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: 7884576
• 负责人: Brian G. Danaher
• 金额: $ 48.26万
• 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/7884576
• 关键词: Address; Area; Arts; Attitude; Australia; Behavior Therapy; Behavioral; Clinic; Clinical; Cognitive; Cognitive Therapy; Data; Depressed mood; 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 Depression; 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; coping; cost; cost efficient; 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（由申请人提供）：背景：产后时期提供了独特的重要公共卫生挑战和机遇。这是一个时间，许多妇女发现压力，意想不到的抑郁症状发生在什么，否则将是一个积极的生活时间。产后抑郁症（PPD）困扰着许多女性。如果不加以治疗，它会对产妇的心理健康和婴儿的发育造成严重后果。这一领域的大多数研究都集中在基于临床的PPD治疗方案上。但最近的证据表明，这种治疗的显著不良吸收与妇女对耻辱的担忧有关，针对其需求的治疗计划有限，计划成本和/或应对新生儿使其无法找到时间安排家庭外的旅行。拟议的研究是创新的：1）它测试了一种新的基于网络的方法，整合了现有的数据和治疗方法;和B）它有可能通过提供一个可行的（有效的，可用的）治疗选择，增加PPD治疗的吸收大量的妇女。拟议的干预措施建立在成功使用认知行为干预（CBT）治疗多种类型抑郁症的既定记录的基础上，它扩展了基于网络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），为项目的成功提供了至关重要的组成部分。目的：我们建议遵循适当的形成步骤，开发一个互动的，基于网络的治疗计划，针对患有PPD的妇女，然后进行可行性测试，评估其相对于对照网站的疗效。方法：在拟议的研究中，100名患有PPD的妇女将被随机分配（每种情况50名妇女）到两个基于网络的条件之一。尖端的增强干预条件提供针对PPD的在线CBT干预，包括具有互动性的参与内容，个性化抑郁症治疗的指导行为策略，使用推荐策略的女性的在线视频，网络论坛（同行和“询问专家”），以及定期电话辅导。基本控制条件将提供有关PPD的信息，女性可以通过典型的谷歌搜索获得（例如，关于PPD的相对详细的信息，包括关于其来源和治疗的基于研究的信息）。措施：我们建议衡量：a）在6周后测和3个月随访时，每个网络程序对PPD症状的改善效果; B）参与者使用该程序的程度;以及c）患有PPD的女性对该程序的接受程度。优点：这项拟议的研究解决了NIMH确定的一个关键主题：即基于互联网的心理教育干预措施对健康相关问题的影响。我们相信这对NIMH关于妇女怀孕和产后心理健康的倡议至关重要。我们提出的研究有可能开发出一种可行的工具，可以接触到大量的产后妇女，并有助于减轻她们的直接和长期痛苦。 公共卫生关系：产后抑郁症（PPD）困扰着许多妇女，如果不加以治疗，它会对产妇的心理健康和婴儿的发育产生严重的后果。最近的证据表明，显着不良的摄取基于诊所的PPD治疗与妇女的关注耻辱，有限的可用性针对他们的需要，计划成本的治疗方案，和/或事实，即处理新生儿使它不可能找到时间来安排家庭以外的旅行。这项拟议的研究将提供一种替代方法的可行性测试-基于网络的认知行为PPD治疗-旨在减少6周后测试和3个月随访时测量的抑郁症状。