Exercise Prescription Toolbox for Depression: A Tailored Web-based Program

描述(由申请人提供)：这项名为《抑郁症运动处方工具箱：基于网络的定制程序》(以下简称《工具箱》)的拟议项目旨在帮助心理健康从业者向抑郁症患者提供有关体育活动和锻炼的咨询。工具箱的主要目标受众是为抑郁症成年人提供治疗的精神健康从业者。该网站的目标将是：1)增加对体育活动或锻炼在治疗抑郁症和合并症中的作用的认识；2)增加咨询，以解决抑郁症患者体育活动和锻炼的主要障碍。这个第一阶段的应用程序将开发一个基于证据的内容库，以增加精神健康顾问对运动在缓解抑郁症状和糖尿病和心血管疾病等非精神病学并存疾病方面的作用的知识。在第一阶段的应用中，我们还将开发一种基于理论的算法，为抑郁症患者提供量身定制的建议和家庭作业。这项工作建立在之前成功的基于行为的生活方式体力活动研究和运动治疗轻度至中度严重抑郁障碍(MDD)的随机试验的基础上。该项目的具体目标是：(1)对社区精神卫生提供者进行调查，以评估其内容知识；(2)对社区心理健康提供者的内容知识进行评估；(2)评估当前心理健康服务的性质和水平；a)针对运动和体力活动的咨询建议；b)使用计算机和互联网作为咨询的一部分；对拟议网站的特定功能进行评级；以及这些临床医生是否可能将拟议网站的特定方面作为其当前实践的一部分；(2)开发治疗算法和评估工具，以开出量身定制的体力活动或锻炼处方；以及(3)开发示意性网络地图、规范文档和原型，以指导第二阶段的生产和测试。该应用程序仅适用于第一阶段，将回答以下问题：心理健康顾问是否会发现这种工具在他们的临床实践中有用，算法需要包括哪些功能，以及应该如何组织这些功能，以便使用基于互联网的程序进行最佳使用。如果在第一阶段达到关键标准，第二阶段将开发网站，对网站进行可用性测试，并评估社区环境中的精神健康顾问是否增加了对抑郁症患者的体力活动或锻炼的咨询。运动处方工具箱的公共卫生意义是改善精神卫生从业者对抑郁症患者的体力活动咨询。帮助抑郁症患者增加和保持定期的体力活动可以帮助缓解抑郁症状，并改善与心脏健康、癌症、糖尿病和身体功能相关的其他健康结果。

DESCRIPTION (provided by applicant): The proposed project, entitled Exercise Prescription Toolbox for Depression: A Tailored Web-based Program (the "Toolbox"), is designed to help mental health practitioners provide counseling to patients with depressive disorders about physical activity and exercise. The primary target audience for the Toolbox is mental health practitioners who provide treatment for depressed adults. The goals of this website will be: 1) increase knowledge on the role of physical activity or exercise in the treatment of depression and co- morbidities; and, 2) increase counseling that addresses major barriers for physical activity and exercise with depressed patients. This Phase I application will develop an evidence-based content library to increase knowledge of mental health counselors about the role of exercise in alleviating symptoms of depression and non-psychiatric co-morbidities such as diabetes and cardiovascular disease. In the Phase I application we will also develop a theoretically based algorithm for providing tailored advice and homework assignments to depressed patients. This works builds on previous successful behaviorally based lifestyle physical activity studies and randomized trials of exercise to treat mild to moderate major depressive disorder (MDD). The specific aims of this project are to: (1) conduct a survey of community mental health providers to assess content knowledge; nature and level of current a) counseling advice for exercise and physical activity and b) use of computers and the Internet as part of this counseling; ratings of specific features of the proposed website; and whether these clinicians would be likely to use particular aspects of the proposed website as part of their current practice (2) develop a treatment algorithm and assessment tool for prescribing tailored physical activity or exercise; and,(3)develop a schematic web map, specifications document, and prototype to guide the Phase II production and testing. This application is for Phase I only and will answer questions about whether mental health counselors would find such a tool to be useful in their clinical practice, what features the algorithm needs to include and how these features should be organized for optimal use employing an Internet- based program. If key criteria are met in Phase I, Phase II will develop the website, conduct usability testing of the website, and assess whether mental health counselors in community settings increase counseling for physical activity or exercise with patients with depression disorders. The public health significance of the Exercise Prescription Toolbox is to improve counseling for physical activity by mental health practitioners with their depressed patients. Helping depressed patients to increase and maintain a regular program of physical activity can help alleviate symptoms of depression and improve other health outcomes related to heart health, cancer, diabetes, and physical functioning.