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改善情绪的身体活动(IMPACT)试验:一项集群随机对照试验,旨在确定与心理教育相比,在青年心理健康服务机构的常规临床护理基础上,对年轻人进行简短的身体活动行为改变干预对抑郁症状的有效性的研究方案。

Improving Mood with Physical ACTivity (IMPACT) trial: a cluster randomised controlled trial to determine the effectiveness of a brief physical activity behaviour change intervention on depressive symptoms in young people, compared with psychoeducation, in addition to routine clinical care within youth mental health services-a protocol study.

机构信息

Institute for Health and Sport, Victoria University, Footscray, Victoria, Australia

Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia.

出版信息

BMJ Open. 2019 Oct 28;9(10):e034002. doi: 10.1136/bmjopen-2019-034002.

Abstract

INTRODUCTION

Depression is highly prevalent and the leading contributor to the burden of disease in young people worldwide, making it an ongoing priority for early intervention. As the current evidence-based interventions of medication and psychological therapy are only modestly effective, there is an urgent need for additional treatment strategies. This paper describes the rationale of the Improving Mood with Physical ACTivity (IMPACT) trial. The primary aim of the IMPACT trial is to determine the effectiveness of a physical activity intervention compared with psychoeducation, in addition to routine clinical care, on depressive symptoms in young people. Additional aims are to evaluate the intervention effects on anxiety and functional outcomes and examine whether changes in physical activity mediate improvements in depressive symptoms.

METHODS AND ANALYSIS

The study is being conducted in six youth mental health services across Australia and is using a parallel-group, two-arm, cluster randomised controlled trial design, with randomisation occurring at the clinician level. Participants aged between 12 years and 25 years with moderate to severe levels of depression are randomised to receive, in addition to routine clinical care, either: (1) a physical activity behaviour change intervention or (2) psychoeducation about physical activity. The primary outcome will be change in the Quick Inventory of Depressive Symptomatology, with assessments occurring at baseline, postintervention (end-point) and 6-month follow-up from end-point. Secondary outcome measures will address additional clinical outcomes, functioning and quality of life. IMPACT is to be conducted between May 2014 and December 2019.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the University of Melbourne Human Research Ethics Committee on 8 June 2014 (HREC 1442228). Trial findings will be published in peer-reviewed journals and presented at conferences. Key messages will also be disseminated by the youth mental health services organisation (headspace National Youth Mental Health Foundation).

TRIAL REGISTRATION NUMBER

ACTRN12614000772640.

摘要

介绍

抑郁症在全球范围内普遍存在,是导致年轻人疾病负担的主要因素,因此,早期干预是一项持续的重点工作。由于目前基于证据的药物和心理治疗干预措施的效果仅为适度,因此迫切需要额外的治疗策略。本文介绍了改善身体活动与情绪(IMPACT)试验的基本原理。IMPACT 试验的主要目的是确定与常规临床护理相比,身体活动干预对年轻人抑郁症状的有效性。此外,该试验还将评估干预对焦虑和功能结果的影响,并探讨身体活动的变化是否可以介导抑郁症状的改善。

方法和分析

该研究在澳大利亚的六家青年心理健康服务机构进行,采用平行组、两臂、集群随机对照试验设计,以临床医生为单位进行随机分组。参与者年龄在 12 岁至 25 岁之间,抑郁程度为中度至重度,随机分配接受常规临床护理加以下两种干预措施之一:(1)身体活动行为改变干预;或(2)关于身体活动的健康教育。主要结局是贝克抑郁自评量表(Quick Inventory of Depressive Symptomatology)的变化,评估时间为基线、干预后(终点)和终点后 6 个月。次要结局指标将涉及其他临床结局、功能和生活质量。IMPACT 研究于 2014 年 5 月至 2019 年 12 月进行。

伦理和传播

2014 年 6 月 8 日,墨尔本大学人类研究伦理委员会(HREC 1442228)批准了该研究。试验结果将发表在同行评议的期刊上,并在会议上报告。青年心理健康服务机构(headspace 国家青年心理健康基金会)也将传播关键信息。

试验注册号

ACTRN12614000772640。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4903/6830686/ad22e0adad66/bmjopen-2019-034002f01.jpg

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