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缓解与2023年艾伯塔省和新斯科舍省野火相关的心理问题:Text4Hope项目的六周成果

Mitigating Psychological Problems Associated with the 2023 Wildfires in Alberta and Nova Scotia: Six-Week Outcomes from the Text4Hope Program.

作者信息

Obuobi-Donkor Gloria, Shalaby Reham, Agyapong Belinda, Dias Raquel da Luz, Agyapong Vincent Israel Opoku

机构信息

Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada.

Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2B7, Canada.

出版信息

J Clin Med. 2024 Feb 1;13(3):865. doi: 10.3390/jcm13030865.

Abstract

In 2023, wildfires led to widespread destruction of property and displacement of residents in Alberta and Nova Scotia, Canada. Previous research suggests that wildfires increase the psychological burden of impacted communities, necessitating population-level interventions. Cognitive Behavioural Therapy (CBT)-based text message interventions, Text4HopeAB and Text4HopeNS, were launched in Alberta and Nova Scotia, respectively, during the 2023 wildfire season to support the mental health of impacted individuals. The study examines the effectiveness of Text4HopeNS and Text4HopeAB in alleviating psychological symptoms and improving wellbeing among subscribers. The study involved longitudinal and naturalistic controlled trial designs. The longitudinal study comprised subscribers who completed program surveys at baseline and six weeks post-enrolment, while the naturalistic controlled study compared psychological symptoms in subscribers who had received daily supportive text messages for six weeks (intervention group) and new subscribers who had enrolled in the program during the same period but had not yet received any text messages (control group). The severity of low resilience, poor mental wellbeing, likely Major Depressive Disorder (MDD), likely Generalized Anxiety Disorder (GAD), likely Post-Traumatic Stress Disorder (PTSD), and suicidal ideation were measured on the Brief Resilience Scale (BRS), the World Health Organization-5 Wellbeing Index (WHO-5), Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7) scale, PTSD Checklist-Civilian Version (PCL-C), and the ninth question on the PHQ-9, respectively. The paired and independent sample -tests were employed in data analysis. The results from the longitudinal study indicated a significant reduction in the mean scores on the PHQ-9 (-12.3%), GAD-7 (-14.8%), and the PCL-C (-5.8%), and an increase in the mean score on the WHO-5, but not on the BRS, from baseline to six weeks. In the naturalistic controlled study, the intervention group had a significantly lower mean score on the PHQ-9 (-30.1%), GAD-7 (-29.4%), PCL-C (-17.5%), and the ninth question on the PHQ-9 (-60.0%) which measures the intensity of suicidal ideation, and an increase in the mean score on the WHO-5 (+24.7%), but not on the BRS, from baseline to six weeks compared to the control group. The results of this study suggests that the Text4Hope program is an effective intervention for mitigating psychological symptoms in subscribers during wildfires. This CBT-based text messaging program can be adapted to provide effective support for individuals' mental health, especially in the context of traumatic events and adverse experiences such as those induced by climate change. Policymakers and mental health professionals should consider these findings when shaping strategies for future disaster response efforts, emphasizing the value of scalable and culturally sensitive mental health interventions.

摘要

2023年,野火导致加拿大艾伯塔省和新斯科舍省的财产遭到广泛破坏,居民被迫流离失所。此前的研究表明,野火会增加受影响社区的心理负担,因此需要采取针对全体居民的干预措施。基于认知行为疗法(CBT)的短信干预项目Text4HopeAB和Text4HopeNS分别于2023年野火季节在艾伯塔省和新斯科舍省启动,以支持受影响个人的心理健康。该研究考察了Text4HopeNS和Text4HopeAB在减轻订阅者心理症状和改善其幸福感方面的有效性。该研究采用了纵向和自然对照试验设计。纵向研究包括在基线时和注册六周后完成项目调查的订阅者,而自然对照研究则比较了连续六周每天收到支持性短信的订阅者(干预组)和同期注册但尚未收到任何短信的新订阅者(对照组)的心理症状。分别使用简易复原力量表(BRS)、世界卫生组织-5幸福指数(WHO-5)、患者健康问卷9(PHQ-9)、广泛性焦虑症7(GAD-7)量表、创伤后应激障碍检查表-平民版(PCL-C)以及PHQ-9的第九个问题来测量低复原力、心理健康状况不佳、可能的重度抑郁症(MDD)、可能的广泛性焦虑症(GAD)、可能的创伤后应激障碍(PTSD)和自杀意念的严重程度。数据分析采用配对样本和独立样本t检验。纵向研究结果表明,从基线到六周,PHQ-9(-12.3%)、GAD-7(-14.8%)和PCL-C(-5.8%)的平均得分显著降低,WHO-5的平均得分有所增加,但BRS的平均得分没有变化。在自然对照研究中,与对照组相比,干预组在PHQ-9(-30.1%)、GAD-7(-29.4%)、PCL-C(-17.5%)以及测量自杀意念强度的PHQ-9第九个问题(-60.0%)上的平均得分显著更低,WHO-5的平均得分有所增加(+24.7%),但BRS的平均得分没有变化。该研究结果表明,Text4Hope项目是减轻野火期间订阅者心理症状的有效干预措施。这个基于CBT的短信项目可以进行调整,以为个人心理健康提供有效支持,尤其是在气候变化引发的创伤事件和不良经历的背景下。政策制定者和心理健康专业人员在制定未来灾难应对策略时应考虑这些发现,强调可扩展且具有文化敏感性的心理健康干预措施的价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4df8/10856019/a4ab6550bd59/jcm-13-00865-g001.jpg

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