Project INSPireD: Integrating Nuanced Support for Perinatal Adherence and Depression
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 23
- 试验地点
- 2
- 主要终点
- Adherence to Antiretroviral Therapy Per Self-Report
研究概览
简要总结
The main aim was to conduct a pilot field test of a group-based depression and adherence counseling intervention with HIV-infected women in the perinatal period. Participants were HIV-infected women living in KwaZulu-Natal, South Africa.
详细描述
The main aim of this study was to conduct a pilot field test of a group-based counseling intervention with HIV-infected women in the perinatal period as delivered by a lay counselor. The primary goal of the intervention was to reduce symptoms of perinatal depression and increase adherence to antiretroviral therapy among HIV-infected women during pregnancy and the postpartum period.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 45 Years（Adult）
- 性别
- Female
- 接受健康志愿者
- 否
入选标准
- •Currently pregnant
- •HIV-infected and diagnosed with HIV during the index pregnancy
- •Meet criteria for a major depressive episode
- •Currently on antiretroviral therapy
- •Receiving antenatal care at PMMH Gateway clinic
- •Primary language English or isiZulu
- •Access to a phone and willing to give researchers permission to reach them via phone
- •Resident of Umlazi
排除标准
- •Unable or unwilling to provide informed consent
- •Active untreated, major mental illness (untreated psychosis, bipolar disorder, dementia, or active suicidality) that would interfere with study participation
- •Less than 18 years of age
研究组 & 干预措施
Intervention: INSPireD
This 5-8 session group intervention, "Integrating Nuanced Support for Perinatal adherence and Depression", aimed to decrease depressive symptoms and improve antiretroviral adherence among HIV-infected pregnant and postpartum women. Intervention content was based on two established cognitive-behavioral interventions: problem-solving therapy and Cognitive Behavioral Therapy for Adherence and Depression.
干预措施: Integrating Nuanced Support for Perinatal adherence and Depression (Behavioral)
Treatment-as-usual + abbreviated intervention
This group received treatment-as usual, plus the option of completing an abbreviated version of the intervention (one session of problem-solving related to adherence and mental health) at the conclusion of study.
干预措施: Integrating Nuanced Support for Perinatal adherence and Depression (Behavioral)
结局指标
主要结局
Adherence to Antiretroviral Therapy Per Self-Report
时间窗: Baseline, Post-Treatment (8-10 weeks), 3-Month Follow-Up (up to 6 months post-baseline)
Adherence to ART during the previous month was measured through a composite score developed by Lu et al. (2008). The composite score combines the scores of three items into a single self-reported adherence score; the three items assess medication use frequency, percentage of time that the medication was taken as prescribed, and a rating of one's ability to take prescribed medication. The percent item had 11 response categories (0, 10, 20...100%), whereas the frequency and ability items had six response categories that were assigned scores of 0, 20, 40, 60, 80, and 100, with 100 considered to be perfect adherence.
Level of Depressive Symptoms Per Edinburgh Postnatal Depression Scale (EPDS)
时间窗: Baseline, Post-Treatment (8-10 weeks), 3-Month Follow-Up (up to 6 months post-baseline)
The 10-item Edinburgh Postnatal Depression Scale (EPDS) was used to measure depressive symptoms at baseline, post-treatment, and three-month follow-up; higher scores indicate more severe depressive symptoms. The minimum possible score is 0, and maximum score is 30. A standard clinical cutoff of 13 on the EPDS was used to distinguish women with and without probable depression.
Number of Participants With Depressive Symptoms Per MINI - Meeting Criteria for MDD
时间窗: Baseline, Post-Treatment (8-10 weeks), 3-Month Follow-Up (up to 6 months post-baseline)
Current and past major depressive disorder was measured using the 17-item Major Depressive Episode Module of the Mini International Neuropsychiatric Interview (MINI). If an individual indicates either that they were "consistently depressed or down, most of the day, nearly every day for the past two weeks" or that they were "less interested in doing most things or less able to enjoy the things that they used to enjoy most of the time," they are asked about 7 symptoms of depression. To meet criteria for a current major depressive episode, at least three symptoms must be endorsed.
Adherence to Antiretroviral Therapy Per MEMS Caps
时间窗: Baseline, Post-Treatment (8-10 weeks), 3-Month Follow-Up (up to 6 months post-baseline)
Objective ART adherence data were collected using the Medication Event Monitoring System (MEMS), which comprises a pill bottle with a digitized cap that measures and records when the bottle was opened each day. MEMS timepoints were defined as average MEMS use across the two-week period prior to each of the three assessment visits.
次要结局
- Level of Social Support Per Duke-UNC Functional Social Support Questionnaire(Baseline, Post-Treatment (8-10 weeks), 3-Month Follow-Up (up to 6 months post-baseline))
- Level of Stigma Per HIV/AIDS Stigma Instrument (HASI-P)(Baseline, Post-Treatment (8-10 weeks), 3-Month Follow-Up (up to 6 months post-baseline))
研究者
Christina Psaros
Assistant Professor of Psychology
Massachusetts General Hospital