Eisen Jeffrey C, Marko-Holguin Monika, Fogel Joshua, Cardenas Alonso, Bahn My, Bradford Nathan, Fagan Blake, Wiedmann Peggy, Van Voorhees Benjamin W
Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois (Ms Marko-Holguin and Dr Van Voorhees); Department of Psychiatry, Harvard Medical School, Cambridge Health Alliance, Cambridge, Massachusetts (Dr Eisen); Department of Finance and Business Management, Brooklyn College of the City University of New York, Brooklyn (Dr Fogel); Department of Medicine, University of Chicago, Chicago, Illinois (Mr Cardenas and Dr Bahn); Department of Family Medicine, Anderson Area Medical Center, Anderson, South Carolina (Dr Bradford); Department of Family Medicine, University of North Carolina-Chapel Hill at the Mountain Area Health Education Center, Asheville, North Carolina (Dr Fagan); and Advocate Healthcare, Chicago, Illinois (Dr Wiedmann).
Prim Care Companion CNS Disord. 2013;15(6). doi: 10.4088/PCC.10m01065. Epub 2013 Dec 19.
To explore the implementation of CATCH-IT (Competent Adulthood Transition with Cognitive-behavioral Humanistic and Interpersonal Training), an Internet-based depression intervention program in 12 primary care sites, occurring as part of a randomized clinical trial comparing 2 versions of the intervention (motivational interview + Internet program versus brief advice + Internet program) in 83 adolescents aged 14 to 21 years recruited from February 1, 2007, to November 31, 2007.
The CATCH-IT intervention model consists of primary care screening to assess risk, a primary care physician interview to encourage participation, and 14 online modules of Internet training to teach adolescents how to reduce behaviors that increase vulnerability to depressive disorders. Specifically, we evaluated this program from both a management/organizational behavioral perspective (provider attitudes and demonstrated competence) and a clinical outcomes perspective (depressed mood scores) using the RE-AIM model (Reach, Efficacy, Adoption, Implementation, and Maintenance of the intervention).
While results varied by clinic, overall, clinics demonstrated satisfactory reach, efficacy, adoption, implementation, and maintenance of the CATCH-IT depression prevention program. Measures of program implementation and management predicted clinical outcomes at practices in exploratory analyses.
Multidisciplinary approaches may be essential to evaluating the impact of complex interventions to prevent depression in community settings. Primary care physicians and nurses can use Internet-based programs to create a feasible and cost-effective model for the prevention of mental disorders in adolescents in primary care settings.
ClinicalTrials.gov identifiers: NCT00152529 and NCT00145912.
探讨“CATCH - IT”（具备认知行为、人文及人际训练的成年期能力过渡）这一基于互联网的抑郁症干预项目在12个初级保健场所的实施情况，该项目是一项随机临床试验的一部分，该试验比较了两种干预方式（动机性访谈 + 互联网项目与简短建议 + 互联网项目），研究对象为2007年2月1日至2007年11月31日招募的83名14至21岁的青少年。
“CATCH - IT”干预模式包括初级保健筛查以评估风险、初级保健医生访谈以鼓励参与，以及14个在线互联网训练模块，教导青少年如何减少增加患抑郁症易感性的行为。具体而言，我们使用RE - AIM模型（干预的覆盖范围、效果、采用情况、实施情况和维持情况）从管理/组织行为角度（提供者态度和表现出的能力）和临床结果角度（抑郁情绪评分）对该项目进行了评估。
虽然各诊所的结果有所不同，但总体而言，诊所对“CATCH - IT”抑郁症预防项目的覆盖范围、效果、采用情况、实施情况和维持情况均令人满意。在探索性分析中，项目实施和管理的指标预测了各诊所的临床结果。
多学科方法对于评估社区环境中预防抑郁症的复杂干预措施的影响可能至关重要。初级保健医生和护士可以使用基于互联网的项目，为初级保健环境中预防青少年精神障碍创建一个可行且具有成本效益的模式。
ClinicalTrials.gov标识符：NCT00152529和NCT00145912。
