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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：
8902946
负责人：
TRACY G GLADSTONE
金额：
$ 62.08万
依托单位：
UNIVERSITY OF ILLINOIS AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-02-15 至 2018-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8902946
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 strategy Preventive Preventive Intervention Primary Care Physician Primary Health Care Provider Psychopathology Public Health Quality of life Randomized Randomized Clinical Trials Recruitment Activity Reporting Research Personnel Risk Role Sampling Sensitivity and Specificity Site Social support Specific qualifier value Symptoms Training Universities Video Games Work Youth aged arm base brief advice child depression college community setting cost cost effective depression prevention depressive symptoms efficacy testing ethnic minority population follow-up functional outcomes hazard health related quality of life high risk improved innovation interpersonal therapy intervention program meetings mental disorder prevention mortality motivational enhancement therapy new technology preempt prevent primary care setting programs psychoeducation response screening 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.

描述（由申请人提供）：制定新的干预措施，纳入“精神疾病患者的不同需求和情况”，特别是在初级保健和社区环境中，是 NIMH 的一个关键战略目标。预防精神障碍已成为 NIMH 的首要任务，该机构强调开发“新的、更好的干预措施”以“……预防疾病的发生”的重要性。这些干预措施必须 (1) 在多种不同的环境中发挥作用（例如初级保健）； (2) 适合在传统精神卫生系统之外进行分娩 (3) 使用新技术； (4) 以先前的临床试验为基础； (5) 减少已发现的疾病/增强功能结果； (6) 包括家庭；(7) 针对个人量身定制。尽管有这些 NIMH 指南，虽然初级保健医生仍然是高危青少年的一线提供者，但初级保健机构中还没有针对抑郁症的广泛可用、低成本且文化上可接受的预防方法。为了解决这一差距并指定 NIMH 优先事项，Van Voorhees 博士开发并开展了一项基于互联网的初级保健抑郁症预防干预措施（CATCH-IT，通过认知行为、人文和人际培训进行成年过渡）的 2 期临床试验。在这项研究中，与低强度组（互联网网站转介 + 仅医生简短建议）相比，高强度组（即动机性访谈 + 互联网网站）在 12 个月内表现出抑郁情绪显着减少，保护因素（社会支持、动机）增加，抑郁发作发生率较低（7% 与 28%）。我们现在提出下一步研究，即三期疗效研究。在这项为期 5 年、两个地点的随机临床试验中，我们建议测试 CATCH-IT 初级保健/基于互联网的抑郁症预防干预措施与注意力监测心理教育 (AMPE) 在预防 13-17 岁青少年中高危人群抑郁发作方面的效果。我们计划 (a) 根据 PHQ-A（抑郁症状筛查指标）的高分来识别高风险青少年； (b) 招募 400 名（每个中心 200 名）高危青少年，随机分为 CATCH-IT 组或 AMPE 组； (c) 评估摄入后 2、8、12、18 和 24 个月的结果，包括抑郁症状、抑郁诊断、其他精神障碍的测量结果，以及教育角色损害、生活质量、教育里程碑的实现和家庭功能的测量结果； (d) 进行探索性分析，以检验该干预计划的有效性、保护的调节因素以及干预反应中潜在的种族和文化差异。