Women Physical Disability and Depression: Communities Responding Now!

身体残疾妇女（WPD）的抑郁和自杀率比一般人群高出5倍。尽管存在这种差异，但针对这一人群具体需求的干预研究很少。为了开始实现《2010年健康人》的目标6-3，并减少出现抑郁症状的无水儿童的比例，迫切需要采取与无水儿童生活相关的干预措施。根据国家优先事项和消费者参与开发心理健康疗法的需要，拟议的项目将使用一种现有的认知行为疗法（CBT）干预措施，这种干预措施在减轻妇女抑郁症状方面已证明有效，以此为起点，共同创建一种干预措施，以解决妇女心理疾病的具体需要。共同创造的过程将在研究人员、社区的WPD和三个俄勒冈独立生活中心（CILs）之间的合作关系中进行。在拟议项目的最后一年，这种伙伴关系将扩大到另外四个俄勒冈州的CILs，目的是制定一个同伴指导的培训师计划，以促进消费者控制并促进干预的可持续性。拟议项目的具体目标是：1。修改现有的认知行为团体治疗干预措施，以满足经历抑郁症状的WPD的特定需求；2. 采用混合方法进行疗效试验。拟议的研究结果来自我们之前与WPD的合作以及残疾人社区的成员。采用等候名单对照设计对改良后的干预措施进行疗效试验，共有135名参与者；和3。制定同伴指导的培训师计划，以促进消费者控制和促进干预的可持续性。拟议项目的一个长期目标是提高全国CILs的能力，以提供相关的、有效的、可获得的和负担得起的干预措施，帮助患有抑郁症的WPD克服这种使人衰弱的继发性疾病。

Rates of depression and suicide in women with physical disabilities (WPD) are up to five times higher than in the general population. Despite this disparity, few intervention studies that address the specific needs of this population are available. To begin to address objective 6-3 of Healthy People 2010 and reduce the proportion of WPD who experience depressive symptoms, interventions relevant to the lives of WPD are urgently needed. In keeping with national priorities and the need for consumer participation in the development of mental health therapies, the proposed project will use an existing cognitive behavioral therapy (CBT) intervention that has demonstrated effectiveness in reducing depressive symptoms in women as a starting point from which to co-create an intervention that addresses the specific needs of WPD. The co-creation process will occur in the context of a partnership between the investigators, WPD in the community, and three Oregon Centers for Independent Living (CILs). This partnership will be expanded to include four additional Oregon CILs during the last year of the proposed project for the purpose of developing a peer mentored train-the-trainer program that will facilitate consumer control and promote the sustainability of the intervention. The specific aims of the proposed project are to: 1. Modify an existing cognitive behavioral group therapy intervention to address the specific needs of WPD who experience depressive symptoms; 2. Conduct an efficacy trial using a mixed-methods approach. The proposed study outcomes were derived from our previous work with WPD as well as from members of the disability community. An efficacy trial of the modified intervention with a total of 135 participants will be conducted using a wait list control design; and 3. Develop a peer mentored train-the-trainer program to facilitate consumer control and promote the sustainability of the intervention. A long-term goal of the proposed project is to increase the capacity of CILs across the country to offer a relevant, effective, accessible, and affordable intervention to help WPD with depression overcome this debilitating secondary condition.