LeBlanc Josée, Talbot France, Fournier Vanessa, Titov Nickolai, Dear Blake F
Université de Moncton, Canada.
Macquarie University, Australia.
Internet Interv. 2022 Mar 26;28:100529. doi: 10.1016/j.invent.2022.100529. eCollection 2022 Apr.
Young adults are less likely to use traditional mental health services than adults. iCBT may be more youth friendly, but its access remains limited in several countries. This study aims to evaluate the feasibility of a minimally monitored transdiagnostic iCBT program translated from English to French and offered in Canada for the treatment of anxiety and depression among young adults. The impact of the program on resilience was also assessed. Twenty-five participants from community and university samples were included in the analyses in two separate single-group feasibility trials with a 3-month follow-up. Feasibility outcomes were attrition, adherence, treatment acceptability and treatment gains. Outcome measures included the Patient Health Questionnaire 9-item (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7) and Connor-Davidson Resilience Scale (CD-RISC). In Trial 1 (N = 10), recruiting among the general population proved to be challenging. Low adherence (20%) and high attrition (80%) rates were observed. Methodological changes to recruitment were made and a second trial was conducted among university students using incentives (N = 15). About half of the participants completed treatment (55%, n = 8/15), 12/15 provided post-treatment data and 8/15 provided 3-month follow-up data. All study completers (100%; n = 14) reported they would recommend the program. Mixed effects model analyses revealed significant and large pre-post treatment reductions on the PHQ-9 and GAD-7 (Cohen's = 1.09 and 1.64 respectively) with treatment gains maintained at follow-up. Moderate improvements were found on the CD-RISC post-treatment with further gains at follow-up (ds = 0.55 and 1.10 respectively). These finding suggest that future research on this French-Canadian version of the Mood Mechanic Course is feasible with appropriate attention to recruitment. Translating existing iCBT interventions and using minimal monitoring may be an optimal first step to initiate the cross-cultural dissemination of iCBT while increasing access to treatments among young adults. Lessons learned are discussed.
与成年人相比，年轻人使用传统心理健康服务的可能性较小。互联网认知行为疗法（iCBT）可能对年轻人更友好，但在一些国家，其可及性仍然有限。本研究旨在评估一个从英语翻译成法语、在加拿大提供的最低限度监测的跨诊断iCBT项目治疗年轻人焦虑和抑郁的可行性。同时还评估了该项目对心理复原力的影响。在两项单独的单组可行性试验中，纳入了来自社区和大学样本的25名参与者，并进行了3个月的随访。可行性结果包括损耗率、依从性、治疗可接受性和治疗效果。结果测量包括患者健康问卷9项（PHQ-9）、广泛性焦虑障碍7项（GAD-7）和康纳-戴维森心理复原力量表（CD-RISC）。在试验1（N = 10）中，在普通人群中招募被证明具有挑战性。观察到低依从率（20%）和高损耗率（80%）。对招募方法进行了改进，并在大学生中进行了第二项试验，使用了激励措施（N = 15）。约一半的参与者完成了治疗（55%，n = 8/15），12/15提供了治疗后数据，8/15提供了3个月的随访数据。所有完成研究的参与者（100%；n = 14）都表示他们会推荐该项目。混合效应模型分析显示，PHQ-9和GAD-7在治疗前后有显著且较大的降低（科恩d值分别为1.09和1.64），治疗效果在随访中得以维持。治疗后CD-RISC有中度改善，随访中有进一步改善（d值分别为0.55和1.10）。这些发现表明，对这个法裔加拿大版的情绪调节课程进行未来研究是可行的，但需要适当关注招募问题。翻译现有的iCBT干预措施并使用最低限度监测可能是启动iCBT跨文化传播、同时增加年轻人获得治疗机会的最佳第一步。文中讨论了所吸取的经验教训。
