TY - JOUR
T1 - Feasibility and acceptability of a CF-specific cognitive-behavioral preventive intervention for adults integrated into team-based care
AU - Friedman, Deborah
AU - Smith, Beth A.
AU - Bruce, Amanda
AU - Schwartz, Carolyn E.
AU - Lee, Hang
AU - Pinsky, Hanna
AU - Gootkind, Elizabeth
AU - Hardcastle, Margot
AU - Shea, Nicole
AU - Roach, Christine M.
AU - Miller, Caitlin
AU - Polineni, Deepika
AU - Salathe, Matthias
AU - Quittner, Alexandra L.
AU - Georgiopoulos, Anna M.
N1 - Funding Information:
The study reported in this manuscript was supported through a 2016 Circle of Care Award from Vertex Pharmaceuticals, Inc., and a Cystic Fibrosis Foundation Therapeutics, Inc. research grant [FRIEDM17A0]. A portion of the results have been presented at the North American Cystic Fibrosis Conference in 2019 (Friedman D, Quittner A, Smith B, Schwartz CE, Lee H, Stark RB, et al. Preventing depression and anxiety: Results of a pilot study of a CF‐specific CBT intervention for adults with CF. Pediatr Pulmonol. 2019;54(S2):397 and 2020 (Georgiopoulos AM, Smith B, Schwartz CE, Lee H, Stark RB, Pinsky H, et al., Treatment fidelity and participant engagement in a pilot study of a CF‐specific CBT intervention for adults with CF. Pediatr. Pulmonol. 2020;55: S264)
Funding Information:
We gratefully acknowledge the contributions of Kim Rand in her role as social worker at the University of Buffalo CF program and Massachusetts General Hospital study staff members, Sophie Pollinger, Lauren Guthrie, and Nivedita Chaudhary. We are grateful to Roland Stark, M.Ed., for assistance with statistical programming. Finally, we would like to thank the participants of this study for their time and valuable feedback contributing to the development of the CF-CBT program. The study reported in this manuscript was supported through a 2016 Circle of Care Award from Vertex Pharmaceuticals, Inc., and a Cystic Fibrosis Foundation Therapeutics, Inc. research grant [FRIEDM17A0]. A portion of the results have been presented at the North American Cystic Fibrosis Conference in 2019 (Friedman D, Quittner A, Smith B, Schwartz CE, Lee H, Stark RB, et al. Preventing depression and anxiety: Results of a pilot study of a CF-specific CBT intervention for adults with CF. Pediatr Pulmonol. 2019;54(S2):397 and 2020 (Georgiopoulos AM, Smith B, Schwartz CE, Lee H, Stark RB, Pinsky H, et al., Treatment fidelity and participant engagement in a pilot study of a CF-specific CBT intervention for adults with CF. Pediatr. Pulmonol. 2020;55: S264)
Funding Information:
DF reports grants from the Cystic Fibrosis Foundation (CFF), Dutch Cystic Fibrosis Foundation, and Vertex Pharmaceuticals, and travel reimbursement from the CFF. BAS reports grants, personal fees and travel reimbursement from CFF. ASB reports grant funding from the Cystic Fibrosis Foundation. HP, ES, MH, and NS report grant support from the Cystic Fibrosis Foundation. CMR reports grant support, personal fees and travel reimbursement from the CFF. DP reports grants from the CFF and NIH, consulting and travel fees from Vertex Pharmaceuticals, personal fees from National Jewish Health and Vanderbilt University and advisory board roles with Laurent Pharmaceuticals, Vertex Pharmaceuticals, and TranslateBio. MS reports grants from CFF, Flight Attendant Medical Research Institute, COPD Foundation, and NIH and advisory board role for NHLBI. ALQ reports consulting fees from Vertex Pharmaceuticals and Insmed, and grant funding from the CFF, American Cochlear Implant Alliance, PCORI and the NIH. AMG reports personal fees and travel reimbursement from Cystic Fibrosis Australia; grants, personal fees, and travel reimbursement from CFF; grants from the Dutch Cystic Fibrosis Foundation; travel reimbursement from the European Cystic Fibrosis Society; personal fees from Johns Hopkins University/DKBmed; personal fees from Saudi Pediatric Pulmonology Association; grants and personal fees from Vertex Pharmaceuticals.
Publisher Copyright:
© 2022 Wiley Periodicals LLC.
PY - 2022/11
Y1 - 2022/11
N2 - Background: A cystic fibrosis (CF)-specific cognitive-behavioral therapy intervention (CF-CBT) was developed in partnership with the CF community to advance preventive mental health care. Multidisciplinary providers across three centers were trained to deliver CF-CBT for this pilot assessing feasibility/acceptability and preliminary effectiveness of an integrated model of care. Methods: The 8-session CF-CBT was delivered to 14 adults with mild depression and/or anxiety symptoms in-person and via audio telehealth. Assessment of attrition, engagement, homework completion, treatment satisfaction, and treatment fidelity informed feasibility/acceptability assessment. Mental health outcomes included depression, anxiety, quality of life (Cystic Fibrosis Questionnaire-Revised [CFQ-R), perceived stress and coping. Preliminary effectiveness was evaluated with Cohen's d metric of effect sizes (ES) of pre-post mean change scores. Results: A total of 108 sessions were conducted; 13 adults completed the intervention; 1 discontinued early. Engagement, homework completion, and treatment acceptability were highly rated (mean = 30; SD = 2, range: 27–32 on a 32-point scale). Fidelity scores ranged from 85.7% to 93.6%. Large ES changes reflected improvements in depressive symptoms (−0.83), CFQ-R (Vitality scale: 1.11), and Relaxation Skills (0.93); moderate ES for CFQ-R Role Functioning (0.63), Awareness of Tension (0.62), Coping Confidence (0.70) and CF-specific Coping (0.55); and small ES for anxiety symptoms (−0.22), perceived stress (−0.25), Behavioral Activation (0.29), and several CFQ-R domains, including Emotional Functioning (0.29). Two CFQ-R subscales decreased (Body Image, Eating Concerns). Conclusions: Results indicated feasibility and acceptability of CF-CBT and its integration into team-based CF care with promising effectiveness, especially for depression. A multicenter randomized controlled trial of CF-CBT will further examine effectiveness of a CF-specific integrated care model.
AB - Background: A cystic fibrosis (CF)-specific cognitive-behavioral therapy intervention (CF-CBT) was developed in partnership with the CF community to advance preventive mental health care. Multidisciplinary providers across three centers were trained to deliver CF-CBT for this pilot assessing feasibility/acceptability and preliminary effectiveness of an integrated model of care. Methods: The 8-session CF-CBT was delivered to 14 adults with mild depression and/or anxiety symptoms in-person and via audio telehealth. Assessment of attrition, engagement, homework completion, treatment satisfaction, and treatment fidelity informed feasibility/acceptability assessment. Mental health outcomes included depression, anxiety, quality of life (Cystic Fibrosis Questionnaire-Revised [CFQ-R), perceived stress and coping. Preliminary effectiveness was evaluated with Cohen's d metric of effect sizes (ES) of pre-post mean change scores. Results: A total of 108 sessions were conducted; 13 adults completed the intervention; 1 discontinued early. Engagement, homework completion, and treatment acceptability were highly rated (mean = 30; SD = 2, range: 27–32 on a 32-point scale). Fidelity scores ranged from 85.7% to 93.6%. Large ES changes reflected improvements in depressive symptoms (−0.83), CFQ-R (Vitality scale: 1.11), and Relaxation Skills (0.93); moderate ES for CFQ-R Role Functioning (0.63), Awareness of Tension (0.62), Coping Confidence (0.70) and CF-specific Coping (0.55); and small ES for anxiety symptoms (−0.22), perceived stress (−0.25), Behavioral Activation (0.29), and several CFQ-R domains, including Emotional Functioning (0.29). Two CFQ-R subscales decreased (Body Image, Eating Concerns). Conclusions: Results indicated feasibility and acceptability of CF-CBT and its integration into team-based CF care with promising effectiveness, especially for depression. A multicenter randomized controlled trial of CF-CBT will further examine effectiveness of a CF-specific integrated care model.
KW - anxiety
KW - cognitive-behavioral therapy
KW - cystic fibrosis
KW - depression
KW - prevention
KW - quality of life
UR - https://www.scopus.com/pages/publications/85135881825
U2 - 10.1002/ppul.26101
DO - 10.1002/ppul.26101
M3 - Article
C2 - 35931665
AN - SCOPUS:85135881825
SN - 8755-6863
VL - 57
SP - 2781
EP - 2790
JO - Pediatric Pulmonology
JF - Pediatric Pulmonology
IS - 11
ER -