如何提高精神障碍的利用？一个关于污名化态度和利用过程中介变量可变性的准实验性在线研究。
How can the utilisation of help for mental disorders be improved? A quasi-experimental online study on the changeability of stigmatising attitudes and intermediate variables in the process of utilisation.
机构信息
Department of Health and Prevention, Institute of Psychology, University of Greifswald, Greifswald, Germany.
Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany.
出版信息
BMC Public Health. 2021 Nov 19;21(1):2124. doi: 10.1186/s12889-021-12125-5.
BACKGROUND
Epidemiological studies show that even in highly developed countries many people with depression do not seek help for their mental health issues, despite promising prevention approaches encouraging people to seek help and reduce self-stigma. Therefore, an anti-stigma intervention study to support help-seeking behaviour will be developed on the basis of the newly explicated "Seeking Mental Health Care Model".
METHODS
A quasi-experimental online study will be carried out to assess the effect of different intervention variables relevant for the help-seeking process. The study is conceived as a fractional factorial design. Participants will be screened for depressive complaints (PHQ-9 sum score ≥ 8) and current psychiatric/psychotherapeutic treatment. After baseline assessment the participants will be randomly allocated into one of the 24 study groups receiving different combinations of the vignette-based intervention aiming to reduce stigma and support help-seeking. Next, relevant outcome measures will be administered a second time. In a 3- and 6-month follow-up help-seeking behaviour will be measured. Gamified elements and avatar-choice techniques will be used to heighten study immersion and adherence.
DISCUSSION
On the basis of the project results, promising research and intervention perspectives can be developed. Results, firstly, allow for a more detailed empirical investigation and conceptualisation of the stages of mental health care utilisation, as well as an examination of theoretical approaches to stigmatisation. Secondly, our online study could provide insights for an evidence-based design and evaluation of online interventions for people with a mental illness.
TRIAL REGISTRATION
German Clinical Trials Register: DRKS00023557 . Registered 11 December 2020. World Health Organization, Universal Trial Number: U1111-1264-9954. Registered 16 February 2021.
背景
流行病学研究表明，即使在高度发达的国家，许多患有抑郁症的人也不会寻求帮助来解决他们的心理健康问题，尽管有很多有前景的预防方法鼓励人们寻求帮助并减少自我污名化。因此，将在新阐述的“寻求心理健康护理模型”的基础上，开展一项支持寻求帮助行为的反污名干预研究。
方法
将开展一项准实验性在线研究，以评估与寻求帮助过程相关的不同干预变量的效果。该研究的设计构想为分数阶析因设计。参与者将接受抑郁症状（PHQ-9 总分≥8）和当前精神科/心理治疗的筛选。基线评估后，参与者将被随机分配到 24 个研究组中的一个，接受不同组合的基于情景的干预，以减少污名化并支持寻求帮助。接下来，将再次进行相关的结果测量。在 3 个月和 6 个月的随访中，将测量寻求帮助的行为。将使用游戏化元素和头像选择技术来提高研究的沉浸感和依从性。
讨论
基于项目结果，可以开发出有前途的研究和干预方法。结果首先允许对心理健康护理利用的各个阶段进行更详细的实证调查和概念化，以及对污名化的理论方法进行检验。其次，我们的在线研究可以为针对精神疾病患者的在线干预措施的基于证据的设计和评估提供一些见解。
试验注册
德国临床试验注册处：DRKS00023557。于 2020 年 12 月 11 日注册。世界卫生组织，通用试验编号：U1111-1264-9954。于 2021 年 2 月 16 日注册。
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