印度农村地区的心理健康护理支持:一个集群随机临床试验
Pallab K Maulik1,2, Mercian Daniel1, Siddhardha Devarapalli3
1The George Institute for Global Health, New Delhi, India.
JAMA psychiatry
|August 14, 2024
概括
印度农村地区的数字健康干预和反耻辱运动减少了成年人患抑郁症的风险. 然而,这项干预措施并没有改善心理健康寻求帮助的行为.
科学领域:
- 全球健康 全球健康
- 数字健康数字健康
- 心理健康干预 心理健康干预
背景情况:
- 印度有超过1.5亿人需要心理健康护理,农村地区的治疗机会有限.
- 解决心理健康服务可访问性的差距对于公共卫生至关重要.
- 农村人口在获得足够的心理健康支持方面面临重大障碍.
研究的目的:
- 评估一个多方面的干预,结合数字健康和社区反耻辱的努力.
- 评估干预措施对减少印度农村地区抑郁风险和心理健康污名的影响.
- 确定为服务不足的人群提供综合护理模式的有效性.
主要方法:
- 一个集群随机试验,涉及9928名成年人在印度农村的44个初级卫生中心.
- 干预组接受了数字心理健康计划和反耻辱运动;对照组接受了通常的护理.
- 使用PHQ-9和GAD-7得分来确定高风险成年人;随访评估发生在3,6和12个月.
主要成果:
- 与对照组相比,干预组在12个月内显示出明显较低的平均抑郁评分 (PHQ-9) (-1.71;P < .001).
- 干预组中抑郁和焦虑的缓解率更高 (74.7%与50.6%相比; OR, 2.88; P = .001).
- 在12个月后的组之间,在心理健康知识,态度和行为得分方面没有发现显著差异.
结论:
- 数字健康和反耻辱干预有效地降低了印度农村的抑郁风险.
- 该干预措施在改善抑郁和焦虑结果方面取得了成功.
- 需要进一步的策略来增强心理健康寻求帮助的行为与临床改进一起.
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