Web-Based Cognitive Behavioral Intervention for Women with Postpartum Depression

针对产后抑郁症女性的基于网络的认知行为干预

• 批准号: 7731872
• 负责人: Brian G. Danaher
• 金额: $ 50.91万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-02 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7731872
• 关键词: Address; Area; Arts; Attitude; Australia; Behavior Therapy; Behavioral; Clinic; Clinical; Cognitive; Data; Development; Educational Intervention; Elements; Family; Feedback; Feeling; Focus Groups; Health Services; Health behavior; Home environment; Infant Development; Information Technology; International; Internet; Intervention; Iowa; Left; Life; Measures; Mental Health; Methods; Mothers; NIH Program Announcements; National Institute of Mental Health; Newborn Infant; Online Systems; Oregon; Participant; Postpartum Depression; Postpartum Period; Postpartum Women; Pregnancy; Process; Protocols documentation; Public Health; Randomized; Relative (related person); Research; Research Institute; Research Personnel; Schedule; Seasons; Source; Stigmata; Structure; Symptoms; Technology; Telephone; Testing; Time; Universities; Woman; Work; austin; base; cognitive behavior therapy; coping; cost; cost efficient; depressed; depression; depressive symptoms; design; efficacy testing; evidence base; follow-up; innovation; intervention program; novel; peer; programs; public health relevance; response; skills; social stigma; success; therapy design; tool; treatment program; uptake; usability; web site

DESCRIPTION (provided by applicant): Background: The postpartum period offers uniquely important public health challenges and opportunities. It is a time that many women find stressful, and unexpected depressive symptoms occur in what would otherwise be a positive time of life. Postpartum depression (PPD) afflicts many women. If left untreated, it has serious consequences for maternal mental health and infant development. Most research in this area has focused on clinic-based PPD treatment programs. But recent evidence for significantly poor uptake of this treatment is related to women's concerns about stigma, limited availability of treatment programs targeted to their needs, program costs, and/or the fact that coping with a newborn makes it impossible to find the time to schedule trips outside of the home. The proposed research is innovative: 1) it tests a new Web-based approach that integrates existing data and treatments; and b) it has the potential to increase uptake of PPD treatment by offering a viable (effective, available) treatment option accessible to a large number of women. The proposed intervention builds on an established record of successfully using a cognitive behavioral intervention (CBT) to treat many types of depression and it extends the rapidly-growing evidence base for Web-based health behavior interventions. Finally, the proposed research brings together a very strong International team (US and Australia) that contributes critically important components to make the project a success. Objectives: We propose to follow appropriate formative steps to develop an interactive, Web-based treatment program targeted to women suffering with PPD and then to perform a feasibility test evaluating its efficacy relative to a control website. Methods: In the proposed study, 100 women with PPD will be randomized (50 women per condition) to one of two Web-based conditions. The cutting-edge Enhanced Intervention Condition offering an online CBT intervention targeted to PPD includes engaging content with interactivity, guided behavioral strategies for a personalized depression treatment, online videos of women who have used the recommended strategies, Web forums (peer and "Ask an Expert"), and periodic phone coaching. The Basic Control Condition will present information about PPD that women could obtain through a typical Google search (e.g., relatively detailed information about PPD including what research-based information says about its sources and treatment). Measures: We propose to measure: a) each Web programs' ameliorating effects on PPD symptoms at a 6-week posttest and a 3-month follow-up; b) how much participants use the program; and c) how well the program is received by women with PPD. Benefits: This proposed research addresses a key theme identified by the NIMH: namely, the impact of Internet-based psycho-educational interventions on health-related problems. And we believe it is vital to NIMH's initiatives on women's mental health in pregnancy and the postpartum. Our proposed research has the potential of developing a viable tool that can reach a large number of postpartum women and can help relieve their immediate and long-term suffering. PUBLIC HEALTH RELEVANCE: Postpartum depression (PPD) afflicts many women and, if left untreated, it has serious consequences for maternal mental health and infant development. Recent evidence shows that significantly poor uptake of clinic-based PPD treatment is related to women's concerns about stigma, limited availability of treatment programs targeted to their needs, program costs, and/or the fact that coping with a newborn makes it impossible to find the time to schedule trips outside of the home. The proposed research will provide a feasibility test of an alternative approach - a Web-based cognitive behavioral PPD treatment - designed to reduce depressive symptoms measured at a 6-week posttest and a 3-month follow-up.

描述（申请人提供）：背景：产后时期提供了独特的重要公共卫生挑战和机遇。这是许多妇女感到压力很大的时候，意外的抑郁症状在本来是积极的生活时期。产后抑郁症（PPD）困扰着许多女性。如果不进行治疗，它对孕产妇的心理健康和婴儿的发展会带来严重影响。该领域的大多数研究都集中在基于诊所的PPD治疗计划上。但是，最近证明这种治疗量较差的证据与妇女对污名的担忧，针对其需求的治疗计划的可用性有限，计划成本和/或应对新生儿的事实有关，这使得无法找到时间安排有时间安排在家外面的旅行。拟议的研究具有创新性：1）它测试了一种基于Web的新方法，该方法集成了现有数据和处理； b）它有可能通过提供可行的（有效，可用的）治疗选择来增加PPD治疗的摄取。拟议的干预措施建立在成功使用认知行为干预（CBT）来治疗多种类型抑郁症的既定记录的基础上，并且扩展了基于Web的健康行为干预措施的快速增长的证据基础。最后，拟议的研究汇集了一个非常强大的国际团队（美国和澳大利亚），该团队贡献了至关重要的组成部分，使该项目取得了成功。目标：我们建议遵循适当的形成步骤，以开发针对患有PPD的女性的互动性，基于网络的治疗计划，然后进行可行性测试，以评估其相对于控制网站的功效。方法：在拟议的研究中，有100名PPD女性将被随机分配给两个基于网络的条件之一。针对PPD的在线CBT干预措施提供的尖端增强干预条件包括与互动性，指导性的行为策略一起进行个性化抑郁症治疗，在线视频，这些女性的在线视频，这些女性使用了推荐策略，网络论坛（PEER和“问专家”）以及定期电话教练。基本的控制条件将介绍有关妇女可以通过典型的Google搜索获得的PPD信息（例如，有关PPD的相对详细信息，包括基于研究的信息对其来源和治疗的说法）。措施：我们建议进行衡量：a）每个Web程序在6周的后测和3个月的随访中对PPD症状的改善影响； b）参与者使用该计划多少； c）PPD女性接受该计划的收益如何。好处：这项拟议的研究介绍了NIMH确定的关键主题：即，基于互联网的心理教育干预措施对与健康相关问题的影响。而且我们认为，NIMH关于怀孕和产后妇女心理健康的举措至关重要。我们拟议的研究具有开发一种可行的工具，该工具可以吸引大量产后妇女，并有助于缓解她们的直接和长期苦难。 公共卫生相关性：产后抑郁症（PPD）困扰着许多妇女，如果不及时治疗，它对孕产妇的心理健康和婴儿发育有重大影响。最近的证据表明，基于诊所的PPD治疗的摄取明显较差与妇女对污名的担忧，针对其需求的治疗计划的可用性有限，计划成本和/或应对新生儿应对新生儿的事实使得无法找到时间安排在家以外的情况。拟议的研究将提供对替代方法的可行性测试 - 一种基于Web的认知行为PPD治疗 - 旨在减少在6周后测试和3个月的随访中测量的抑郁症状。