Abstract

MSU

Montana ranks high among states on mental health disorder prevalence and low on access to mental health care.  It has the highest suicide rate in the nation.  Of Montana’s 56 counties, 10 are classified as rural and 45 as frontier, accentuating distance challenges in accessing care.  New treatment delivery modalities are needed to complement, supplement and augment traditional mental health care.  With increase in access to the Internet, computer-administered Cognitive Behavior Therapy (cCBT) programs have emerged as viable approaches to effective treatment of depression.  Thrive, an interactive digital cCBT program, has been shown to significantly reduce depressive symptoms among adults in open trials. 

This study will use a community-based approach to develop relationships with leaders in rural and frontier Montana communities and understand how to effectively promote interactive digital health interventions such as Thrive in these communities.  During Year 1, we will conduct key informant interviews with community leaders, such as county Extension agents and local health care providers, to understand the acceptability of and ways to effectively promote Thrive, and determine optimal methods to recruit community members for Year 2 and 3 activities of the project.  Key informants will be provided free access to Thrive prior to these interviews.  We will also conduct focus groups in each community to understand community members’ attitudes about interactive digital health interventions for treating depression.  These qualitative data will be used for the project’s long-term goal: to conduct a randomized controlled trial (RCT) in selected rural and frontier communities.  During Years 2 and 3, we will implement a RCT in multiple rural and frontier communities. This project is expected to have an immediate positive impact on depression for some Montanans with the ultimate aims to produce gold-standard evidence on the efficacy ofThrive, a cCBT program to treat depression, in rural and frontier settings and, more broadly, the potential for interactive digital health interventions.

Specific Aims

This project is expected to have an immediate positive impact on some Montanans suffering depression.  The ultimate aims are to produce gold-standard evidence on the efficacy ofThrive, a cCBT program to treat depression in rural and frontier settings and more broadly, the potential value of interactive digital health interventions. These goals will be accomplished by addressing the following three aims:

  1. Identify, recruit, and conduct key informant interviews with rural Montana community leaders to ascertain the acceptability of and ways to effectively promote Thrive, an interactive cCBT treatment program for depression.
  2.  Conduct focus groups in selected communities to understand community members’ attitudes about interactive digital health interventions for treating depression.
  3. Conduct a randomized controlled trial of Thrive in selected communities to determine its efficacy in treating depression and improving mental health and functioning in general.

Primary Contact

Mark Schure mark.schure@montana.edu

Co-Investigators: 

Sandra Bailey (MSU), Matt Byerly (MSU) and John Greist (University of Wisconsin-Madison) are co-investigators for this project.