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16至18岁青少年抑郁和焦虑的早期干预:学校开放式心理工作坊可行性整群随机对照试验方案(DISCOVER)

Early intervention for depression and anxiety in 16-18-year-olds: Protocol for a feasibility cluster randomised controlled trial of open-access psychological workshops in schools (DISCOVER).

作者信息

Michelson Daniel, Sclare Irene, Stahl Daniel, Morant Nicola, Bonin Eva-Maria, Brown June S L

机构信息

CAMHS Research Unit, Dept of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, UK; Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Barnett House, 32 Wellington Square, Oxford OX1 2ER, UK.

Southwark CAMHS, Child and Adolescent Mental Health Services Clinical Academic Group, South London & Maudsley NHS Foundation Trust, Mapother House, De Crespigny Park, London SE5 8AZ, UK.

出版信息

Contemp Clin Trials. 2016 May;48:52-8. doi: 10.1016/j.cct.2016.02.003. Epub 2016 Feb 12.

Abstract

Adolescence is a vulnerable period for the development of mental health problems. The DISCOVER intervention aims to provide accessible, acceptable and cost-effective psychological support for stressed adolescents in inner-city secondary schools. The intervention uses age-appropriate cognitive-behavioural therapy (CBT) methods and materials, delivered in an interactive 1-day workshop with additional telephone support. An open-access entry route allows students to self-refer. This protocol describes a feasibility cluster randomised controlled trial (RCT) comparing DISCOVER with a waitlist control condition. The study will run across 10 clusters (secondary schools) in the inner London Boroughs of Southwark and Lambeth. Participants are students aged over 16years who are seeking help with anxiety and/or depressive symptoms. Key feasibility parameters relate to the proportion of students willing to participate in the research following publicity events; the proportion of students who complete the intervention; and response rates for outcome measures. Outcome variance estimates and intra-cluster correlations will be obtained for future power calculations. Qualitative methods will be used to explore the acceptability of the intervention and research procedures for students and school staff. The feasibility of an economic evaluation will also be examined. The results will (i) determine the appropriateness of proceeding to a definitive full-scale trial; and (ii) inform the development of an optimised version of the DISCOVER intervention that can be tested within feasible parameters.

摘要

青春期是心理健康问题发展的脆弱时期。“发现”干预旨在为市中心区中学中压力过大的青少年提供可及、可接受且具有成本效益的心理支持。该干预采用适合年龄的认知行为疗法(CBT)方法和材料,在为期1天的互动研讨会上进行,并提供额外的电话支持。开放的报名途径允许学生自我推荐。本方案描述了一项可行性整群随机对照试验(RCT),将“发现”干预与等待名单对照条件进行比较。该研究将在伦敦南部南华克区和兰贝斯区的10个整群(中学)中开展。参与者为16岁以上寻求焦虑和/或抑郁症状帮助的学生。关键的可行性参数涉及在宣传活动后愿意参与研究的学生比例;完成干预的学生比例;以及结果测量的反应率。将获得结果方差估计值和组内相关性,以供未来的功效计算使用。将采用定性方法探讨该干预措施以及研究程序对学生和学校工作人员的可接受性。还将考察经济评估的可行性。研究结果将(i)确定是否适合进行确定性的全面试验;(ii)为开发可在可行参数范围内进行测试的优化版“发现”干预提供信息。

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