1. Is supported self-management for depression effective for adults in community-based settings in Vietnam?: a modified stepped-wedge cluster randomized controlled trial
- Author
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Jill Murphy, Charles H. Goldsmith, Hayami Lou, Nguyen Van Hoi, Hui Xie, Harry Minas, Wayne Jones, Leena W. Chau, Pham Thi Oanh, Yue Ma, Tran Kieu Nhu, Vu Cong Nguyen, and John O’Neil
- Subjects
medicine.medical_specialty ,Blinding ,Randomization ,lcsh:RC321-571 ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Intervention (counseling) ,Medicine ,030212 general & internal medicine ,Cluster randomised controlled trial ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Depression (differential diagnoses) ,Task-sharing ,Self-management ,Depression ,business.industry ,Research ,Health Policy ,Public Health, Environmental and Occupational Health ,Odds ratio ,16. Peace & justice ,3. Good health ,030227 psychiatry ,Psychiatry and Mental health ,Vietnam ,Supported self-management ,Physical therapy ,Pshychiatric Mental Health ,business - Abstract
BackgroundThis study tested the effectiveness of a supported self-management (SSM) intervention to reduce symptoms of depression among adults compared with enhanced treatment as usual in community-based and primary care settings in Vietnam.MethodsThe cluster randomized trial included 376 adults in 32 communes in eight provinces. Eligible participants scored > 7 on the SRQ-20 depression scale. Patients with severe symptoms were excluded and referred to tertiary care. Randomization took place at the commune level. The immediate intervention group included 16 communes with 190 participants and the delayed group included 16 communes with 186 participants. Participants in communes randomized to the immediate intervention group received a two-month course of SSM, consisting of a workbook and supportive coaching. Those in communes randomized to the delayed group received enhanced treatment as usual and, for ethical purposes, received the SSM intervention after 4 months. The primary outcome is the effect of SSM on reduction in depression scores as indicated by a reduced proportion of participants with SRQ-20 scores > 7 at 2 months after commencement of SSM intervention. Blinding was not possible during intervention delivery but outcome assessors were blinded. Analysis was intention-to-treat.ResultsAt 2 months, 26.4% of the intervention group and 42.3% of the delayed group had SRQ-20 scores > 7. The adjusted odds ratio of having depression between the intervention and control was 0.42 (p ConclusionsResults suggest that SSM is effective for decreasing depression symptoms among adults in community-based settings in Vietnam.Trial RegistrationThis trial is registered at ClinicalTrials.gov, number NCT03001063.
- Published
- 2020
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