Multisite feasibility of BA-HD: An integrated depression and behavioral risk factor reduction coaching program following acute coronary syndrome

项目摘要 急性冠脉综合征(ACS)是一个紧急的公共卫生问题，导致超过100万人 每年住院治疗。抑郁症破坏了急性冠脉综合征后的最佳康复，通常至少是部分地 通过干预健康行为。ACS后抑郁患者吸烟较多，坚持 与没有服药的急性冠脉综合征患者相比，服药频率更低，体力活动更少，饮食更差 抑郁症。这减少了对推荐的健康行为的遵守，进而恶化了心血管健康 并增加额外发病率和死亡率的风险。我们团队开发了用于健康的行为激活 和抑郁症(BA-HD)，这是一种基于行为激活的干预措施，整合了对 急性冠脉综合征后抑郁和多种健康行为改变。此R34应用程序的主要目标是 在三个不同的地区(东北部、中西部和东南部)试行BA-HD，为后续 全动力多点随机对照疗效试验。具体来说，研究小组将进行一项 BA-HD的多点试点随机对照可行性试验，比较干预和增强的通常情况 CARE(EUC)对照组。这项试验将达到两个目的：第一，我们将审查研究的可行性(例如， 招募、治疗参与、保留)以及研究程序和BA-HD的可接受性 治疗。第二，我们将检验BA-HD对改善(1)抑郁情绪和(2)的初步疗效。 心血管健康通过美国心脏协会的生活简单7总分进行评估。发现 来自拟议的研究都是最终确定研究设计所必需的，为随后的充分 评价BA-HD改善心血管健康和抑郁的疗效的动力性试验

PROJECT ABSTRACT Acute coronary syndrome (ACS) is an urgent public health issue which contributes to over one million hospitalizations annually. Depression undermines optimal recovery following ACS, often at least partially through interference with health behaviors. Post-ACS patients with depression smoke more, adhere to medications less often, are less physically active, and have poorer diet than post-ACS patients without depression. This reduced adherence to recommended health behaviors, in turn, worsens cardiovascular health and increases risk of additional morbidity and mortality. Our team developed Behavioral Activation for Health and Depression (BA-HD) which is a behavioral activation-based intervention that integrates treatment for depression and multiple health behavior change post-ACS. The overarching goal of this R34 application is to pilot BA-HD across three distinct regions (Northeast, Midwest, and Southeast) in preparation for a subsequent fully powered multisite randomized controlled efficacy trial. Specifically, the research team will conduct a multisite pilot randomized controlled feasibility trial of BA-HD comparing the intervention to an Enhanced Usual Care (EUC) control group. This trial will accomplish two aims: First, we will examine study feasibility (e.g., recruitment, treatment engagement, retention) and acceptability of both study procedures and the BA-HD treatment. Second, we will examine the preliminary efficacy of BA-HD to improve (1) depressed mood and (2) cardiovascular health assessed via the American Heart Association’s Life’s Simple 7 Total Score. Findings from the proposed research are necessary to finalize study design in preparation for a subsequent fully powered trial to evaluate the efficacy of BA-HD to improve cardiovascular health and depression