Depression and CVD are currently ranked three and four in the top 20 causes of burden of disease worldwide, and are elevated to numbers one and two on this list when middle-high income countries, such as Australia, are considered. Several theories can account for the increased risk of these among people with depression, including the impact of unhealthy lifestyle choices often inherent among this group. A US survey of 1,612 patients, which assessed a range of CVD risk factors, indicated that depressive symptomatology was associated with significantly higher caloric intake, significantly decreased physical activity, and significantly increased number of daily cigarettes compared to people without depression.
Professor Robyn Richmond (Public Health and Community Medicine, UNSW)
Professor Amanda Baker (University of Newcastle)
This project involves the development of the first web-based multi-factor psychological treatment for people with depression, heavy tobacco use and a range of other comorbid cardiovascular disease (CVD) risk factors (poor nutrition, physical inactivity, weight). This treatment is known as Healthy Lifestyles.
This project seeks to increase the accessibility of an innovative, evidence-based psychological treatment (Healthy Lifestyles Treatment, HLT) for improving cardiovascular and mental health among people with depression, by translating it to internet-based delivery (iHLT). HLT has already been developed and evaluated in face-to-face format by the investigative team . iHLT will contain interactive components, including video demonstrations, voiceovers and in-session exercises and will be made widely available via the internet. It will be menu-driven, with site users able to select a CVD risk factor on which to focus for each session in addition to their depressive symptomatology (i.e. smoking cessation, physical activity, nutrition and diet), with options available to integrate messages regarding other relevant CVD risk factors as relevant. The iHLT website will contain self-administered assessment instruments covering relevant mental and general health domains. Users of the site will be prompted to complete these questionnaires at suitable points within the iHLT program, to enable self-monitoring of progress and facilitating ongoing research evaluation with the target group. Site users will also receive a printout and summary of these assessment scores, and be encouraged to discuss these results with their relevant health worker.
Recruitment to the study has now been completed, and data analysis is underway.
Healthy Lifestyles website.
Baker, A., Hiles, S., Thornton, L., Searl, A., Kelly, P. and Kay-Lambkin, F. (2013) From Comorbidity to Multiple Health Behaviour Change, in Emerging Perspectives on Substance Misuse (ed W. Mistral), John Wiley & Sons, Ltd, Chichester, UK.
It is hypothesised that completion of the iHLT program will be associated with decreases in CVD risk factors (including alcohol use, tobacco use, physical inactivity, dietary issues, and obesity), decreases in depression, and improvements in quality of life and general functioning. A dose-response relationship is suggested, with greater improvement hypothesised among those completing more iHLT modules. Providing internet-based access to iHLT could result in individuals receiving treatment in an earlier phase of their disorder, thereby contributing to the prevention, early detection and management of depression and CVD. An additional aim is to empower people to become more actively involved in their own health care, largely via the provision of relevant and tailored information. This approach should also facilitate the strengthening of subsequent client-healthcare professional communications.