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BACKGROUND/RATIONALE:
Studies on the models of coordinating depression treatment within the primary care setting demonstrate that it can significantly improve quality of care and improve outcomes, but few patients receive guideline-concordant care, and many remain significantly depressed after a year with the program. The objective of this new research program is to produce a feasible and testable model of family intervention/social support that can be used to improve the effectiveness of one variant of this model within VA—TIDES-- in promoting recovery and reducing relapse in major depression. The rationale for developing a family intervention is based on several observations. Family interventions have been found to reduce relapse and improve adherence in the treatment of other psychiatric disorders. Family interventions have been found to be useful in the treatment of other chronic non-psychiatric disorders. Finally, previous research on TIDES-type programs shows that limited social support is a strong predictor of continued depression.
OBJECTIVE(S):
In this two site Baltimore and West LA VA) developmental project we will conduct the preliminary phase of this effort, with our immediate outcome being the development of a pilot intervention which will then form the basis for a randomized control trial.
METHODS:
In this project, we will complete the following: 1. Conduct an in-depth literature review of family/social support interventions; 2. Review current VA and HIPPA regulations regarding patient privacy/confidentiality: 3. Conduct semi-structured qualitative interviews of 12-1 5 Depression Nurse Care Managers (DNCM) who have been providing care to in TIDES. The interview will focus on the perceptions regarding how families or social support networks promote or inhibit the appropriate utilization of depression services and treatment by the patient. We will also focus on what the TIDES model and DNCM’s could do to enhance the likelihood that such family support could promote depression care; 4. Conduct semi-structured interviews of 5-10 primary care physicians participating in TIDES, and 5. Conduct semi-structured interviews of persons from consumer and family groups such as the National Alliance on Mental Illness to obtain such consumer perspectives on how to engage families within a model such as TIDES in primary care.
After these activities are completed, the project steering committee (SC) which includes expertise in family interventions and depression treatment in primary care, will meet in person to synthesize the data and draft a TIDES caregiver intervention model. This model will then be reviewed by a subset of the original stakeholders who were interviewed and by two in person expert panels--one in Baltimore and one in Los Angeles. These panels will provide feedback regarding the model. The final step of the application will be a second in-person meeting of the project SC at which all of the model feedback will be synthesized and the model revised. We expect at this point to have a model of a TIDES Family Support Program ready for pilot testing.
FINDINGS/RESULTS:
No results at this time.
IMPACT:
None as of yet
PUBLICATIONS:
None at this time.
DRA:
Mental Illness
DRE:
Quality of Care, Treatment
Keywords:
Caregivers – not professionals, Depression
MeSH Terms:
none
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