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Project UPLIFT

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

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  1. Project UPLIFT Main Outcome Results November 6, 2009 Nancy J. Thompson, Ph.D., M.P.H.

  2. Using Practice and Learning to Increase Favorable Thoughts

  3. 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

  4. The 8 Sessions

  5. Each Session • Check-in • Teaching • Group Exercise • Discussion • Skill-building w/ discussion • Review & Homework

  6. 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

  7. Results

  8. 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

  9. 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

  10. Depression Measures

  11. 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*

  12. Depression: BDI • Treatment vs. Waitlist • Foverall = 42.22, p=.0001 • Finteraction = 11.99, p=.001*

  13. Depression: BDI By Intervention Type • Phone vs. Web vs. Waitlist • Foverall = 41.65, p=.0001 • Finteraction = 5.93, p=.006*

  14. Effect by Presence of MDD * < .05 1Time by Condition 2Time by Condition by MDD

  15. Maintenance of Effects * < .05

  16. Knowledge/Skills & Self-Efficacy

  17. 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*

  18. Depression Coping Self-Efficacy • Treatment vs. Waitlist • Foverall = 6.89, p=.013 • Finteraction = 3.59, p=.066

  19. Quality of Life 1.05<p<.10

  20. Satisfaction with Life • Treatment vs. Waitlist • Foverall = 4.52, p=.040 • Finteraction = 3.03, p=.090

  21. 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

  22. 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

  23. 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

  24. 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.)

  25. Going Forward • ~$1 million Challenge Grant • UPLIFT for Prevention • Participants in 4 states • Georgia • Michigan • Texas • Washington

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