Women Physical Disability and Depression: Communities Responding Now!

肢体残疾妇女(WPD)的抑郁和自杀率比普通人群高五倍。尽管存在这种差异，但很少有针对这一人群特定需求的干预研究。为了开始解决2010年健康人的目标6-3，并减少出现抑郁症状的WPD的比例，迫切需要与WPD的生活相关的干预措施。根据国家优先事项和消费者参与开发心理健康疗法的需要，拟议的项目将使用已证明在减少妇女抑郁症状方面有效的现有认知行为疗法(CBT)干预措施，作为共同创建满足WPD特定需求的干预措施的起点。共同创建过程将在调查人员、社区WPD和三个俄勒冈州独立生活中心(CILS)之间的合作伙伴关系中进行。在拟议项目的最后一年，这一合作伙伴关系将扩大到包括另外四个俄勒冈州CILs，目的是开发一个同行指导的培训者培训计划，以促进消费者控制和促进干预的可持续性。拟议项目的具体目标是：1.修改现有的认知行为团体治疗干预措施，以满足经历抑郁症状的WPD的特定需求；2.使用混合方法进行疗效试验。拟议的研究结果来自我们以前与世界残疾人联合会以及残疾人社区成员的合作。将采用轮候名单对照设计，对修改后的干预措施进行总共135名参与者的疗效试验；以及3.制定同行指导的培训师培训计划，以促进消费者控制和促进干预措施的可持续性。拟议项目的一个长期目标是提高全国CILS的能力，提供相关、有效、可获得和负担得起的干预措施，帮助患有抑郁症的WPD克服这种令人衰弱的继发性疾病。

Rates of depression and suicide in women with physical disabilities (WPD) are up to five times higher than in the general population. Despite this disparity, few intervention studies that address the specific needs of this population are available. To begin to address objective 6-3 of Healthy People 2010 and reduce the proportion of WPD who experience depressive symptoms, interventions relevant to the lives of WPD are urgently needed. In keeping with national priorities and the need for consumer participation in the development of mental health therapies, the proposed project will use an existing cognitive behavioral therapy (CBT) intervention that has demonstrated effectiveness in reducing depressive symptoms in women as a starting point from which to co-create an intervention that addresses the specific needs of WPD. The co-creation process will occur in the context of a partnership between the investigators, WPD in the community, and three Oregon Centers for Independent Living (CILs). This partnership will be expanded to include four additional Oregon CILs during the last year of the proposed project for the purpose of developing a peer mentored train-the-trainer program that will facilitate consumer control and promote the sustainability of the intervention. The specific aims of the proposed project are to: 1. Modify an existing cognitive behavioral group therapy intervention to address the specific needs of WPD who experience depressive symptoms; 2. Conduct an efficacy trial using a mixed-methods approach. The proposed study outcomes were derived from our previous work with WPD as well as from members of the disability community. An efficacy trial of the modified intervention with a total of 135 participants will be conducted using a wait list control design; and 3. Develop a peer mentored train-the-trainer program to facilitate consumer control and promote the sustainability of the intervention. A long-term goal of the proposed project is to increase the capacity of CILs across the country to offer a relevant, effective, accessible, and affordable intervention to help WPD with depression overcome this debilitating secondary condition.