Partnership to Develop and Pilot-Test a Peer Program to Reduce Depressive Symptoms in Men with Physical Disabilities

 描述(由申请人提供)：之前，我们与俄勒冈州独立生活中心(CILS)合作开发、测试和传播了一个高效的同伴咨询计划，以减少肢体残疾女性的抑郁症状。我们的学术残疾社区合作伙伴关系使用基于社区的参与式研究方法创建了康复之路，我们已经持续了9年多的合作伙伴关系。治愈路径目前是由俄勒冈州七个CILS中的四个提供公共资金和服务的。治愈之路的成功是社区对该计划的投资和所有权的直接结果。我们建议复制这一模型来解决男性肢体残疾(MPD)患者的抑郁问题。抑郁症是MPDS的常见继发性疾病，发生率在37%-之间。这是非残疾男性抑郁症发病率的2-3倍。与一般人群中的男性相比，患有抑郁症的MPDS患者的身体功能下降、失业、社会孤立、生活满意度下降、住院和死亡的风险更大。为了建立在修复路径的成功基础上，并开始解决MPD中抑郁症状的严重问题，我们的学术残疾社区合作伙伴提出了一项社区参与的、探索性的顺序混合方法研究，以实现以下三个具体目标：1)调整修复路径计划以满足具有抑郁症状的MPD的需求；2)进行一项试点研究，以评估Peer计划的可行性和可接受性；以及3)估计Peer计划对抑郁症状的影响规模。这项研究计划的长期目标是通过与这个社区的成员合作来改善肢体残疾人士的心理健康结果。这项拟议研究的结果将共同为未来设计用于治疗MPDS抑郁症状的PEER计划的随机对照试验的发展提供信息。拟议的研究涉及几个公共卫生目标，包括健康人2020目标DH18，以减少报告严重情绪困扰的残疾人的比例，以及总统新的精神健康自由委员会目标1-3，以了解心理健康对整体健康至关重要，促进由消费者驱动的心理健康治疗，并消除精神卫生保健方面的差距。

 DESCRIPTION (provided by applicant): Previously we developed, tested and disseminated a highly effective peer counseling program to reduce depressive symptoms in women with physical disabilities in partnership with Oregon Centers for Independent Living (CILs). Our academic-disability community partnership created Healing Pathways using community- based participatory research methods and we have sustained our partnership over 9 years. Healing Pathways is currently publicly funded and offered by four of the seven CILs in Oregon. The success of Healing Pathways is a direct result of community investment in and ownership of the program. We propose replicating this model to address depression in men with physical disabilities (MPDs). Depression is a common secondary condition in MPDs, occurring at rates between 37-64%. This is 2-3 times the rate of depression found in non-disabled men. MPDs with depression are at greater risk for decreased physical functioning, unemployment, social isolation, decreased life satisfaction, institutionalization, and death compared to men in the general population. To build on the success of Healing Pathways and to begin to address the serious problem of depressive symptoms in MPDs our academic disability community partnership proposes a community-engaged, exploratory sequential, mixed methods study to achieve the following three specific aims 1) Adapt the Healing Pathways program to meet the needs of MPDs with depressive symptoms; 2) Conduct a pilot study to assess the feasibility and acceptability of the peer program; and 3) Estimate the effect size of the peer program for depressive symptoms. The long-term goal of this program of research is to improve mental health outcomes in people with physical disabilities by partnering with members of this community. The outcomes of the proposed study will collectively inform the development of a future randomized controlled trial of the peer program designed to treat depressive symptoms in MPDs. The proposed study addresses several public health goals including Healthy People 2020 goal DH18 to reduce the proportion of people with disabilities who report serious emotional distress, and the President's New Freedom Commission on Mental Health goals 1-3, to understand that mental health is essential to overall health, promote mental health treatments that are consumer-driven, and eliminate disparities in mental health care.