PDF(Pubmed)
Abstract：
Limited English Proficiency (LEP) Latinxs experience a longer duration of untreated depression and anxiety. LEP Latinxs have difficulty accessing mental healthcare due to insufficient Spanish-speaking behavioral/mental health clinicians to meet demand. These under-resourced healthcare systems are less likely to be the site for the implementation of innovations. Digital interventions can provide an effective option for overcoming these barriers; yet, when digital evidence-based treatments are available, uptake and engagement is often low. This manuscript presents the protocol for the SUPERA (SUpport from PEeRs to expand Access) study which will evaluate the implementation of an evidence-based, Spanish language, digital cognitive-behavioral therapy (dCBT) intervention (i.e., SilverCloud) in safety-net primary care clinics for LEP Latinx patients with depression or anxiety.
We will conduct an effectiveness-implementation hybrid trial (Type 2) design comparing engagement and clinical outcomes in two modalities of dCBT delivery (peer-supported vs. unsupported). We will also compare provider-level outreach (using a clinic patient registry) versus inreach (traditional provider referral) to compare rates of initiation, completion, and cost. Participants will be 426 LEP Latinx adults ≥18 years of age, PHQ-9 ≥ 10 or GAD-7 ≥ 8, with access to the internet via smartphone, and not currently receiving individual psychotherapy. We will collect baseline, post-intervention (8 weeks), and follow up (3 months) data.
The long-term goal of this research is to aid in the implementation of digital mental health interventions that can be sustainably implemented in low-resourced settings, while reducing the reliance on professionals, overcoming workforce deficits, and increasing relevance for diverse populations.
We will conduct an effectiveness-implementation hybrid trial (Type 2) design comparing engagement and clinical outcomes in two modalities of dCBT delivery (peer-supported vs. unsupported). We will also compare provider-level outreach (using a clinic patient registry) versus inreach (traditional provider referral) to compare rates of initiation, completion, and cost. Participants will be 426 LEP Latinx adults ≥18 years of age, PHQ-9 ≥ 10 or GAD-7 ≥ 8, with access to the internet via smartphone, and not currently receiving individual psychotherapy. We will collect baseline, post-intervention (8 weeks), and follow up (3 months) data.
The long-term goal of this research is to aid in the implementation of digital mental health interventions that can be sustainably implemented in low-resourced settings, while reducing the reliance on professionals, overcoming workforce deficits, and increasing relevance for diverse populations.
摘要：
背景：英语能力有限（LEP）的拉丁人经历了较长的时间未经治疗的抑郁和焦虑。由于讲西班牙语的行为/心理健康临床医生不足以满足需求，LEPLatinxs难以获得精神医疗保健。这些资源不足的医疗保健系统不太可能成为实施创新的场所。数字干预可以为克服这些障碍提供有效的选择；然而，当基于数字证据的治疗可用时，摄取和参与度通常很低。该手稿提出了SUPERA（从PEeRs扩展访问权限的支持）研究的协议，该研究将评估基于证据的实施，西班牙语,数字认知行为疗法(dCBT)干预(即，SilverCloud）在患有抑郁症或焦虑症的LEPLatinx患者的安全网初级保健诊所中。
方法：我们将进行有效性实施混合试验（2型）设计，比较两种dCBT交付方式的参与和临床结果（同行支持与不支持)。我们还将比较提供者级别的外展（使用临床患者注册表）与内展（传统提供者转诊），以比较启动率，完成,和成本。参与者将是426名LEP拉丁裔成年人≥18岁，PHQ-9≥10或GAD-7≥8，可通过智能手机访问互联网，目前没有接受单独的心理治疗。我们将收集基线，干预后（8周），和随访（3个月）数据。
结论：这项研究的长期目标是帮助实施可以在低资源环境中可持续实施的数字心理健康干预措施。在减少对专业人士依赖的同时，克服劳动力短缺，与不同人群的相关性日益增强。
方法：我们将进行有效性实施混合试验（2型）设计，比较两种dCBT交付方式的参与和临床结果（同行支持与不支持)。我们还将比较提供者级别的外展（使用临床患者注册表）与内展（传统提供者转诊），以比较启动率，完成,和成本。参与者将是426名LEP拉丁裔成年人≥18岁，PHQ-9≥10或GAD-7≥8，可通过智能手机访问互联网，目前没有接受单独的心理治疗。我们将收集基线，干预后（8周），和随访（3个月）数据。
结论：这项研究的长期目标是帮助实施可以在低资源环境中可持续实施的数字心理健康干预措施。在减少对专业人士依赖的同时，克服劳动力短缺，与不同人群的相关性日益增强。
