Behavioral activation based on the Health Action Process Approach – Efficacy of a theory-based online intervention in depression

行为激活是治疗抑郁症的一种非常有效的方法。然而，被归类为“行为激活”的干预措施存在显著的异质性。这种异质性的一个主要原因是干预发展缺乏理论：现有的干预手册都没有给出他们的干预技术的理论基础。本研究将首次使用基于理论的行为激活干预(InterAKTIV)。干预措施以卫生行动程序方法(HAPA)为基础，并在网上实施，以确保广泛传播和标准化。这项研究旨在调查干预对抑郁症患者的疗效。主要结果是抑郁的严重程度；次要结果是行为激活和HAPA过程变量。此外，还将对干预效果的主持人进行分析。将进行平行设计的双臂随机对照试验(RCT)。参与者将通过一家大型健康保险公司(AOK Baden-Württemberg)的印刷和在线媒体招募。符合纳入标准的参与者(年龄：18-65岁，被诊断为抑郁症，没有目前的心理治疗或精神药理药物的变化，没有排除诊断)将被确定。128名参与者的目标样本将被随机分为干预组(立即参加国际AKTIV)或等待名单对照组(在后续评估后参加国际AKTIV)。电话和在线评估在基线、随机化后两个月和六个月进行。初步分析将遵循意向治疗原则。本研究首次从健康心理学和临床心理学的角度对基于理论的行为激活干预进行了评估。为德国行为激活研究的进一步深入和研究领域的发展做出了贡献。

Behavioral activation is a highly effective treatment in depression. Yet, there is a significant heterogeneity of interventions that are grouped under the term of “behavioral activation”. One main reason for the heterogeneity is a lack of theory in the intervention development: None of the established intervention manuals gives a theoretical rationale for their intervention techniques.For the first time, this study will use a theory-based behavioral activation intervention (InterAKTIV). The intervention is based on the Health Action Process Approach (HAPA) and is implemented online to ensure broad dissemination and standardization. The study aims at investigating the efficacy of the intervention in depressive people. Primary outcome is depression severity; secondary outcomes are behavioral activation and HAPA process variables. In addition, moderators of the intervention effects will be analyzed. A two-arm randomized controlled trial (RCT) of parallel design will be conducted. Participants will be recruited through print and online media of a large health insurance company (AOK Baden-Württemberg). Participants fulfilling the inclusion criteria (age: 18-65 years, diagnosis of depression, no current psychotherapy or changes in psychopharmacologic medication, none of the exclusion diagnoses) will be identified. A target sample of 128 participants will be randomized to either intervention (immediate participation in InterAKTIV) or wait list control (participation in InterAKTIV after follow-up assessment). Telephone and online assessments take place at baseline, two months and six months after randomization. Primary analyses will follow the intention-to-treat principle.The study is the first to evaluate a theory-based behavioral activation intervention by combining perspectives from health psychology and clinical psychology. It contributes to further research on behavioral activation in Germany and to develop the field of research in general.