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Project UPLIFT. Main Outcome Results November 6, 2009 Nancy J. Thompson, Ph.D., M.P.H. U sing P ractice and L earning to I ncrease F avorable T houghts. Project UPLIFT. Delivery of MBCT by Web and Telephone Groups To people with epilepsy Randomly assigned to groups of 7

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project uplift

Project UPLIFT

Main Outcome Results

November 6, 2009

Nancy J. Thompson, Ph.D., M.P.H.

slide3

Project UPLIFT

  • Delivery of MBCT by Web and Telephone Groups
    • To people with epilepsy
    • Randomly assigned to groups of 7
    • Computers and Internet access provided if needed
    • Groups used for support surrounding Epilepsy
  • 8 Sessions
  • Facilitators
    • Peers and Graduate Students
    • Supervised by a licensed psychologist
  • Funding: Centers for Disease Control and Prevention
each session
Each Session
  • Check-in
  • Teaching
  • Group Exercise
  • Discussion
  • Skill-building w/ discussion
  • Review & Homework
slide6

Design

  • Emphasis on Feasibility and Acceptability
  • Cross-over Design to Explore Effectiveness

Stratum 1:Pretest2 gp 8 wk phoneInterimFollow-up

Stratum 2:Pretest2 gp8 wk Web InterimFollow-up

Stratum 3: PretestInterim2 gp8 wk phone Follow-up

Stratum 4: PretestInterim2 gp 8 wk Web Follow-up

Baseline Week 8 Week 16

participation
Participation
  • Screened (n=98)
    • Excluded (n=34)
    • Eligible (n=53)
  • Assessments
    • Completed Baseline (n=48)
    • Completed Interim Survey (n=40)
    • Completed Third Survey (n=35)
  • Participated in at least one session
    • Phone Intervention Group (n=12)
    • Web Intervention Group (n=10)
    • Phone Waitlist Group (n=10)
    • Web Waitlist Group (n=10)
  • 40 (75.5%) participated and completed the assessment following their participation
data analysis
Data Analysis
  • Baseline Differences
    • Only mean Self Compassion was statistically significant (t = 3.00, df = 38, p = 0.005)
      • Intervention group (mean = 19.7)
      • Waitlist group (mean = 16.0)
  • Repeated Measures ANCOVA
    • Assess the change in scores over time in the intervention and the waitlist groups
    • Controlled all analyses for Self Compassion
slide11

Depression: mBDI

  • Treatment vs. Waitlist
    • Foverall = 40.93, p=.0001
    • Finteraction = 10.14, p=.003*
  • Phone vs. Web vs. Waitlist
    • Foverall = 40.11, p=.0001
    • Finteraction = 4.99, p=.012*
depression bdi
Depression: BDI
  • Treatment vs. Waitlist
    • Foverall = 42.22, p=.0001
    • Finteraction = 11.99, p=.001*
slide13

Depression: BDI By Intervention Type

  • Phone vs. Web vs. Waitlist
    • Foverall = 41.65, p=.0001
    • Finteraction = 5.93, p=.006*
slide14

Effect by Presence of MDD

* < .05

1Time by Condition

2Time by Condition by MDD

knowledge skills
Knowledge & Skills
  • Treatment vs. TAU Waitlist
    • Foverall = 8.97, p=.005
    • Finteraction = 4.75, p=.036*
  • Phone vs. Web vs. Waitlist
    • Foverall = 9.67, p=.004
    • Finteraction = 3.67, p=.036*
depression coping self efficacy
Depression Coping Self-Efficacy
  • Treatment vs. Waitlist
    • Foverall = 6.89, p=.013
    • Finteraction = 3.59, p=.066
quality of life
Quality of Life

1.05<p<.10

satisfaction with life
Satisfaction with Life
  • Treatment vs. Waitlist
    • Foverall = 4.52, p=.040
    • Finteraction = 3.03, p=.090
mental health qol
Mental Health QOL
  • Treatment vs. Waitlist
    • Foverall = 16.07, p=.0001
    • Finteraction = 0.12, p=.727
  • Phone vs. Web vs. Waitlist
    • Foverall = 15.10, p=.0001
    • Finteraction = 0.50, p=.609
physical health qol
Physical Health QOL
  • Treatment vs. Waitlist
    • Foverall = 3.99, p=.053
    • Finteraction = 0.50 , p=.486
  • Phone vs. Web vs. Waitlist
    • Foverall = 3.83, p=.058
    • Finteraction = 0.31, p=.737
summary
Summary
  • Effective in:
    • Reducing depressive symptoms and teaching knowledge and skills associated with reducing depression
      • Intervention group showed significant improvement compared to the waitlist
      • Equally effective for those with and without MDD
      • Reduction in depressive symptoms maintained
    • Approaching significance for Satisfaction with Life and Depression Coping Self-Efficacy
  • Delivery
    • Both phone and web were significantly more effective in reducing depression than waitlist condition
summary1
Summary
  • QOL Findings consistent with the premises of mindfulness
    • that suffering is not something to turn away from or something in need of fixing,
    • that it is worthy of attention,
    • that through attention we can see the ways in which we attach thoughts to the suffering that exacerbate it, and
    • that letting go of these thoughts reduces suffering (Segal et al.)
going forward
Going Forward
  • ~$1 million Challenge Grant
  • UPLIFT for Prevention
  • Participants in 4 states
    • Georgia
    • Michigan
    • Texas
    • Washington
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