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）：以前，我们开发，测试和传播了一个非常有效的同伴咨询计划，以减少与俄勒冈州中心的独立生活（CILs）的伙伴关系，身体残疾妇女的抑郁症状。我们的学术残疾社区伙伴关系使用基于社区的参与性研究方法创建了愈合途径，我们已经持续了9年的伙伴关系。愈合之路目前是由公共资金和提供的七个CIL在俄勒冈州四。治愈之路的成功是社区投资和拥有该计划的直接结果。我们建议复制这种模式，以解决身体残疾（MPD）男性的抑郁症。抑郁症是MPD中常见的继发性疾病，发生率在37- 64%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MPD的身体功能下降，失业，社会孤立，生活满意度下降，机构化和死亡的风险更大。为了建立在治疗途径的成功和开始，以解决抑郁症状的严重问题，在MPD我们的学术残疾社区伙伴关系提出了一个社区参与，探索性的顺序，混合方法的研究，以实现以下三个具体目标1）适应治疗途径计划，以满足抑郁症状的MPD的需要; 2）进行试点研究，以评估同伴程序的可行性和可接受性;和3）估计的效果大小的同伴程序的抑郁症状。这项研究计划的长期目标是通过与该社区的成员合作，改善身体残疾者的心理健康状况。拟议研究的结果将共同为未来旨在治疗MPD抑郁症状的同行计划的随机对照试验的发展提供信息。这项拟议的研究涉及几个公共卫生目标，包括健康人2020目标DH 18，以减少报告严重情绪困扰的残疾人比例，以及总统新自由委员会的精神健康目标1-3，以了解精神健康对整体健康至关重要，促进消费者驱动的精神健康治疗，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.