| 1. |
- Blomberg, Oscar, et al.
(author)
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Adaptation of a guided low-intensity behavioral activation intervention for people with dementia in Sweden : a qualitative study exploring the needs and preferences of key stakeholders
- 2024
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In: BMC Geriatrics. - : Springer. - 1471-2318. ; 24:113
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Journal article (peer-reviewed)abstract
- BackgroundDespite depression being prevalent in people with dementia, contributing to negative health outcomes and placing increased burden on individuals and family members, access to psychological interventions is limited. A potential solution is guided low-intensity behavioral activation, supported by informal caregivers and guided by healthcare professionals. However, it is necessary to adapt interventions to meet the needs and preferences of key stakeholders to enhance acceptability and relevance. Study objectives were to: (1) explore needs and preferences concerning the content and delivery model of the guided low-intensity behavioral activation intervention; and (2) adapt the intervention to ensure cultural appropriateness, relevancy, and acceptability to people with dementia and their caregivers in Sweden.MethodsSemi-structured interviews and focus group discussions were conducted with key stakeholders, including healthcare professionals (n = 18), community stakeholders (n = 7), people with dementia (n = 8), and informal caregivers (n = 19). A draft of the written low-intensity behavioral activation intervention and a description of the proposed intervention delivery model were provided to participants. Open-ended questions explored the perceived relevance of the intervention, alongside needs and preferences concerning content and delivery. A manifest content analysis approach was adopted.ResultsContent analysis resulted in three categories: Content, Delivery procedures, and Illness trajectory. Results highlighted a need to consider the intervention Content via increased cultural adaptation to the Swedish context, and increasing the inclusiveness of intervention content. Delivery procedures were identified as needing to be flexible given the unpredictable nature of caring for people with dementia, with the provision of additional guidance to informal caregivers supporting the intervention. Illness trajectory was viewed as essential to consider, with the intervention regarded as suitable for those early in the dementia trajectory, alongside a need to reduce workbook text to minimize burden given dementia symptomology.ConclusionsThe intervention and proposed delivery model were generally well received by all stakeholders. We were able to identify key adaptations to enhance cultural appropriateness, relevancy, and acceptability for a currently neglected population. Results will inform a feasibility study to explore the feasibility and acceptability of the intervention and study procedures to inform the design of a future superiority randomized controlled trial.
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| 2. |
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| 3. |
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| 4. |
- Mårtensson, Erika, et al.
(author)
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Psychological interventions for depression among informal caregivers of older adult populations : protocol of a systematic review and meta-analysis of randomised controlled trials.
- 2020
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 10:9
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Research review (peer-reviewed)abstract
- Introduction: Increased life expectancy has led to an increased demand for family members to provide informal care for their older relatives in the home. Many studies suggest informal caregivers are at greater risk of experiencing symptoms of depression. However, there is a lack of research examining the effectiveness of psychological interventions targeting these symptoms alongside clinical and methodological moderators potentially associated with intervention effectiveness. This review aims to address this gap and will inform the development of a psychological intervention targeting depression among adult-child caregivers of older parents, given many studies show that among informal caregivers of older adults, adult children experience specific difficulties and needs for psychological support. Further, the lack of studies targeting adult children specifically necessitates conducting this review targeting caregivers of older adults in general.Methods and analysis: Randomised controlled trials of psychological interventions targeting symptoms of depression among informal caregivers will be identified via a systematic search of electronic databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica DataBase, PsycINFO, Cochrane Library and Web of Science) and supplemented by handsearching of previous systematic reviews, reference and forward citation checking, and expert contact. If possible, a meta-analysis will be conducted to examine the: (1) effectiveness of psychological interventions for depression among informal caregivers of older adults, (2) effectiveness of psychological interventions for secondary outcomes such as anxiety, stress, caregiver burden, psychological distress, quality of life, well-being and self-efficacy and (3) moderating effects of clinical and methodological factors on effectiveness.Ethics and dissemination: Ethical approval will not be necessary for this study given primary data will not be collected. Results will inform the development of a psychological intervention for adult-child caregivers of older parents and will be disseminated through publication in peer-reviewed journals and conference presentations.PROSPERO registration number: CRD42020157763.
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| 5. |
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| 6. |
- Pettman, Danelle, et al.
(author)
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Effectiveness and acceptability of cognitive behavioural therapy based interventions for maternal peripartum depression : A systematic review, meta-analysis and thematic synthesis protocol
- 2019
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 9:12
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Journal article (peer-reviewed)abstract
- INTRODUCTION:Peripartum depression is a common mental health difficulty associated with a range of negative impacts for the mother, infant and wider family. This review will examine the effectiveness of cognitive-behavioural therapy (CBT) based interventions for peripartum depression. Secondary aims are to explore the effect of CBT-based interventions targeted at peripartum depression on novel secondary outcomes and moderators potentially associated with effectiveness. To date, there has been little examination of effect on important secondary outcomes (eg, anxiety, stress and parenting), nor clinical and methodological moderators. Further, this review aims to explore the acceptability of CBT-based interventions for women with peripartum depression and examine important adaptations for this population.METHODS AND ANALYSIS:Electronic databases (e.g., MEDLINE; ISI Web of Science; CINAHL; CENTRAL; Prospero; EMBASE; ASSIA; PsychINFO; SCOPUS; And Swemed+) will be systematically searched. Database searches will be supplemented by expert contact, reference and citation checking, and grey literature. Primary outcomes of interest will be validated measures of symptoms of depression. A proposed meta-analysis will examine: (1) the overall effectiveness of psychological interventions in improving symptoms of depression (both self-reported and diagnosed major depression) in the peripartum period; (2) the impact of interventions on secondary outcomes (eg, anxiety, stress and parenting); (3) clinical and methodological moderators associated with effectiveness. A thematic synthesis will be conducted on qualitative data exploring the acceptability of CBT-based intervention for postpartum depression including participants' experience and perspectives of the interventions, satisfaction, barriers and facilitators to intervention use, intervention relevance to mothers' situations and suggestions for improvements to tailor interventions to the peripartum client group.ETHICS AND DISSEMINATION:Formal ethical approval is not required by the National Ethical Review Board in Sweden as primary data will not be collected. The results will be disseminated through a peer-reviewed publication and inform the development of a new psychological intervention for peripartum depression. This study including protocol development will run from March 2019 to March 2020.
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| 7. |
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| 8. |
- Pettman, Danelle, et al.
(author)
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Effectiveness of cognitive behavioural therapy-based interventions for maternal perinatal depression : a systematic review and meta-analysis
- 2023
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In: BMC Psychiatry. - : BioMed Central (BMC). - 1471-244X. ; 23:1
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Journal article (peer-reviewed)abstract
- BackgroundDepression during the perinatal period (during pregnancy and the year after childbirth) is common and associated with a range of negative effects for mothers, infants, family members, and wider society. Although existing evidence suggests cognitive behavioral therapy (CBT) based interventions are effective for perinatal depression, less is known about the effect of CBT-based interventions on important secondary outcomes, and a number of potential clinical and methodological moderators have not been examined.MethodsA systematic review and meta-analysis primarily examined the effectiveness of CBT-based interventions for perinatal depression on symptoms of depression. Secondary aims examined the effectiveness of CBT-based interventions for perinatal depression on symptoms of anxiety, stress, parenting, perceived social support, and perceived parental competence; and explored clinical and methodological moderators potentially associated with effectiveness. A systematic search of electronic databases and other sources was performed up to November 2021. We included randomized controlled trials comparing CBT-based interventions for perinatal depression with control conditions allowing for the isolation of the effects of CBT.ResultsIn total, 31 studies (5291 participants) were included in the systematic review and 26 studies (4658 participants) were included in the meta-analysis. The overall effect size was medium (hedges g = − 0.53 [95% CI − 0.65 to − 0.40]); with high heterogeneity. Significant effects were also found for anxiety, individual stress, and perceived social support, however few studies examined secondary outcomes. Subgroup analysis identified type of control, type of CBT, and type of health professional as significant moderators of the main effect (symptoms of depression). Some concerns of risk of bias were present in the majority of studies and one study had a high risk of bias.ConclusionsCBT-based interventions for depression during the perinatal period appear effective, however results should be interpreted with caution given high levels of heterogeneity and low quality of included studies. There is a need to further investigate possibly important clinical moderators of effect, including the type of health professional delivering interventions. Further, results indicate a need to establish a minimum core data set to improve the consistency of secondary outcome collection across trials and to design and conduct trials with longer-term follow-up periods.
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| 9. |
- Pettman, Danelle, et al.
(author)
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Effectiveness of cognitive behavioural therapy-based interventions for maternal perinatal depression : A systematic review and meta-analysis
- 2022
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In: BABCP 50th Annual Conference.
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Conference paper (peer-reviewed)abstract
- Background: Perinatal depression is prevalent condition which impact negatively upon mothers, infants, families and widersociety. The evidence based suggests that cognitive behavioral therapy (CBT) based interventions are effective for perinataldepression, however the effect upon important secondary outcomes, and a number of potential clinical andmethodological moderators has yet to be examined.Methods: A systematic review and meta-analysis was conducted to explore the effectiveness of CBT-based interventionsfor perinatal depression on symptoms of depression, anxiety, stress, parenting, perceived social support, and perceivedparental competence. Clinical and methodological moderators potentially associated with effectiveness were explored. Asystematic search was performed for randomized controlled trials (RCTs) of CBT-based interventions for perinataldepression. Searches were performed up until November 2021.Results: The systematic review included 31 studies (5,291 participants) and the meta-analysis included 26 studies (4,658participants). The overall effect size was medium (hedges g = -0.53 [95% CI -0.65 to -0.40]); with high heterogeneity.Significant effects were found for anxiety, individual stress, and perceived social support, however few studies includedthese secondary outcomes. In the subgroup analysis; type of control, type of cognitive behavioral therapy, and type ofhealth professional were significant moderators of the main effect (symptoms of depression). Some concerns of risk of biaswere present in many studies and one study had a high risk of bias.27Conclusions: CBT-based interventions for perinatal depression appear effective, however results should be cautiouslyinterpreted given high levels of heterogeneity and risk of bias presented in many studies. The moderating effect of the typeprofessional delivering interventions warrants further study. Additionally, the results indicate a need to improveconsistency of reporting across trials with the development of a minimum core data set and to design and conduct trialswith longer-term follow-up periods.PROSPERO registration: CRD42020152254.
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| 11. |
- Svedin, Frida, Doktorand, et al.
(author)
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Adapting a guided low-intensity behavioural activation intervention for people with dementia and depression in the Swedish healthcare context (INVOLVERA) : a study protocol using codesign and participatory action research.
- 2021
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In: BMJ Open. - : BMJ. - 2044-6055. ; 11:7
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Dementia is a worldwide health concern with incident rates continuing to increase. While depression prevalence is high in people with dementia and psychological interventions such as cognitive behavioural therapy (CBT) are effective, access to psychological interventions remains limited. Reliance on traditional CBT for people with dementia and depression may present difficulties given it is a complex psychological approach, costly to deliver, and professional training time is lengthy. An alternative approach is behavioural activation (BA), a simpler psychological intervention for depression. The present study seeks to work with people with dementia, informal caregivers, community stakeholders, and healthcare professionals, to adapt a guided low-intensity BA intervention for people with dementia and depression, while maximising implementation potential within the Swedish healthcare context.METHODS AND ANALYSIS: A mixed methods study using codesign, principles from participatory action research (PAR) and normalisation process theory to facilitate the cultural relevance, appropriateness and implementation potential of the intervention. The study will consist of four iterative PAR phases, using focus groups with healthcare professionals and community stakeholders, and semi-structured interviews with people with dementia and informal caregivers. A content analysis approach will be adopted to analyse the transcribed focus groups and semi-structured interviews recordings.ETHICS AND DISSEMINATION: The study will be conducted in accordance with the Declaration of Helsinki and data handled according to General Data Protection Regulation. Written informed consent will be obtained from all study participants. In accordance with the Swedish Health and Medical Services Act, capacity to consent will be examined by a member of the research team. Ethical approval has been obtained from the Swedish Ethical Review Authority (Dnr: 2020-05542 and Dnr: 2021-00925). Findings will be published in an open access peer-reviewed journal, presented at academic conferences, and disseminated among lay and healthcare professional audiences.
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| 12. |
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| 13. |
- Svedin, Frida, Doktorand, et al.
(author)
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Adapting a guided low-intensity behavioural activation intervention for people with dementia and depression in the Swedish healthcare context (INVOLVERA)
- 2021
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Conference paper (peer-reviewed)abstract
- Global health and social care policy highlights the need to support people to ‘live well’ with dementia. This is of particular importance given the high burden placed on individuals with dementia, informal caregivers, and society. Depression is highly prevalent in people with dementia, stressing the importance of developing interventions to support people with both dementia and depression. Despite evidence-based psychological interventions (e.g., cognitive behavioral therapy (CBT)) being effective, access is limited. To overcome this psychological ‘treatment gap’, there have been global efforts made via the provision of low-intensity CBT (LI-CBT). Behavioural activation (BA), an example of a LI-CBT approach shown to be as effective as CBT in the treatment of depression. Research informed by the Medical Research Council complex interventions framework has been conducted in the United Kingdom to develop and test a guided low-intensity BA intervention adapted for people with dementia. An innovative aspect of the intervention is support to the person with dementia is provided by an informal caregiver, in turn the informal caregiver receives guidance from a healthcare professional. Initial results indicated the intervention was acceptable and feasible, and may therefore represent a solution for the Swedish context. However, before implementing in Sweden, there is a need for contextual adaptation. Using a mixed-methods study design, informed by principles from participatory action research, this study involved people with dementia, informal caregivers, healthcare professionals and community organisations to co-design and adapt the guided low-intensity BA intervention for the Swedish context. Through a series of iterative phases, we conduct interviews and focus groups with participants to gain feedback on the BA intervention to inform adaptations to improve the acceptability, relevancy, and feasibility of the intervention. After each phase we amend the intervention according to feedback. During the presentation the preliminary results and research progress will be presented.
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| 14. |
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| 15. |
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| 16. |
- Svedin, Frida, Doktorand, 1995-, et al.
(author)
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Developing and adapting a guided low-intensity behavioral activation intervention targeting depression in people with dementia for the Swedish context (The INVOLVERA Study)
- 2022
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Conference paper (peer-reviewed)abstract
- Introduction: Dementia continues to increase worldwide, with numbers set to rise from 50 million in 2021 to 150 million by 2050. Global health and social care policies highlight a need to support people with dementia to ‘live well’. This is of particular importance given the high burden caused by dementia on individuals, informal caregivers, and society. Depression is highly prevalent in people with dementia. Whilst evidence-based psychological interventions (e.g. Cognitive Behavioral Therapy (CBT)) have been shown effective, access remains limited. To overcome this psychological ‘treatment gap’, global efforts have been made to increase access via provision of low-intensity CBT. Behavioral activation (BA), an example of an evidence-based low-intensity CBT approach, may represent a solution for people with dementia and depression in Sweden. Given the promise of BA, research was conducted in the United Kingdom to develop and examine feasibility of a low-intensity BA intervention tailored to people with dementia. Findings indicated the intervention feasible and acceptable to people with dementia and their informal caregivers. Given the promise of the intervention, development work has taken place in Sweden to maximise acceptability, relevancy, and feasibility in the Swedish context.Method: A mixed-methods study involving people with dementia, informal caregivers, healthcare professionals, and non-governmental organisations (NGOs) to co-design and adapt the intervention for the Swedish context. Through iterative phases, interviews and focus groups were conducted with all stakeholders to gain feedback on the intervention. Results informed adaptations to improve intervention acceptability, relevancy, and feasibility. Interviews and focus groups were analysed using framework content analysis according to Normalization Process Theory (NPT) constructs (Coherence, Cognitive Participation, Collective Action, Reflexive Monitoring). Alongside, a Public Involvement group was established to further inform the intervention design.Results: Preliminary results indicate facilitators include: (1) intervention has the potential to fill a large psychological treatment gap given lack of current support (Coherence); (2) objectives and potential benefits of intervention were understood and agreed by stakeholders (Coherence). Barriers include: (1) lack of involvement and engagement from politicians, decision-makers, and managers (Collective Action); (2) lack of appropriate workforce providing guidance to the intervention in Sweden (Collective Action); (3) NGOs not recognising their potential role in the intervention (Cognitive Participation); (4) lack of time and financial resources (Collective Action); (5) healthcare professionals and NGOs acting gatekeepers for informal caregivers accessing support (Cognitive Participation).Discussion: Psychological needs of people with dementia and depression are currently unmet by Swedish healthcare. The proposed intervention has potential to meet unmet psychological needs and global priorities to support people with dementia to ‘live well’. Given barriers to intervention implementation are common, NPT provides a useful framework for understanding potential barriers and facilitators to implementation from the intervention development phase. Understanding barriers and facilitators to implementation at the intervention development phase may enhance future implementation potential if intervention is shown effective.Conclusion: Results inform the development of a tailored intervention, optimised to improve maximise acceptability, relevancy, and feasibility for people with dementia and depression. A subsequent feasibility study will further examine the feasibility and acceptability of the intervention.
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| 17. |
- Svedin, Frida, Doktorand, 1995-, et al.
(author)
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Development and co-design of a behavioral activation intervention targeting depression among people with dementia for the Swedish context
- 2023
-
Conference paper (peer-reviewed)abstract
- Background: Approximately 40% of people with dementia experience depression. Whilst psychological interventions are effective for the treatment of depression in dementia, access remains low. A behavioural activation self-help intervention, with support to the person with dementia to use the intervention provided by an informal caregiver, who themselves receives guidance from an occupational therapist (or other trained healthcare professional), may represent a solution.Objective: To develop a behavioral activation intervention targeting depression among people with dementia for the Swedish context together with key stakeholders.Methods: Semi-structured interviews and focus groups were held with people with dementia (n=8), informal caregivers (n=19), healthcare professionals (n=18), and non-governmental organisations (n=7) and analysed using manifest content analysis. A Public Advisory Group, consisting of informal caregivers of people with dementia (n=4), worked alongside the research team to support the interpretation and sense-making of research findings and co-design of the intervention.Results: An overarching theme ‘Tailoring and flexibility’ resulted from interviews and focus groups. Stakeholders expressed a need to adapt intervention material to increase relevancy and representativeness by: (1) adding multiple case stories to illustrate different life situations, age groups, ethnic backgrounds, and to increase relevance to Swedish society and culture; (2) designing new illustrations, as proposed illustrations were perceived old-fashioned and reinforced ageing and dementia stereotypes; and (3) reducing text to minimize treatment burden. Stakeholders also expressed a need for flexibility concerning intervention delivery and expressed a need for choice concerning: (1) location of guidance sessions to enable face-to-face sessions to be delivered in a familiar, safe, and convenient environment (e.g., home or familiar community setting); (2) mode of guidance (e.g., face-to-face, telephone, online); and (3) amount of guidance (e.g., frequency and number of guidance sessions).Conclusions: Results informed the development of a tailored intervention, optimised to improve acceptability, feasibility, and relevancy for people with dementia and depression. A planned feasibility study will further examine feasibility and acceptability of the intervention.Public involvement: Our Public Advisory Group has worked closely together with the research team to support the interpretation and sense-making of research findings and co-design the intervention to increase acceptability and relevancy of the intervention.
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| 18. |
- Svedin, Frida, Doktorand, 1995-, et al.
(author)
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Effectiveness, acceptability, and completeness and quality of intervention reporting of psychological interventions for people with dementia or mild cognitive impairment : protocol for a mixed-methods systematic review
- 2023
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:12
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Journal article (peer-reviewed)abstract
- Introduction: Mental health difficulties such as anxiety and depression have negative impacts on psychological well-being and are common in people with dementia and mild cognitive impairment. However, access to psychological treatments is limited. This mixed-method systematic review will: (1) examine the effectiveness of psychological interventions to improve mental health and psychological well-being in people with dementia or mild cognitive impairment; (2) examine the effectiveness of these psychological interventions to improve mental health and psychological well-being in informal caregivers; (3) examine potential clinical and methodological moderators associated with effectiveness; (4) explore factors associated with the acceptability of psychological interventions from the perspective of key stakeholders; and (5) examine the completeness and quality of intervention reporting.Methods and analysis: Electronic databases (ASSIA, CENTRAL, CINAHL, EMBASE, PsycINFO and MEDLINE) will be systematically searched and supplemented with expert contact, reference and citation checking, and grey literature searches. If possible, we will conduct a meta-analysis to examine the overall effectiveness of psychological interventions to improve mental health and psychological well-being in people with dementia or mild cognitive impairment and their informal caregivers; and examine potential clinical and methodological moderators associated with effectiveness. We will conduct a deductive framework synthesis, informed by the theoretical framework of acceptability, to explore factors associated with the acceptability of psychological interventions from the perspective of key stakeholders. In accordance with Joanna Briggs Institute guidance, we will adopt a convergent segregated approach to data synthesis and integration of quantitative and qualitative findings. We will examine the completeness and quality of intervention reporting according to the Template for Intervention Description and Replication checklist and guide.Ethics and dissemination: No primary data will be collected, and therefore, ethical approval is not required. Results will be disseminated through a peer-reviewed publication, academic conferences, and plain language summaries.PROSPERO registration number: CRD42023400514.
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| 19. |
- Svedin, Frida, Doktorand, 1995-, et al.
(author)
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Healthcare and community stakeholders' perceptions of barriers and facilitators to implementing a behavioral activation intervention for people with dementia and depression : a qualitative study using Normalization Process Theory
- 2023
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In: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 23:1
-
Journal article (peer-reviewed)abstract
- BackgroundDepression is commonly experienced by people with dementia, and associated with lower quality of life and functional decline. However, access to evidence-based psychological interventions for people with dementia and depression is limited. One potential solution is guided low-intensity behavioral activation. Following the new Medical Research Council Framework, considering factors such as potential barriers and facilitators to implementation is recommended during the development of new interventions. Aims of this study were to: (1) develop an understanding of existing healthcare and community support in the Swedish context for people with dementia and their informal caregivers; and (2) identify barriers and facilitators to intervention uptake informed by Normalization Process Theory.MethodsSemi-structured interviews and focus groups were held with healthcare (n = 18) and community (n = 7) stakeholders working with people with dementia and/or informal caregivers. Interview questions were informed by Normalization Process Theory. Data was analysed utilizing a two-step deductive analysis approach using the Normalization Process Theory coding manual, with inductive categories applied to data related to the main mechanisms of the theory, but not captured by its sub-constructs.ResultsTwelve deductive and three inductive categories related to three Normalization Process Theory primary mechanisms (Coherence, Cognitive Participation, and Collective Action) were identified. Identified barriers to intervention uptake included: (1) additional burden for informal caregivers; (2) lack of appropriate workforce to provide guidance; (3) lack of time and financial resources; (4) people with dementia not recognising their diagnosis of dementia and/or a need for support; and (5) stigma. Identified facilitators to intervention uptake included: (1) intervention has potential to fill a large psychological treatment gap in Sweden; (2) objectives and potential benefits understood and agreed by most stakeholders; and (3) some healthcare professionals recognized their potential role in providing intervention guidance.ConclusionsSeveral barriers and facilitators for future implementation, specific to the intervention, individuals and families, as well as professionals, were identified during intervention development. Barriers were mapped into evidence-based implementation strategies, which will be adopted to overcome identified barriers. A feasibility study further examining implementation potential, acceptability and feasibility, alongside clinical, methodological, and procedural uncertainties associated with the intervention will be conducted.
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| 20. |
- Svedin, Frida, Doktorand, 1995-, et al.
(author)
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Professional stakeholders’ perceptions of barriers and facilitators to implementing a behavioural activation intervention for people with dementia
- 2024
-
Conference paper (peer-reviewed)abstract
- Introduction: Depression is commonly experienced by people with dementia. Whilst evidence-based psychologicalinterventions are effective, a large psychological care gap remains. Behavioral activation may representa potential solution to close this gap. Following the MRC Framework for developing complexinterventions, considering potential barriers and facilitators to implementation is recommended duringintervention development. This study aimed to identify professional stakeholders’ perceptions of barriersand facilitators to future implementation.Methods: Following a topic guide informed by Normalization Process Theory (NPT), focus groups and semistructuredinterviews were held with healthcare professionals (n=18) and community stakeholders (n=7).Data was analyzed using the NPT coding manual, with inductive categories generated for data related tomain NPT mechanisms, but not captured by its sub-constructs.Results: A number of barriers and facilitators were identified. Facilitators include the proposed intervention: (1)has potential to fill a large psychological care gap; (2) has understandable and agreed upon objectivesand potential benefits; and (3) could easily be integrated into the lives of people with dementia and theirinformal caregivers. Barriers include lack of: (1) engagement from politicians and decision-makers; (2)appropriate workforce to provide intervention guidance; (3) time and financial resources.Conclusions: Results have informed the adaptation of a tailored intervention, optimized to improve futureimplementation potential. A subsequent feasibility study will further examine intervention feasibility andacceptability.
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| 21. |
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| 22. |
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| 23. |
- Pettman, Danelle, et al.
(author)
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- 2020
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In: 6th International Congress of Clinical Psychology and Health with Children and Adolescents. - : Ediciones Pirámide (Grupo Anaya, S. A.). ; , s. 84-84
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Conference paper (other academic/artistic)abstract
- Postpartum depression (PPD) can interfere witha mother’s ability to engage in sensitive caregiving,however a recent systematic review and meta-analysisby our group (Pettman et al., 2020) revealed the majority of existing PPD interventions focus on the mothersmood alone, without additional support with parenting.Further, in a recent randomised controlled feasibilitytrial telephone supported internet-administered behavioural activation (BA) intervention for PPD demonstrated feasibility and acceptability with a large effectsize for depression at post-treatment (-0.87, 95% CI0.42-1.32), maintained at 6 months (O’Mahen et al.,2014). Attrition rates were low, with 10% attrition inthe BA group at post-treatment and 14% at 6-monthfollow-up. However, only small effect sizes were foundfor self-reported perception of relationship with infant(parental bonding). The purpose of this research is todevelop an accessible internet-based intervention thatintegrates BA treatment for PPD with parenting skillsand to adapt it to a Swedish population. Adopting theMedical Research Council (United Kingdom) phase I(development) framework, this qualitative study willuse a participatory action research (PAR) approach.Using PAR will place Swedish mothers with lived experience of PPD at the centre of the intervention development process. Through a series of iterative workshops,meetings and online feedback, a Mother ResearcherPartner Panel of mothers with lived experience ofPPD and Health Care Professional Advisory Group willassist the research team in iteratively developing theintegrated PPD and parenting intervention. Resultswill report mothers’ intervention design and deliverypreferences, including technical elements, visual andaudio elements, and amount and format of professional support. Results will also describe adaptations toimprove the cultural appropriateness, relevance, andacceptability of the intervention to Swedish mothers.
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