National Center for PTSD Women's Health Sciences Division, VA Boston Healthcare System, Boston, MA, USA; Boston University School of Medicine, Boston, MA, USA.
RAND Corporation, Santa Monica, CA, USA.
Psychiatry Res. 2018 May;263:108-114. doi: 10.1016/j.psychres.2018.02.045. Epub 2018 Mar 30.
Inclusion of consumer preferences to disseminate evidence-based psychosocial treatment (EBPT) is crucial to effectively bridge the science-to-practice quality chasm. We examined this treatment gap for insomnia, posttraumatic stress disorder (PTSD), depression, and comorbid symptoms in a sample of 622 young adult veterans through preference in symptom focus, treatment modality, and related gender differences among those screening positive for each problem. Data were collected from veteran drinkers recruited through targeted Facebook advertisements as part of a brief online alcohol intervention. Analyses demonstrated that veterans reported greater willingness to seek insomnia-focused treatment over PTSD- or depression-focused care. Notably, even when participants screened negative for insomnia, they preferred sleep-focused care to PTSD- or depression-focused care. Although one in five veterans with a positive screen would not consider care, veterans screening for both insomnia and PTSD who would consider care had a preference for in-person counseling, and those screening for both insomnia and depression had similar preferences for in-person and mobile app-based/computer self-help treatment. Marginal gender differences were found. Incorporating direct-to-consumer methods into research can help educate stakeholders about methods to expand EBPT access. Though traditional in-person counseling was often preferred, openness to app-based/computer interventions offers alternative methods to provide veterans with EBPTs.
将消费者偏好纳入传播基于证据的心理社会治疗(EBPT)对于有效弥合科学与实践之间的质量差距至关重要。我们通过对 622 名年轻成年退伍军人样本中失眠、创伤后应激障碍(PTSD)、抑郁和共病症状的偏好,检查了这种治疗差距。这些数据是通过有针对性的 Facebook 广告招募退伍军人饮酒者作为简短在线酒精干预的一部分收集的。分析表明,退伍军人表示更愿意寻求以失眠为重点的治疗,而不是以 PTSD 或抑郁为重点的治疗。值得注意的是,即使参与者筛查出失眠症状呈阴性,他们也更愿意接受以睡眠为重点的治疗,而不是以 PTSD 或抑郁为重点的治疗。尽管五分之一的有阳性筛查结果的退伍军人不会考虑接受治疗,但对失眠和 PTSD 都进行筛查并愿意接受治疗的退伍军人更倾向于面对面咨询,而对失眠和抑郁都进行筛查并愿意接受治疗的退伍军人则对面对面和基于移动应用程序/计算机自助治疗有类似的偏好。发现了微小的性别差异。将直接面向消费者的方法纳入研究可以帮助教育利益相关者扩大 EBPT 获得途径的方法。虽然传统的面对面咨询通常是首选,但对基于应用程序/计算机的干预措施持开放态度为退伍军人提供 EBPT 提供了替代方法。