Major depression is one of the most prevalent mental disorders to afflict adults. It seriously impacts role functioning and often takes a recurrent or chronic course. Given the high prevalence and associated impairments, major depression has become a major public health concern. Because most adults who suffer from depression never receive treatment, there is a critical need to develop prevention programs that can be easily implemented and widely disseminated. This project will develop and test an interactive multimedia program aimed at preventing depression by modifying risk factors and promoting protective factors among at- risk workers. In order to ensure privacy of the worker, the program will be developed for delivery via Employee Assistance Program services. An empirically tested framework will be adapted for self-administration via the Internet or CD-ROM. The program will consist of 11 knowledge- and skills-based modules including: understanding depression, monitoring mood and activity levels, thinking more positively, scheduling pleasant activities, evaluating the relationship between mood and activities, online depression resources, depression self-screening, interpersonal relations, learning to relax, communication and problem solving, and planning for the future. The instructional design will be structured for multiple sessions using video-based tutorials, peer testimonials, and behavior modeling vignettes. The Phase I prototype, targeted to 80 women 18 to 39 years of age, with three of the 11 modules on understanding depression, monitoring mood and activity, and online depression resources will be evaluated using a randomized control trial. The anticipated results from the Phase I trial will demonstrate clinically significant pre-post change with respect to knowledge, intentions, attitudes, and self-efficacy regarding the skills presented. In Phase II, all 11 modules will be developed and targeted to six age and gender groups, and evaluated in a larger randomized trial with a 12-month follow-up period. The Phase II trial is expected to show reductions in depressive symptoms and the onset of major depressive episodes, and increases in occupational functioning, and these changes in the outcome measures are expected to be mediated by changes in the specific skills acquired through the intervention. The potential commercial applications of the Phase II product are to employee assistance firms, behavioral health organizations, health insurance companies, and mental health clinics/practices. Major depression has become a major public health concern given its high prevalence and associated impairments. Although there have been significant advances in the diagnosis and treatment of depression, the design and evaluation of preventive interventions for depression has received little attention to date. Because most adults who suffer from depression never receive treatment, there is a critical need to develop prevention programs that can be easily implemented and widely disseminated. ? ? ?
