Amsterdam 2015
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| Abstract #2185 - No health without mental health | ||||
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Session: 40.4: No health without mental health (Parallel) on Thursday @ 16.30-18.00 in C103 Chaired by Mark Tomlinson, Tomas Campbell Authors: Presenting Author: Ms Jinghua Li - The Chinese University of Hong Kong, Hong Kong |
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| Additional Authors: | ||||
| Aim: HIV positive men who have sex with men (HIVMSM), facing severe stigma and many stressors, have high prevalence of mental health problems, such as depression. However, mental health promotion services targeting this population are very scarce in China. The Three Good Things (TGT) exercise is one of the commonly used positive psychology interventions, which has been shown to be effective in reducing depression. This study aimed at investigating the efficacy of a one-month online intervention combining TGT with social networking (TGT-SN) versus a control on information dissemination in reducing depressive symptoms among HIVMSM in Chengdu, China. | ||||
| Method / Issue: A randomized controlled trial was conducted. A total of 205 HIVMSM were recruited and randomly assigned to the TGT-SN (N=100) or control group (N=105) by four well-trained peer fieldworkers. Self-administered surveys were conducted among all participants at baseline, at the end of the 1-month intervention (T1), and at the 3-month (T2) and 6-month (T3) post-intervention follow-ups. The intervention was delivered via “QQ”, the most widely used Chinese social networking tool. Participants in TGT-SN group were divided into four “QQ” groups each of size of 20-30 persons. Participants in TGT-SN were asked to post three things they experienced that they feel grateful about daily onto the QQ platform and share it with members of their group. They were also asked to read others’ messages and give positive and encouraging feedbacks to those messages. Members of the control group received information about mental health promotion from research assistants once a week. The primary mental health outcome was depressive symptoms measured by Center for Epidemiologic Studies Depression Scale (CES-D). Secondary psychological outcomes include anxiety, positive and negative affect, life satisfaction, subjective happiness, gratitude level, and perceived social support. Generalized Estimating Equation models were fit. Structural equation modeling was applied for mediation analysis. | ||||
| Results / Comments: Among all participants, the baseline prevalence of probable mild to severe depression (CESD=16) was 59.5%. All baseline background characteristics and outcome measures were balanced (statistically non-significant) between the two study arms. Based on data obtained at T1, T2 and T3 that were analyzed by GEE model, there was a significant main effect of TGT-SN on reducing depression (B=-2.35, 95% CI=-4.53, -0.16, p=0.035), indicating significantly lower depression score in the intervention group as compared with that of control group. Significant differences were also found between the TGT-SN and the control group in anxiety symptoms (B=-1.29, 95% CI=-2.22, -0.36, p=0.007) and negative affect (B=-2.24, 95% CI=-3.73, -0.74, p=0.003). The effect of TGT-SN on reducing depression was most evident at T3. Structural equation modeling indicated that gratitude and negative affect fully mediated the effect of TGT-SN in reduction of depression and anxiety (mediation effect=-0.17, 95% CI=-0.30, -0.04, p<0.05) at T3. | ||||
| Discussion: TGT-SN is a feasible and acceptable intervention which can effectively reduce psychological symptoms and improve gratitude among HIVMSM. TGT-SN can be self-administered by non-professionals at low-cost, and can hence be scaled up in resource-limited settings such as China. Future translational studies should be conducted to investigate its efficacy and effectiveness in other groups of people living with HIV. | ||||
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