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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.


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Using Practice and Learning to Increase Favorable Thoughts


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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


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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



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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*


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Depression: BDI By Intervention Type

  • Phone vs. Web vs. Waitlist

    • Foverall = 41.65, p=.0001

    • Finteraction = 5.93, p=.006*


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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