Women Physical Disability and Depression: Communities Responding Now!

身体残疾妇女的抑郁症和自杀率比一般人口高出五倍。 尽管存在这种差异，但很少有针对这一人群具体需求的干预研究。 为了开始实现《2010年健康人》目标6-3，减少出现抑郁症状的妇女残疾人比例，迫切需要采取与妇女残疾人生活相关的干预措施。 为了与国家优先事项和消费者参与精神健康疗法开发的需要保持一致，拟议项目将使用现有的认知行为疗法（CBT）干预措施，该干预措施已被证明在减少女性抑郁症状方面有效，作为共同创建干预措施的起点，以解决WPD的具体需求。共同创造的过程将发生在调查人员，WPD在社区和三个俄勒冈州中心的独立生活（CILs）之间的伙伴关系的背景下。 在拟议项目的最后一年，这一伙伴关系将扩大到包括另外四个俄勒冈州CIL，目的是制定一个同行指导的培训师培训计划，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.使用混合方法进行有效性试验。 拟议的研究成果来自我们以前与WPD的工作以及残疾社区的成员。 将使用等待列表对照设计对总共135名参与者进行改良干预的有效性试验;以及3. 制定一个同行指导的培训员培训计划，以促进消费者控制和促进干预的可持续性。 拟议项目的长期目标是提高全国CIL的能力，提供相关，有效，可获得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.