This work received support from KT Canada funding from the Canadian Institutes of Health
Research (CIHR)

Welcome!
Psychol...
Funding & Partners
Participant Side Panel
in WebEx

Housekeeping
Use Q&A to post comments/questions
during the webinar
•‘Send’ questions to A...
The Health Evidence Team

Kara DeCorby
Managing Director

Heather Husson
Project Manager

Robyn Traynor
Research Coordinat...
What is www.healthevidence.org?

Evidence
inform

Decision Making
Why use www.healthevidence.org?
1. Saves you time
2. Relevant & current evidence
3. Transparent process
4. Supports for EI...
A Model for Evidence-Informed
Decision Making

Source: National Collaborating Centre for Methods and Tools. (revised 2012)...
Evidence-Informed Decision Making
1. Cultivate a culture of inquiry, critical thinking
and evidence-based practice “cultur...
Evidence-Informed Decision Making
5. Synthesize and integrate the evidence with expertise,
local context, and client prefe...
Review
Merry, S., Hetrick, S.E., Cox, G.R., Brudevold-Iversen, T.,
Bir, J.J., & McDowell, H. (2011). Psychological and/or
...
Importance of this Review
• The World Health Organization estimates that
depression represents the largest burden of disea...
Poll Question #1
Who has heard of a PICO(S)
question before?

1.Yes
2.No
Searchable Questions
1. Population (situation)
2. Intervention (exposure)
3. Comparison (other group)
4. Outcomes
5. Setti...
Evidence Summary:
Edmonds (2013)
Objective: To determine whether psychological or
educational interventions, or both, are ...
Overall Considerations
• Quality Rating: 10 (strong) Methodologically strong
review based on 68 randomized controlled tria...
Targeted vs. Universal
Interventions
Similar level of
effectiveness for BOTH
targeted and universal
interventions

Up to 9...
What’s the evidence Outcomes reported in the review
1. Diagnosis of depressive disorder (16 RCTs, 3240
subjects)

2. Depre...
What’s the evidence – Diagnosis of
depressive disorders
• Compared to no intervention, intervention participants
showed a ...
What’s the evidence – Diagnosis of
depressive disorders
• At 3 to 9 months, risk reduction is maintained for:
Interventio...
What’s the evidence – Diagnosis of
depressive disorders

• There was no risk reduction at 24 months (8 studies),
but a ver...
What’s the evidence – Depression Scores
• Compared to no intervention, intervention
participants showed a small to very sm...
What’s the evidence – Depression Scores
• No impact on depression symptoms at 24 months (12
studies) and 36 months (5 stud...
What’s the evidence – Depression Scores
(Targeted vs. Universal)

• Interventions targeting high-risk individuals and thos...
General Implications
Public Health should provide psychological and
educational interventions to prevent depression in
chi...
Questions?
Poll Questions # 2 and 3

Survey Participation
Your Feedback is greatly appreciated!
Contact Us
info@healthevidence.org
For a copy of the presentation please visit:
http://www.healthevidence.org/webinars.asp...
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Psychological depression prevention programs for 5-10 year olds: What’s the evidence?

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Health Evidence hosted a 90 minute webinar on psychological depression prevention programs for children and adolescents. This work received support from KT Canada funding from the Canadian Institutes of Health Research (CIHR). Key messages and implications for practice were presented.

This webinar focused on interpreting the evidence in the following review:
Merry, S., Hetrick, S.E., Cox, G.R., Brudevold-Iversen, T., Bir, J.J., & McDowell, H. (2011).Psychological and/or educational interventions for the prevention of depression in children and adolescents. Cochrane Database of Systematic Reviews, 2011(12), Art. No.: CD003380.

Kara DeCorby, Managing Director & Knowledge Broker with Health Evidence, lead the webinar.

Published in: Health & Medicine
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Psychological depression prevention programs for 5-10 year olds: What’s the evidence?

  1. 1. This work received support from KT Canada funding from the Canadian Institutes of Health Research (CIHR) Welcome! Psychological Depression Prevention Programs for 5-19 Year Olds: What’s the Evidence? You will be placed on hold until the webinar begins. The webinar will begin shortly, please remain on the line.
  2. 2. Funding & Partners
  3. 3. Participant Side Panel in WebEx Housekeeping Use Q&A to post comments/questions during the webinar •‘Send’ questions to All (not privately to ‘Host’) Connection issues •Recommend using a wired Internet connection (vs. wireless), to help prevent connection challenges WebEx 24/7 help line: 1-866-229-3239 Q&A
  4. 4. The Health Evidence Team Kara DeCorby Managing Director Heather Husson Project Manager Robyn Traynor Research Coordinator Lori Greco Knowledge Broker Stephanie Workentine Research Assistant Maureen Dobbins Scientific Director Matt Edmonds Research Assistant Tel: 905 525-9140 ext 22481 E-mail: dobbinsm@mcmaster.ca Yaso Gowrinathan Research Assistant/ Coordinator Kelly Graham Research Assistant
  5. 5. What is www.healthevidence.org? Evidence inform Decision Making
  6. 6. Why use www.healthevidence.org? 1. Saves you time 2. Relevant & current evidence 3. Transparent process 4. Supports for EIDM available 5. Easy to use
  7. 7. A Model for Evidence-Informed Decision Making Source: National Collaborating Centre for Methods and Tools. (revised 2012). A Model for Evidence-Informed DecisionMaking in Public Health. [fact sheet]. Retrieved from http://www.nccmt.ca/pubs/FactSheet_EIDM_EN_WEB.pdf
  8. 8. Evidence-Informed Decision Making 1. Cultivate a culture of inquiry, critical thinking and evidence-based practice “culture” 2. Ask a clear, focused, searchable question 3. Search for the best available evidence 4. Critically appraise the relevant evidence
  9. 9. Evidence-Informed Decision Making 5. Synthesize and integrate the evidence with expertise, local context, and client preference 6. Implement and evaluate the outcome(s) of the change in practice or policy 7. Engage in knowledge exchange
  10. 10. Review Merry, S., Hetrick, S.E., Cox, G.R., Brudevold-Iversen, T., Bir, J.J., & McDowell, H. (2011). Psychological and/or educational interventions for the prevention of depression in children and adolescents. Cochrane Database of Systematic Reviews, 2011(12), Art. No.: CD003380.
  11. 11. Importance of this Review • The World Health Organization estimates that depression represents the largest burden of disease to Canadians older than 14 years of age, as the years lost to premature death and disability from depression outnumber those lost to any other disease. • High stress levels and feelings of depression are more common between the ages for 18 and 19 than in any other age group.
  12. 12. Poll Question #1 Who has heard of a PICO(S) question before? 1.Yes 2.No
  13. 13. Searchable Questions 1. Population (situation) 2. Intervention (exposure) 3. Comparison (other group) 4. Outcomes 5. Setting Think “PICOS”
  14. 14. Evidence Summary: Edmonds (2013) Objective: To determine whether psychological or educational interventions, or both, are effective in preventing the onset of depressive disorder in children and adolescents. P Children and adolescents ages 5 to 19 years old I Psychological or educational programs, or both, which are either targeted or universal C Placebo, any comparison intervention, or no intervention O Prevalence of depressive disorder and depressive symptoms
  15. 15. Overall Considerations • Quality Rating: 10 (strong) Methodologically strong review based on 68 randomized controlled trials of moderate quality. • Psychological and educational interventions are effective at preventing depressive disorder and reducing depression symptoms in children and adolescents aged 5 to 19 years. • Effectiveness is maintained from immediately postintervention, to 3 to 9 months, and 12 months post intervention; The longer term impact is unclear.
  16. 16. Targeted vs. Universal Interventions Similar level of effectiveness for BOTH targeted and universal interventions Up to 9 months post intervention ONLY targeted interventions At 12 months No effect has been shown to persist beyond 24 months for both targeted and universal interventions.
  17. 17. What’s the evidence Outcomes reported in the review 1. Diagnosis of depressive disorder (16 RCTs, 3240 subjects) 2. Depression scores (55 RCTS, 14, 406 subjects)
  18. 18. What’s the evidence – Diagnosis of depressive disorders • Compared to no intervention, intervention participants showed a very small statistically significant reduced risk of depressive disorder : Immediately post-intervention (15 studies; RD -0.09; 95% CI -0.14 to -0.05) At 3 to 9 months (14 studies; RD -0.11; 95% CI -0.16 to 0.06) At 12 months (10 studies; RD -0.06; 95% CI -0.11 to -0.01)
  19. 19. What’s the evidence – Diagnosis of depressive disorders • At 3 to 9 months, risk reduction is maintained for: Interventions targeting high-risk individuals (10 studies; RD -0.06; 95% CI -0.10, -0.03) Universally applied interventions, regardless of risk factors (9 studies; RD -0.10, 95% CI -0.33, -0.05) • At 12 months, only targeted interventions with highrisk subjects had significantly reduced risk of depressive disorder (3 studies; RD -0.14; 95% CI -0.24, 0.04)
  20. 20. What’s the evidence – Diagnosis of depressive disorders • There was no risk reduction at 24 months (8 studies), but a very small statistically significant risk reduction at 36 months (2 studies; RD -0.10; 95%CI -0.19 to -0.02)
  21. 21. What’s the evidence – Depression Scores • Compared to no intervention, intervention participants showed a small to very small statistically significant decrease in depression symptoms:  immediately post-intervention (50 studies; SMD -0.20; 95% CI -0.26 to -0.14)  at 3 to 9 months (31 studies; SMD -0.16; 95% CI -0.23 to -0.10)  at 12 months (19 studies; SMD -0.10; 95% CI -0.18 to 0.02)
  22. 22. What’s the evidence – Depression Scores • No impact on depression symptoms at 24 months (12 studies) and 36 months (5 studies) • No impact on depression symptoms post-intervention when the intervention is compared to a placebo (5 studies)
  23. 23. What’s the evidence – Depression Scores (Targeted vs. Universal) • Interventions targeting high-risk individuals and those universally applied showed decrease in depression symptoms from immediately post-intervention to 9 months post intervention • At 12 months, only targeted interventions showed a decrease in depression symptoms • No decrease was seen at 24 months
  24. 24. General Implications Public Health should provide psychological and educational interventions to prevent depression in children and adolescents up to 12 months post intervention. Public Health should not expect children and adolescents to experience positive effects more than 12 months after intervention. Public Health should consider how the effects of psychological and educational interventions can best be maintained.
  25. 25. Questions?
  26. 26. Poll Questions # 2 and 3 Survey Participation Your Feedback is greatly appreciated!
  27. 27. Contact Us info@healthevidence.org For a copy of the presentation please visit: http://www.healthevidence.org/webinars.aspx Login with your Health Evidence username and password or register if you aren’t a member yet.

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