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：产后期提供了独特重要的公共卫生挑战和机遇。这是许多女性感到压力很大的时期，在原本是生活的积极时期却出现了意想不到的抑郁症状。产后抑郁症（PPD）困扰着许多女性。如果不及时治疗，会对孕产妇心理健康和婴儿发育造成严重后果。该领域的大多数研究都集中在基于临床的 PPD 治疗计划。但最近的证据表明，这种治疗的接受率明显较差，这与女性对耻辱感的担忧、针对其需求的治疗方案的有限性、方案成本和/或因应对新生儿而无法抽出时间安排外出旅行的事实有关。拟议的研究具有创新性：1）它测试了一种新的基于网络的方法，该方法集成了现有的数据和治疗方法； b) 通过为大量女性提供可行（有效、可用）的治疗选择，有可能提高 PPD 治疗的采用率。拟议的干预措施建立在使用认知行为干预 (CBT) 治疗多种类型抑郁症的成功记录的基础上，并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），他们为项目的成功贡献了至关重要的组成部分。目标：我们建议遵循适当的形成步骤，开发一个针对患有产后抑郁症的女性的交互式、基于网络的治疗计划，然后进行可行性测试，评估其相对于对照网站的功效。方法：在拟议的研究中，100 名患有 PPD 的女性将被随机分配到两种基于网络的病症之一（每种病症 50 名女性）。尖端的增强干预条件提供针对产后抑郁症的在线 CBT 干预，包括具有互动性的内容、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“咨询专家”）以及定期电话辅导。基本控制条件将提供有关产后抑郁症的信息，女性可以通过典型的谷歌搜索获得这些信息（例如，关于产后抑郁症的相对详细的信息，包括基于研究的信息说明其来源和治疗）。措施：我们建议测量：a) 在 6 周后测试和 3 个月随访中，每个网络程序对 PPD 症状的改善效果； b) 有多少参与者使用该程序； c) 患有产后抑郁症的女性对该计划的接受程度如何。好处：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。我们相信这对于 NIMH 针对女性孕期和产后心理健康的举措至关重要。我们提出的研究有可能开发出一种可行的工具，可以惠及大量产后妇女，并帮助减轻她们眼前和长期的痛苦。 公共卫生相关性：产后抑郁症 (PPD) 困扰着许多女性，如果不及时治疗，会对孕产妇心理健康和婴儿发育造成严重后果。最近的证据表明，基于临床的 PPD 治疗的接受率显着下降，这与女性对耻辱感的担忧、针对其需求的治疗方案的可用性有限、方案成本和/或因应对新生儿而无法抽出时间安排外出旅行这一事实有关。拟议的研究将对另一种方法（基于网络的认知行为 PPD 治疗）进行可行性测试，旨在减少 6 周后测试和 3 个月随访中测量到的抑郁症状。