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2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 656-656
Author(s):  
Yue Sun ◽  
Zhi-wen Wang

Abstract Cognitive behavioral therapy (CBT) has been shown to be effective to delay cognitive decline for family dementia caregivers (DCs). However, whether cognitive intervention could effectively reduce depression through internet, group, telephone, individual, unguided self-help and combined formats remains unclear. Pubmed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials, Web of science, China National Knowledge Infrastructure database, Chinese Biomedical Literature database and Wan Fang database were systematically searched. A total of 34 studies were included in our analysis based on a series of rigorous screenings, which comprised 3577 DCs. We conducted a network meta-analysis (NMA) to evaluate the relative effects and rank probability of different CBT delivery formats. A series of analyses and assessments, such as the pairwise meta-analysis and the risk of bias, were performed concurrently. Compared with controls, internet, telephone, and individual showed the largest improvement on depressive symptoms, whereas the unguided self-help delivery format was less effective. Internet delivery formats had the highest probability among the five CBT delivery formats. Our study indicated that the internet might be the best delivery formats for reducing the depression of family DCs. The findings from our study may be useful for policy makers and service commissioners when they make choices among different CBT delivery formats.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 651-651
Author(s):  
Yue Sun ◽  
Zhi-wen Wang

Abstract Cognitive intervention has been shown to be effective to delay cognitive decline in older adults with dementia. However, whether cognitive intervention could be effectively delivered in individual, group, telephone, guided self-help and unguided self-help formats remains unclear. Pubmed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), CINAHL, the Cochrane Central Register of Controlled Trials, Web of science, China National Knowledge Infrastructure database, Chinese Biomedical Literature database and Wan Fang database were systematically searched. 3419 records were extracted, quality assessed, and double-blind screened by 2 authors. Totally 51 studies were included which enrolled 3388 participants. Network meta-analysis (NMA) was conducted to evaluate the relative effects and rank probability of different cognitive intervention delivery formats. For older adults with dementia, guided self-help, group and individual cognitive intervention delivery formats appeared effective in improving the cognitive function, while telephone and unguided self-help were not significantly inferior to control condition. Guided self-help had the highest probability of being the best treatment among the five cognitive intervention delivery formats. Health-care professionals should apply personalized cognitive intervention format based on individual condition and preferences.


2021 ◽  
pp. 1357633X2199400
Author(s):  
Katrina M Serwe ◽  
Angela LE Walmsley

Introduction This study compared outcomes of a telehealth and in-person delivered caregiver wellness program called Powerful Tools for Caregivers (PTC). Methods A total of 11 pairs of PTC class leaders delivered in-person and telehealth PTC classes. Caregiver participants completed a health-related questionnaire one week before, one week after, and six months after completing the program. A split-plot, mixed-design analysis of variance (ANOVA) and t tests were used to examine attendance and health-related outcome measures: depression as measured by the Center for Epidemiological Studies Depression Scale-Revised (CESD-R), caregiver experience as measured by the Bakas Caregiving Outcomes scale (BCOS), caregiver self-efficacy, and number of negative self-care behaviors. Results A total of 72 caregivers attended PTC in-person and 42 attended via telehealth. Mean attendance was 4.97 ± 1.21 for the in-person group and 5.21 ± 0.071 for the telehealth group, with no significant difference between delivery formats t(112) = 1.074, p = 0.285; 23 caregivers completed all three assessment periods for ANOVA. Interaction of group and time was non-significant for all outcome measures and the main effect of group was only significant for CESD-R scores at pre-PTC assessment, indicating that there were no differences between the two delivery formats for outcomes at post test or six months. The effect of time was significant for all outcome measures, indicating both in-person and telehealth participants improved on health-related outcomes over time. Discussion Telehealth is an effective delivery format for PTC – a traditionally in-person caregiver wellness program. This trial was registered [ClinicalTrials.gov identifier: NCT03800238].


2021 ◽  
pp. 070674372110273
Author(s):  
Irena Milosevic ◽  
Duncan H. Cameron ◽  
Melissa Milanovic ◽  
Randi E. McCabe ◽  
Karen Rowa

Objective: Telehealth is being increasingly incorporated into the delivery of mental health care and has received widespread attention during the COVID-19 pandemic for its ability to facilitate care during physical distancing restrictions. Videoconferencing is a common telehealth modality for delivering psychotherapy and has demonstrated similar outcomes to those of face-to-face therapy. Cognitive behavioural therapy (CBT) is the most common psychotherapy evaluated across various telehealth modalities; however, studies on CBT delivered via videoconference, particularly in a group therapy format, are lacking. Further, little research exists on videoconference group CBT for anxiety disorders. Accordingly, the present study compared the outcomes of group CBT for anxiety and related disorders delivered via videoconference versus face-to-face. Method: Using a non-randomized design, data on attendance, dropout, clinical outcomes, and functional impairment were collected from 413 adult outpatients of a tertiary care anxiety disorders clinic who attended a CBT group for panic disorder/agoraphobia, social anxiety disorder, generalized anxiety disorder (GAD), or obsessive-compulsive disorder delivered either face-to-face (pre-COVID-19 pandemic) or via videoconference (since the onset of COVID-19 pandemic). Outcomes were assessed using well-validated self-report measures. Data were collected pre-treatment, across 12 weekly sessions, and post-treatment. Intent-to-treat analyses were applied to symptom outcome measures. Results: Face-to-face CBT conferred only a slight benefit over videoconference CBT for symptom outcomes across all groups, but when assessed individually, only the GAD group showed greater symptom improvement in the face-to-face format. Effect sizes for significant differences between the delivery formats were small. Participants in videoconference groups tended to have slightly higher attendance rates in some instances, whereas functional improvement and treatment dropout were comparable across the delivery formats. Conclusions: Results provide preliminary evidence that videoconference group CBT for anxiety and related disorders may be a promising and effective alternative to face-to-face CBT. Additional research is needed to establish equivalence between these delivery formats.


2021 ◽  
Author(s):  
Akash Wasil ◽  
Tanvi Malhotra ◽  
Nandita Tuteja ◽  
Nivedita Nandakumar ◽  
Laleh Pandole ◽  
...  

BACKGROUND Digital mental health treatments have the potential to expand access to services in low- and middle-income countries (LMICs), but the uptake of interventions has been limited. Furthermore, the attitudes of those in LMICs toward intervention formats are rarely studied. OBJECTIVE To understand the attitudes of Indian college students toward a variety of digital and non-digital treatment delivery formats. METHODS Indian college students received descriptions of seven treatment delivery formats: unguided digital self-help, guided digital self-help, bibliotherapy, one-on-one therapy with a professional, one-on-one therapy with a lay provider, group therapy with a professional, and group therapy with a lay provider. They were asked to rate each delivery format on three domains: a) perceived helpfulness, b) availability, and c) willingness to try. RESULTS 95% of individuals were willing to try one-on-one therapy with a professional, 56% were willing to try one-on-one therapy with a lay counselor, participants were less willing to try group interventions than one-on-one interventions, and <50% were willing to try digital self-help interventions. Additionally, there was a strong association between willingness to try and ratings of helpfulness (r=0.61). Ratings were not associated with gender, age, or depressive symptoms. CONCLUSIONS Our findings suggest that one barrier limiting the uptake of digital interventions in LMICs is that individuals do not perceive them as helpful. Efforts to disseminate information about non-traditional intervention delivery formats and their benefits are warranted.


2021 ◽  
Vol 12 ◽  
Author(s):  
Shurong Lu ◽  
Yanling He ◽  
Kendall Searle ◽  
Pilvikki Absetz ◽  
Brian Oldenburg ◽  
...  

Background: The Mental Health First Aid (MHFA) training program has been widely implemented in many high-income countries. Evidence on the adaptation of this and other similar programs in resource-constrained settings like China is very limited. This study aimed to explore the views of key stakeholders on the implementation issues and contextual factors relevant to the scale-up of MHFA in China.Methods: Informed by the Consolidated Framework for Implementation Research, five implementation domains of intervention characteristics, characteristics of individuals, contextual adaptation, outer and inner setting, and implementation process were investigated through semi-structured in-depth interviews. Twenty-four stakeholders with diverse expertise in the Chinese mental health system were interviewed. Transcripts were coded using NVivo 12 software and thematically analyzed.Results: Fifteen themes and 52 sub-themes were identified in relation to the five domains. Participants saw MHFA as meeting the need for more evidence-based interventions to improve population mental health. Previous participants in MHFA training were satisfied with the course, but their intentions to help and levels of self-efficacy varied. Contextual adaptation of course content, delivery formats, and financing models, was seen as essential. External health policies and some socioeconomic factors (e.g., improved living conditions) were perceived as potential enablers of scalability. Low levels of engagement in health interventions and lack of supportive social norms were identified as potential barriers while executive support, quality control, and sustainable funding were viewed as facilitators of implementation.Conclusion: MHFA training meets some very important current societal and public health needs in China. To achieve its potential impact, significant contextual adaptation is required, particularly in terms of course content, delivery formats, and financing models. Overcoming low levels of engagement in community-based mental health interventions and combating stigma will also be critical for its scale-up.


Author(s):  
Marla Cunningham ◽  
Gabriel Vinderola ◽  
Dimitris Charalampopoulos ◽  
Sarah Lebeer ◽  
Mary Ellen Sanders ◽  
...  

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