Ward Earlise C, Brown Roger L
School of Nursing, University of Wisconsin.
School of Nursing, Medicine and Public Health, University of Wisconsin.
Am J Orthopsychiatry. 2015 Jan;85(1):11-22. doi: 10.1037/ort0000027. Epub 2014 Nov 24.
The purpose of this article is to describe development of a culturally adapted depression intervention (Oh Happy Day Class, OHDC) designed for African American adults experiencing major depressive disorder (MDD). This project included 2 pilot studies testing the feasibility and acceptability of the OHDC and examining short-term effects of the OHDC in reducing symptoms of MDD. The OHDC is a 2.5-hr weekly, culturally specific, cognitive behavioral, group counseling intervention for 12 weeks. Cultural adaptations of the OHDC are based on the ecological validity and culturally sensitive framework, along with an Afrocentric paradigm. Fifty African American participants with MDD were enrolled (15 in Pilot I and 35 in Pilot II). All participants in Pilots I and II received the 12-week intervention and completed assessments at baseline, mid-intervention, end-intervention, and 3 months postintervention. General linear mixed modeling for assessment of pre-post longitudinal data analysis was conducted. Results for Pilot I showed 73% of participants completed the full OHDC, a statistically significant decline in depression symptoms from pre- to postintervention, and a 0.38 effect size. Participants were very satisfied with the OHDC. In Pilot II, 66% of participants completed the full OHDC, and there was a significant pre-post intervention decrease in depression symptoms. For men, the OHDC showed a 1.01 effect size and for women, a 0.41 effect size. Both men and women were very satisfied with the OHDC based on the satisfaction measure. These promising findings are discussed with a focus on future plans for examining efficacy of the OHDC in a large-scale, randomized, control trial.
本文旨在描述一种为患有重度抑郁症（MDD）的非裔美国成年人设计的文化适应性抑郁症干预措施（“欢乐日课程”，OHDC）的开发情况。该项目包括两项试点研究，测试OHDC的可行性和可接受性，并检验OHDC在减轻MDD症状方面的短期效果。OHDC是一项为期12周、每周一次、时长2.5小时的针对特定文化背景的认知行为团体咨询干预措施。OHDC的文化适应性基于生态效度和文化敏感框架，以及以非洲为中心的范式。招募了50名患有MDD的非裔美国参与者（试点一15名，试点二35名）。试点一和试点二的所有参与者都接受了为期12周的干预，并在基线、干预中期、干预结束时以及干预后3个月完成评估。进行了用于评估前后纵向数据分析的一般线性混合模型分析。试点一的结果显示，73%的参与者完成了完整的OHDC，干预前后抑郁症状有统计学意义的下降，效应量为0.38。参与者对OHDC非常满意。在试点二中，66%的参与者完成了完整的OHDC，干预前后抑郁症状有显著下降。对于男性，OHDC的效应量为1.01，对于女性，效应量为0.41。根据满意度测量，男性和女性对OHDC都非常满意。本文讨论了这些有前景的发现，并重点关注未来在大规模随机对照试验中检验OHDC疗效的计划。
