term goal is to improve treatment outcomes and physical health of persons with depression through increasing physical activity. The overall objective of this project is to conduct a pilot study of an adapted Behavioral Activation intervention that aims to improve depression treatment outcomes by specifically targeting physical activity. The central hypothesis is that such an intervention can be developed for depressed individuals and is feasible to deliver through teletherapy. In order to fill the gap in knowledge and unmet need, we will pursue the following two specific aims: 1) Refine and evaluate an existing, manualized behavioral activation intervention that specifically targets physical activity-based activities by gathering focus group and semi-structured interviews and exit surveys from participants, partial-completers and non-initiators and 2) Determine the feasibility and acceptability of intervention delivery and conduct a preliminary analysis of intervention efficacy by measuring recruitment and retention, intervention adherence, and evaluating changes in depressive symptoms and physical activity as distal and proximal intervention outcomes, respectively. We also evaluate the intervention’s mechanism of action using RDoC-based criteria and include an exploratory aim, analyzing minimum number of completed therapy sessions needed to achieve depression remission. Successful completion of the proposed study aims move the field forward by providing empirical evidence for shortening established Behavioral Activation interventions and demonstrating feasibility of recruitment from and intervention delivery to patients referred from real-world clinical practice, thus expanding the intervention’s reach and impact and informing scalability. This project also informs subsequent R01 grants to (a) conduct a randomized control trial with the refined intervention against a control group and (b) a subsequent project testing implementation science principles – i.e. multiple kinds of interventionists (unlicensed versus licensed master’s level), settings (interventionist at home versus embedded in primary care) and delivery platforms (video versus telephone) – so as to create a scalable and sustainable intervention embedded in existing reimbursable service delivery mechanisms. The current project has the potential to increase care access for patients, especially those with low SES or in rural areas, provide a safe mechanism of intervention delivery during the COVID-19 pandemic, and improve depression treatment outcomes through physical activity in populations for whom its adherence is especially important but also especially challenging.

项目总结