A digital iCBT intervention for social anxiety disorder in Quebec and Ontario: protocol for a multi-phase effectiveness-implementation study.

Autor: Vasiliadis HM; Faculté de Médecine et sciences de la santé, Université de Sherbrooke, 150, place Charles‑Le Moyne, Longueuil, Québec, C. P. 200, J4K 0A8, Canada. helen-maria.vasiliadis@usherbrooke.ca.; Centre de recherche Charles-Le Moyne, Longueuil, Québec, Canada. helen-maria.vasiliadis@usherbrooke.ca., Roberge P; Faculté de Médecine et sciences de la santé, Université de Sherbrooke, 150, place Charles‑Le Moyne, Longueuil, Québec, C. P. 200, J4K 0A8, Canada.; Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada., Spagnolo J; Centre de recherche Charles-Le Moyne, Longueuil, Québec, Canada.; École des sciences de l'administration, Université TÉLUQ, Montréal, Québec, Canada., Lamoureux-Lamarche C; Faculté de Médecine et sciences de la santé, Université de Sherbrooke, 150, place Charles‑Le Moyne, Longueuil, Québec, C. P. 200, J4K 0A8, Canada., Chapdelaine A; Faculté de Médecine et sciences de la santé, Université de Sherbrooke, 150, place Charles‑Le Moyne, Longueuil, Québec, C. P. 200, J4K 0A8, Canada., Brodeur M; Faculté de Médecine et sciences de la santé, Université de Sherbrooke, 150, place Charles‑Le Moyne, Longueuil, Québec, C. P. 200, J4K 0A8, Canada.; Centre de recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Québec, Canada., Grenier J; University of Ottawa, Ottawa, ON, Canada.; Institut du Savoir Montfort, Ottawa, ON, Canada., Mahoney A; Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Darlinghurst, Sydney, Australia.; School of Psychiatry, University of New South Wales, Sydney, Australia., Koszycki D; University of Ottawa, Ottawa, ON, Canada.; Institut du Savoir Montfort, Ottawa, ON, Canada., Chomienne MH; University of Ottawa, Ottawa, ON, Canada.; Institut du Savoir Montfort, Ottawa, ON, Canada., Drapeau M; Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada., Labelle R; Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada.; Center for Research and Intervention on Suicide, Ethical Issues and End-of-Life Practices, Université du Québec à Montréal, Montréal, Québec, Canada., Provencher MD; École de psychologie, Université Laval, Québec, Québec, Canada., Ishimo MC; Public Health Agency of Canada, Ottawa, ON, Canada., Naslund JA; Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA., Lesage A; Department of Psychiatry, University of Montreal, Montréal, Québec, Canada.; Research Center of the Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada.
Jazyk: angličtina
Zdroj: BMC psychiatry [BMC Psychiatry] 2024 Oct 08; Vol. 24 (1), pp. 662. Date of Electronic Publication: 2024 Oct 08.
DOI: 10.1186/s12888-024-06082-7
Abstrakt: Background: Social anxiety disorder (SAD) is one of the most prevalent anxiety disorders in Canada. Viable therapy options for the treatment of SAD include CBT being delivered virtually. In Australia, an innovative internet-delivered cognitive-behavioral therapy (iCBT) program for social anxiety has been developed, implemented, and demonstrated as effective. To make available high-quality and real-time evidence in response to the crucial need to access psychological services to meet population mental health needs, we propose to conduct a Canadian adaptation of the iCBT Shyness Program and to examine the program's effectiveness, and implementation in two Canadian provinces (Quebec and Ontario).
Methods: The overall study design is a hybrid effectiveness-implementation study of a quasi-experimental parallel group trial. Prior to implementing the iCBT Shyness Program, it will undergo an initial adaptation to the Canadian context and focus groups will be conducted with key actor groups to discuss the adaptations to the graphics, narration of the lessons, and this to better reflect varying socio-cultural context among Canadian French- and English-speaking populations. We will evaluate the effectiveness of the program in three parallel pathways reflecting real-world pathways: (1) self-refer to the intervention; (2) recommended by a health professional without guidance; and (3) recommended by a health professional, with low-intensity guidance. Data collection will be carried out at baseline, at the beginning of each lesson, 12-week and 6-month follow-up. Outcomes measured will include anxiety and depressive symptoms, psychological distress, disability, as well as health service utilization and satisfaction. Semi-structured interviews will then be conducted with study participants and health care providers to explore facilitating factors and barriers to the implementation of the iCBT adapted program.
Discussion: This study will provide evidence on the effectiveness, barriers and facilitating factors to implementing a low-intensity iCBT in the Canadian context for SAD, which will bridge an important care gap for undeserved populations in Canada with SAD. Findings will inform the eventual scaling up of the program in community-based primary care across Canada. This would improve equity of the health care system by helping a large number of Canadians to timely access to mental health services.
Trial Registration: clinicaltrials.gov NCT06403995. Prospectively registered on 05/03/2024.
(© 2024. The Author(s).)
Databáze: MEDLINE
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