Stepping Up: Predictors of 'Stepping' within an iCBT Stepped-Care Intervention for Depression.

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Abstrakt

Tytuł:: Stepping Up: Predictors of 'Stepping' within an iCBT Stepped-Care Intervention for Depression.
Autorzy:: Nicholas J; Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, USA.
Ringland KE; Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, USA.; Department of Communication Studies, Northwestern University, Chicago, IL 60611, USA.
Graham AK; Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, USA.; Department of Medical Social Sciences, Northwestern University, Chicago, IL 60611, USA.
Knapp AA; Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, USA.
Lattie EG; Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, USA.; Department of Medical Social Sciences, Northwestern University, Chicago, IL 60611, USA.
Kwasny MJ; Biostatistics Collaboration Center, Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
Mohr DC; Center for Behavioral Intervention Technologies, Department of Preventive Medicine, Northwestern University, Chicago, IL 60611, USA.
Źródło:: International journal of environmental research and public health [Int J Environ Res Public Health] 2019 Nov 25; Vol. 16 (23). Date of Electronic Publication: 2019 Nov 25.
Typ publikacji:: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural
Język:: English
Imprint Name(s):: Original Publication: Basel : MDPI, c2004-
MeSH Terms:: Cognitive Behavioral Therapy*
Internet-Based Intervention*
Depression/*therapy
Depressive Disorder/*therapy
Adult ; Female ; Humans ; Internet ; Male ; Middle Aged ; Treatment Outcome
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Grant Information:: K08 MH112878 United States MH NIMH NIH HHS; UL1 TR001422 United States TR NCATS NIH HHS; R01 MH095753 United States MH NIMH NIH HHS; T32 MH115882 United States MH NIMH NIH HHS; K01 DK116925 United States DK NIDDK NIH HHS
Contributed Indexing:: Keywords: depression; digital mental health; eHealth; stepped-care; telepsychiatry
Entry Date(s):: Date Created: 20191129 Date Completed: 20200407 Latest Revision: 20231027
Update Code:: 20240104
PubMed Central ID:: PMC6926538
DOI:: 10.3390/ijerph16234689
PMID:: 31775297
: Czasopismo naukowe

Internet-based cognitive behavioral therapy (iCBT) may overcome barriers to mental health care and has proven efficacious. However, this approach currently exists outside the existing mental health care delivery system. Stepped care is a proposed framework for integrating digital mental health (DMH) into health systems by initiating iCBT and "stepping up" care to a more intensive intervention should iCBT prove ineffective. This study explores pre-treatment factors associated with reaching stepping criteria among patients receiving iCBT. This exploratory analysis of a stepped care arm of a larger randomized trial examined participants who were stepped to a more intensive intervention if they did not respond to iCBT. The association of pre-treatment factors on stepping were examined using Kruskal-Wallis and Chi-square tests. One-fifth of the 151 participants met criteria for stepping within the 20-week treatment period. Only pre-treatment depression severity and treatment preference were associated with increased likelihood of stepping ( p = 0.049 and 0.048, respectively). The low number of individuals who stepped provides support for iCBT as an effective, low intensity treatment for depression. The modest association of pre-treatment depression and preference to not receive iCBT may be useful in identifying patients who are less likely to respond.

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