Primary Care Internet-Based Depression Prevention for Adolescents (CATCH-IT)

基于互联网的青少年初级保健抑郁症预防 (CATCH-IT)

基本信息

批准号：
8040833
负责人：
TRACY G GLADSTONE
金额：
$ 8.49万
依托单位：
UNIVERSITY OF CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-01-15 至 2011-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8040833
关键词：
Address Adherence Adolescent Adult Adverse event Age Alcohol consumption Anxiety Attention Award Behavioral Chicago Child Clinical Trials Cognition Cognitive Control Groups Coping Skills Depressed mood Diagnosis Disease Education Educational Intervention Effectiveness of Interventions Ethnic Origin Exhibits Family Foundations Future Generations Goals Grant Growth Guidelines Health system Healthcare Impairment Incidence Individual Intake Internet Intervention Learning Life Manuals Measures Mediating Mediator of activation protein Mental Depression Mental Health Mental disorders Modeling Monitor Morbidity - disease rate Motivation Music National Institute of Mental Health Outcome Parents Participant Phase Phase II Clinical Trials Physicians Population Prevention Prevention strategy Preventive Preventive Intervention Primary Care Physician Primary Health Care Provider Psychopathology Psychotherapy Public Health Quality of life Randomized Randomized Clinical Trials Recruitment Activity Reporting Research Personnel Risk Role Sampling Screening procedure Sensitivity and Specificity Site Social support Specific qualifier value Symptoms Training Universities Video Games Work Youth aged arm base brief advice college community setting cost cost effective depressive symptoms efficacy testing ethnic minority population follow-up functional outcomes hazard health related quality of life high risk improved innovation intervention program meetings mental disorder prevention mortality motivational enhancement therapy new technology preempt prevent primary care setting programs psychoeducation response single episode major depressive disorder

项目摘要

DESCRIPTION (provided by applicant): Developing new interventions that incorporate the "diverse needs and circumstances of people with mental illness," particularly in primary care and community settings, is a key NIMH strategic objective. Prevention of mental disorders has become a priority for the NIMH, which emphasizes the importance of developing "new and better interventions" to "...preempt the occurrence of disease." These interventions must (1) work in multiple and diverse settings (e.g. primary care); (2) be suitable for delivery outside of traditional mental health systems (3) use new technologies; (4) build on previous clinical trials; (5) reduce identified disorders/enhance functional outcomes; (6) include families and (7) be tailored to the individual. Despite these NIMH guidelines, while primary care physicians remain the first line providers for at-risk adolescents, there is no widely available, low cost and culturally acceptable preventive approach that targets depression in primary care settings. To address this gap and specified NIMH priority, Dr. Van Voorhees developed and conducted a phase 2 clinical trial of a primary care Internet-based depression prevention intervention (CATCH-IT, Competent Adulthood Transition with Cognitive Behavioral Humanistic and Interpersonal Training). In this study, the high intensity arm (i.e., motivational interview + internet site) demonstrated significant reductions in depressed mood and increases in protective factors (social support, motivation) and lower incidence of depressive episodes over 12 months (7% versus 28%), compared to the low intensity arm (internet site referral + only physician brief advice). We now propose the next step study, a phase 3 efficacy study. In this 5-year, two-site randomized clinical trial, we propose to test the efficacy of the CATCH-IT primary care/Internet based depression prevention intervention against Attention Monitoring Psychoeducation (AMPE) in preventing the onset of depressive episodes in an intermediate to high risk group of adolescents aged 13-17. We plan to (a) identify high risk adolescents based on elevated scores on the PHQ-A, a screening measure of depressive symptoms; (b) recruit 400 (200 per site) of these at-risk adolescents to be randomized into either the CATCH-IT or the AMPE group; (c) assess outcomes at 2, 8, 12, 18, and 24 months post intake on measures of depressive symptoms, depressive diagnoses, other mental disorders, and on measures of role impairment in education, quality of life, attainment of educational milestones, and family functioning; and (d) conduct exploratory analyses to examine the effectiveness of this intervention program, moderators of protection, and potential ethnic and cultural differences in intervention response. PUBLIC HEALTH RELEVANCE: This a randomized clinical trial to determine if a primary care internet-based depression prevention intervention (CATCH-IT 2R) can build resiliency and protect adolescents (ages 13-17) against depression and strengthen their ability to attain their life goals. The intervention includes a motivational interview with the adolescent's primary care physician and learning coping skills through stories, videos and games on-line. Adolescents, who will be randomly assigned to the intervention or an education control groups, will be evaluated for progress over two years.

描述（由申请人提供）：开发新的干预措施，这些干预措施纳入了“精神疾病患者的各种需求和情况”，尤其是在初级保健和社区环境中，是NIMH的关键战略目标。预防精神障碍已成为NIMH的优先事项，该NIMH强调了发展“新，更好的干预措施”对“ ...抢占疾病发生”的重要性。这些干预措施必须（1）在多种和多样化的环境（例如初级保健）中工作；（2）适合在传统心理卫生系统之外交付（3）使用新技术；（4）基于先前的临床试验；（5）减少已识别的疾病/增强功能结果；（6）包括家庭，（7）为个人量身定制。尽管有这些NIMH指南，但初级保健医师仍然是高危青少年的第一线提供者，但没有广泛可用的，低成本和具有文化上可接受的预防方法可以针对初级保健环境中的抑郁症。为了解决这一差距并指定了NIMH的优先级，范·沃希斯（Van Voorhees）博士开发了基于互联网的抑郁症预防干预措施（通过认知行为人文和人际关系培训）的基于互联网的抑郁症预防干预（Catch-IT，胜任的成年过渡）进行了2期临床试验。在这项研究中，与低强度（7％对28％vs 28％）相比，高强度臂（即动机访谈 +互联网站点）表明，情绪抑郁症和保护因素（社会支持，动机）和抑郁发作发作的发病率的增加显着减少，与低强度组（Internet Site Site Site todral + Phystral + Haphician简短建议）相比）。现在，我们提出了下一步研究，这是一项第三阶段功效研究。在这项为期5年的两次随机临床试验中，我们建议测试基于捕获的初级保健/互联网基于互联网的抑郁症预防干预措施，以防止注意力监测心理教育（AMPE）在防止抑郁发作在中间至高风险的13-17岁的高风险群体中的抑郁发作发作。我们计划（a）基于PHQ-A的得分升高，这是抑郁症状的筛查度量；（b）这些处于危险的青少年的招募400（每个站点）将被随机分为捕获者或AMPE组；（c）在摄入抑郁症状，抑郁诊断，其他精神障碍以及在教育，生活质量，教育里程碑的成就和家庭功能中的抑郁症状，抑郁诊断，其他精神障碍以及措施的措施后，评估2、8、12、18和24个月的结果；（d）进行探索性分析，以检查该干预计划的有效性，保护的主持人以及潜在的干预反应中种族和文化差异。公共卫生相关性：这项随机临床试验旨在确定基于互联网的抑郁症预防干预（Catch-IT 2R）是否可以增强弹性并保护青少年（13-17岁）免受抑郁症并增强其实现其生活目标的能力。该干预措施包括对青少年的初级保健医师的动机访谈，并通过在线故事，视频和游戏来学习应对技巧。将在两年内将其随机分配到干预措施或教育对照组的青少年将得到评估。