一项针对有高血压风险的年轻抑郁黑人女性的远程自我管理项目(TEAM-Red)的前瞻性先导随机对照试验结果

IF 1.3 4区 医学 Q4 PSYCHIATRY
Jennifer B Levin, Erika Kelley, Farren Briggs, Mahboob Rahman, Taylor Maniglia, Emma Church, Nicole Fiorelli, Carla Conroy, Jessica Surdam, Kathy-Diane Reich, Gracie Howard Griggs, Danette Conklin, Carla Harwell, Vicki Haywood Doe, Martha Sajatovic
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This 24-week pilot prospective crossover randomized-controlled trial tested TEAM-Red, a 5-session, biweekly, nurse and peer-educator remotely delivered group self-management intervention for young Black women, vs Enhanced waitlist control (eWL).MethodsTEAM-Red intervention, adapted from an evidence-based program and culturally tailored based on stakeholder input, enrolled 50 depressed Black women ages 18-49 with at least one risk factor for hypertension. Participants were randomized to TEAM-Red (n = 25) or eWL (n = 24) and assessed at Screening, Baseline, 12 weeks, and 24 weeks. Those in eWL crossed over to receive TEAM-Red at 12 weeks and all participants were followed to 24 weeks. The primary goal was acceptability and feasibility. The primary outcome was change on depression severity from baseline to 12 weeks assessed via 9-item Patient Health Questionnaire (PHQ-9). 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引用次数: 0

摘要

目的:很少有研究同时关注黑人女性心血管和心理健康的自我管理。这项为期24周的前瞻性交叉随机对照试验测试了TEAM-Red,一项针对年轻黑人女性的5次、每两周一次、由护士和同伴教育者远程提供的群体自我管理干预,与强化候补名单控制(eWL)。方法steam - red干预,改编自一个基于证据的项目,并根据利益相关者的意见进行文化定制,招募了50名年龄在18-49岁之间,至少有一种高血压危险因素的抑郁黑人女性。参与者被随机分配到TEAM-Red组(n = 25)或eWL组(n = 24),并在筛查、基线、12周和24周时进行评估。那些在eWL中的人在12周时接受TEAM-Red,所有参与者都被跟踪了24周。主要目标是可接受性和可行性。主要结果是通过9项患者健康问卷(PHQ-9)评估抑郁严重程度从基线到12周的变化。次要结局是感知压力、心理健康生活质量、饮食质量、能量消耗、社会支持、高血压知识和酒精使用。结果在基线抑郁的女性中(N = 31), TEAM-Red参与者在第12周抑郁缓解的几率高出17.1倍(OR = 17.14, 95% CI: 1.78, 164.97; P = 0.014)。在12周时,与eWL相比,TEAM-Red参与者的PHQ-9得分显著降低(P = 0.042),饮食质量(P = 0.025)和心理健康生活质量(P = 0.032)得到改善,感知压力(P = 0.038)减少。治疗满意度和参与度很高(89%的人认为治疗有用),有22%的人流失。结论:与对照组相比,steam - red显示出显著的临床益处,抑郁缓解的几率高出17倍,在心理健康、生活质量、饮食质量和感知压力方面都有显著改善。尽管样本量小、随访时间短等方面存在局限性,但这种针对不同文化的干预措施有望降低有高血压风险的年轻黑人女性的心血管风险,并改善其心理健康状况,如果在全动力试验中采用更大的样本来复制结果的话。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcomes of a Prospective Pilot RCT of a Remotely Delivered Self-Management Program (TEAM-Red) for Depressed Young Black Women at Risk for Hypertension.

ObjectiveFew studies have simultaneously addressed self-management of cardiovascular and mental health in Black women at cardiovascular risk. This 24-week pilot prospective crossover randomized-controlled trial tested TEAM-Red, a 5-session, biweekly, nurse and peer-educator remotely delivered group self-management intervention for young Black women, vs Enhanced waitlist control (eWL).MethodsTEAM-Red intervention, adapted from an evidence-based program and culturally tailored based on stakeholder input, enrolled 50 depressed Black women ages 18-49 with at least one risk factor for hypertension. Participants were randomized to TEAM-Red (n = 25) or eWL (n = 24) and assessed at Screening, Baseline, 12 weeks, and 24 weeks. Those in eWL crossed over to receive TEAM-Red at 12 weeks and all participants were followed to 24 weeks. The primary goal was acceptability and feasibility. The primary outcome was change on depression severity from baseline to 12 weeks assessed via 9-item Patient Health Questionnaire (PHQ-9). Secondary outcomes were perceived stress, mental health quality of life, diet quality, energy expended, social support, hypertension knowledge, and alcohol use.ResultsAmong women depressed at baseline (N = 31), TEAM-Red participants had 17.1 times higher odds of depression remission at week 12 (OR = 17.14, 95% CI: 1.78, 164.97; P = .014). At 12 weeks, TEAM-Red participants showed significantly lower PHQ-9 scores (P = .042), improved diet quality (P = .025) and mental health quality of life (P = .032) and reduced perceived stress (P = .038) compared to eWL. Treatment satisfaction and engagement was high (89% found it useful), with 22% attrition.ConclusionsTEAM-Red demonstrated significant clinical benefits with a 17-fold higher odds of depression remission and meaningful improvements in mental health quality of life, diet quality, and perceived stress compared to controls. Despite limitations including small sample size and short follow-up period, this culturally tailored intervention shows promise for reducing cardiovascular risk and improving mental health outcomes in young Black women at risk for hypertension should results be replicated with a larger sample in a fully powered trial.

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来源期刊
CiteScore
3.00
自引率
5.00%
发文量
55
审稿时长
6-12 weeks
期刊介绍: The International Journal of Psychiatry in Medicine (IJPM) bridges the gap between clinical psychiatry research and primary care clinical research. Providing a forum for addressing: The relevance of psychobiological, psychological, social, familial, religious, and cultural factors in the development and treatment of illness; the relationship of biomarkers to psychiatric symptoms and syndromes in primary care...
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