Digital Commons Network^™

Prevalence And Correlates Of Food And Housing Insecurities At A Historically Black College, Melissa Massey Lockard

Doctoral Dissertations and Projects

The purpose of this quantitative, predictive correlational study was to determine the prevalence of food and housing insecurities at one historically Black college and explore whether these insecurities influence students’ academic performance or their mental health quality. The study also explored possible predictors of students at risk of experiencing these basic needs challenges. A convenience sample of 175 participant surveys was collected in the fall 2021 semester at the small, private, liberal arts college in urban South Carolina. The instruments used in the survey included the USDA’s 6-item Household Food Security Survey Module, the Housing Insecurity and Homelessness Module, the …

Autism Camouflaging In Relation To Views About Autism, Mental Health, And Gender Identity, Joshua A. Evans

Global Tides

This study examined relationships between autism camouflaging behavior, personal views about autism, community support, camouflaging emotional impact, depression, anxiety, ability to be one’s authentic self and gender in autistic adults. Participants were recruited through Facebook groups. There were 248 participants (174 cisgender women, 22 cisgender men, and 43 nonbinary people). It was hypothesized autism camouflaging behavior, its emotional impact and authentic self would correlate with depression and anxiety. Gender and camouflaging emotional impact were correlated with depression levels, but camouflaging behavior was not correlated with depression or anxiety. Participants with lower self-reported acceptance of authentic self had higher depression and …

Does Having A Pet Really Benefit Your Mental Health?, Harold Herzog

Herzog - Companion Animals and Health

A study in the United Kingdom of the effect of pet's on owner's mental health during the COVID pandemic produced surprising results. The owners of pets did not have improved mental health and those owners who were more attached to their pets were more depressed and lonelier than less attached owners.

Hiv-Related Stigma, Sexual Identity, And Depressive Symptoms Among Msm Living With Hiv: A Moderated Mediation Modeling Analysis, Tianyue Mi, Guanghua Lan, Xueying Yang Ph.D., Xiaoming Li Ph.D., Shan Qiao Ph.D., Zhiyong Shen, Yuejiao Zhou

Faculty Publications

Depression is one of the biggest health issues among men who have sex with men (MSM) living with HIV, where sexual identity might play an intricate role. Yet, findings of the relationship between sexual identity and depression were mixed and few studies explored its underlying mechanisms. This study aimed to examine the association between sexual identity and depression, and the potential mediating role of HIV-related stigma and moderating role of age. A cross-sectional survey was conducted among 203 MSM living with HIV in Guangxi, China. Participants provided information on sexual identity, depression, HIV-related stigma, and background information. Descriptive statistics, bivariate …

Introspective Meditation Before Seeking Pleasurable Activities As A Stress Reduction Tool Among College Students: A Multi-Theory Model-Based Pilot Study, Manoj Sharma, Amar Kanekar, Kavita Batra, Traci Hayes, Ram Lakhan

Social and Behavioral Health Faculty Research

In the realm of behavioral interventions, a combined approach of yoga and a cognitive-behavioral strategy in the form of introspective meditation (manan-dhyana) may offer benefits as a stress management tool. This pilot study focuses on introspective meditation performed before seeking pleasurable activities, which is a self-reflection about whether to pursue a goal that will bring sensory pleasure in life. A non-probability sample of college students was recruited from a mid-sized Southern University of the United States using a 52-items web-based survey built in Qualtrics. Univariate, bivariate, and multivariate statistics were used to analyze data. Of total 65 students, only 21.5% …

Prevention Of Violence Against Women And Girls: A Cost-Effectiveness Study Across 6 Low- And Middle-Income Countries, Giulia Ferrari, Sergio Torres-Rueda, Esnat Chirwa, Andrew Gibbs, Stacey Orangi, Edwine Barasa, Theresa Tawiah, Rebecca Kyerewaa Dwommoh Prah, Rozina Karmaliani, Hussain Maqbool Ahmed Khuwaja

School of Nursing & Midwifery

Background: Violence against women and girls (VAWG) is a human rights violation with social, economic, and health consequences for survivors, perpetrators, and society. Robust evidence on economic, social, and health impact, plus the cost of delivery of VAWG prevention, is critical to making the case for investment, particularly in low- and middle-income countries (LMICs) where health sector resources are highly constrained. We report on the costs and health impact of VAWG prevention in 6 countries.
Methods and findings: We conducted a trial-based cost-effectiveness analysis of VAWG prevention interventions using primary data from 5 randomised controlled trials (RCTs) in sub-Saharan Africa …

Experiential Avoidance In Depression, Anxiety, Obsessive-Compulsive Related, And Posttraumatic Stress Disorders: A Comprehensive Systematic Review And Meta-Analysis, Mehdi Akbari, Mohammad Seydavi, Zahra S. Hosseini, Jennifer Krafft, Michael E. Levin

Psychology Faculty Publications

Although numerous studies on experiential avoidance and its relationship to psychopathology have been conducted, systematic summaries of this research are lacking. The current systematic review and meta-analysis evaluated the transdiagnostic role of experiential avoidance across depression, anxiety and related disorders (obsessive-compulsive and related disorders [OCRDs] and post-traumatic stress disorder [PTSD]) as well as potential moderators of these relations. A total of 441 eligible studies including 135,347 participants (66.16% female, mean age = 31.53) and 899 effect-sizes were summarized. Results indicated a moderate-to-large association of experiential avoidance with anxiety (r = .506) and depressive symptoms (r = .562), major …

The Possible Application Of Ketamine In The Treatment Of Depression In Alzheimer's Disease, Islam Mohammad Shehata, Waniyah Masood, Nouran Nemr, Alexandra Anderson, Kamal Bhusal, Amber N. Edinoff, Elyse M. Cornett, Adam M. Kaye, Alan David Kaye

School of Pharmacy Faculty Articles

Depression is a leading cause of disability globally, with a prevalence of 3.8% among the whole population, 5% of the adult population, and 5.7% of the elderly population over 60 years of age. There is evidence that depression is linked to certain neurodegenerative diseases, one being Alzheimer's disease (AD). The efficacy of conventional antidepressants to treat depression in AD is conflicting, especially regarding selective serotonin reuptake inhibitors (SSRIs). A recent systemic review and meta-analysis of 25 randomized controlled trials including fourteen antidepressant medications showed no high efficacy in treating AD patients' symptoms. However, ketamine, a nonselective N-methyl-D-aspartate (NMDA) receptor antagonist, …

Differences In Distress Between Rural And Non-Rural Appalachian Breast Cancer Patient / Caregiver Dyads During The First Year Of Treatment, Jordan Tasman, Callie D. Mcadams, Jillian Lloyd, Ashton J. Brooks, Patricia Nola Eugene Roberson

Journal of Appalachian Health

Introduction: Breast cancer patients and their caregivers living in rural Appalachia face substantial health disparities compared to their non-rural Appalachian counterparts. However, there is limited research on how these specific health disparities in rural Appalachian communities may impact patient psychological distress and caregiver strain during the first year of breast cancer treatment.

Purpose: The purpose of the current study was to assess differences in patient psychological distress (depression and anxiety) and caregiver strain between rural non-rural Appalachian breast-cancer-affected dyads (patients and their caregivers) during the first year of treatment.

Methods: A total of 48 Appalachian breast cancer patients (with a …

Increased Risk Of Major Depressive Disorder Following Tinnitus: A Population-Based Study, Herng-Ching Lin, Sudha Xirasagar Mbbs, Ph.D., Chia-Hui Wang, Yen-Fu Cheng, Tzong-Hann Yang

Faculty Publications

Background and Purpose: In this study, we aimed to evaluate the relationship between tinnitus and a subsequent diagnosis of major depressive disorder (MDD) by studying the incidence of both entities.

Design: A retrospective cohort study.

Methods: Data for this observational follow-up study were retrieved from the Taiwan's National Health Insurance Dataset. A total of 375,272 patients with newly diagnosed tinnitus (study group) were retrieved. The date of first diagnosis of tinnitus was assigned as their index date. Comparison patients were selected by propensity score matching (one per case, n = 375,272 controls) from the same dataset, with their index date …

Clinical And Psychopathological Features Of The Structure Of Affective Disorders In Elderly Patients, Lola Sh. Shadmanova, Zarif Sh. Ashurov, Nargiza F. Yadgarova, Yekaterina M. Lyan

Central Asian Journal of Medicine

Last decades approaches to an assessment of an outcome of depressive distress at persons of serotinal age have undergone essential changes. Along with conservation of traditional methodology in definition of categories of an outcome of depression and their division into the congenial and unfavorable bunches (Jhingan H.P., Sagar R., 2001; Baldwin R.CandGallagley A., 2006), representation about criteria of reference of each concrete variant of an outcome to one of these categories has extended.

Development And Management Of Depression During And After Pregnancy, Alexa Bouts, Maria Patnella, Jourdan Ujlaki, Emily Wells, Hannah Lamb, Michelle Musser

Pharmacy and Wellness Review

Depression during pregnancy is common, whether it is a new onset of the disease or emerging symptoms of the already existent disease. Due to patient and prescriber concerns with antidepressant use during pregnancy, approximately three-quarters of those diagnosed with depression remain untreated. Furthermore, up to half of pregnant women with depression remain undiagnosed due to lack of recognition. As a result, both mother and fetus are at risk for negative health outcomes including substance abuse, functional impairment, increased risk of postnatal depression and poor pregnancy outcomes. Benefits must be balanced against the risks when considering pharmacologic treatment options to manage …

The Impact Of Mindfulness Practices In Teachers, Shawn M. Martin Hettinga

ATU Theses and Dissertations 2021 - Present

Mindfulness training has been identified as a promising means for cultivating social and emotional competencies and reducing stress. The purpose of the quantitative pre-post study using convenience sampling of educators in a rural K-12 in the Arkansas River Valley was to examine whether teachers’ participation in mindfulness activities were associated with changes in levels of stress, anxiety, depression, and job satisfaction. The study used the Depression, Anxiety, and Stress Scale (DASS-21) and the Job Satisfaction Survey (JSS) and measured the responses from novice (0-3 years) and experienced (4+ years) teachers. The findings revealed that there was no difference between the …

The Therapeutic Effect Of Exogenous Melatonin On Depressive Symptoms: A Systematic Review And Meta-Analysis, Cancan Li, Dandan Ma, Min Li, Tao Wei, Xuan Zhao, Yuanyuan Heng, Delong Ma, Enoch Odame Anto, Yanbo Zhang, Mingyun Niu, Wangxin Zhang

Research outputs 2022 to 2026

Background: Depression-related mortality and morbidity pose growing public health burdens worldwide. Although the therapeutic effect of exogenous melatonin on depression has been investigated, findings remain inconsistent. We conducted this systematic review and meta-analysis to clarify the effectiveness of melatonin in the treatment of depression, including primary and secondary depression symptoms. Methods: We searched the online databases of PubMed, EMBASE, and the Cochrane Library for original studies published up to May 2021. We used STATA 14.0 software to synthesize the results of included studies. To evaluate the effectiveness of melatonin, we calculated the standardized mean differences (SMDs) and 95% confidence intervals …

Prevalence And Predictors Of Depressive Symptoms In Ncaa Division Iii Collegiate Athletes, Sayre Wilson, Sebastian Harenberg, Tara Stilwell, Justine Vosloo, Lindsey Keenan

Journal of Athlete Development and Experience

Mental health disorders are important health concerns among collegiate athletes. Estimations of elevated depressive symptoms in this population range from 1.1-26%. However, these data are derived mostly from NCAA Division I institutions or professional athletes. Evidence from lower divisions (e.g., NCAA Division III) is currently sparse in the literature. Hence, the primary purpose of the present study was to examine the prevalence of depressive symptoms in NCAA Division III collegiate athletes. The secondary purpose was to examine which mental health indicators predict depressive symptoms. In total, 186 participants completed several mental health scales (e.g., PHQ-9, DASS-21). The results revealed a …

Mental Health Prevalence In Ncaa Division Iii Collegiate Athletes, Katelin Valster, Kristen Cochrane-Snyman, Keith Jones, Daniel Smith

Journal of Athlete Development and Experience

Stressors related to academic requisites, sport participation and pressure to perform may increase college athlete risk for mental health symptoms (Cox, Ross-Stewart, & Foltz, 2017; Sudano & Miles, 2017; Yang et al., 2007). The purpose of this study was to identify the level of clinically relevant self-reported mental health symptoms in National Collegiate Athletic Association (NCAA) Division III athletes and variations based on sport participation (i.e., men’s or women’s athletics; team or individual sports) over a two-year period. A nonexperimental, trend study design was used. Data analysis included descriptive statistics, chi square test, and multivariate analysis of variance (MANOVA) which …

A Qualitative Report Of The Perceptions Of The Covid-19 Pandemic From Collegiate Student-Athletes, Dylan C. Rowe, Zachary K. Winkelmann Phd, Lat, Atc, Shawn M. Arent Ph.D., Cscs*D, Fissn, Facsm, Fnak, Michelle Angelique Arent Rd, Mph, Cscs, Cissn, Alexa Jenny Chandler, Nancy A. Uriegas, Toni Torres-Mcgehee Phd, Lat, Atc

Faculty Publications

Context

The COVID-19 pandemic led to an abrupt disruption in access to services and personnel for collegiate student-athletes in the spring and summer of 2020. We sought to identify the effects of this unprecedented change by examining the psychological well-being, changes to normal routines, and return-to-play considerations of current student-athletes in order to guide support for both current and future student-athletes who may face similar situations. Methods

We utilized a phenomenological approach to interview a purposeful sample of eighteen collegiate student-athletes (7 males, 11 females; mean age = 20 years) from across the United States. The participants were interviewed using …

Depression Among Medical Students In The United States During The Covid-19 Pandemic: The Role Of Communication Between Universities And Their Students, Alexandra Ecker, Abbey B Berenson, Sandra J Gonzalez, Roger Zoorob, Jacqueline M Hirth

Faculty, Staff and Students Publications

OBJECTIVE: Medical students are vulnerable to stress and depression during medical school and the COVID-19 pandemic may have exacerbated these issues. This study examined whether the risk of depression was associated with COVID-19 pandemic-related medical school communication.

METHODS: A 144 - item pilot cross-sectional online survey of medical students in the US, was carried out between September 1, 2020 and December 31, 2020. Items on stress, depression, and communication between students and their medical schools were included. This study examined associations of student perceptions of universities' communication efforts and pandemic response with risk of developing depression.

RESULTS: The sample included …

Vitamin D Supplementation For The Treatment Of Depressive Symptoms In Women With Type 2 Diabetes: A Randomized Clinical Trial, Sue Penckofer Phd, Monique Ridosh, William Howard Adams, Meghan Grzesiak, Jennifer Woo, Mary Byrn, Joanne Kouba Phd, Rdn, Ldn, Patricia M. Sheean, Colleen Kordish, Ramon Durazo-Arvizu, Diane Wallis, Mary Ann Emanuele, Angelos Halaris

Nursing: School of Nursing Faculty Publications and Other Works

Aim. To determine the efficacy and safety of vitamin D₃ supplementation in reducing depressive symptoms in women with type 2 diabetes (T2D), depression, and low vitamin D. Methods. In this double-blind randomized active comparator-controlled trial, women with significant depressive symptoms as assessed by the Center for Epidemiologic Studies Depression (CES-D) scale received weekly oral vitamin D₃ supplementation (50,000 IU) or an active comparator (5,000 IU) for 6 months. Assessments of vitamin D, 25-hydroxyvitamin D [25 (OH) D], and depression were measured at baseline, 3 months, and 6 months. Results. A total of 129 women were …

Association Between Diagnosed Anxiety And Depression And Exposure To Life Stressors During The Covid-19 Pandemic, Emily Hallgren Phd, Don E. Willis Phd, Brett Rowland Ma, James P. Selig Phd, Pearl A. Mcelfish Phd

Journal of Health Disparities Research and Practice

Research suggests that mental health disorders heighten the risk of exposure to life stressors. Drawing on a sample of 754 adults from a survey distributed at six primary care clinics, we examine whether adults who reported ever being diagnosed with depression or anxiety were more likely to experience an employment disruption, a housing disruption, and/or report more COVID-19-related stressors during the COVID-19 pandemic. Individuals who reported ever being diagnosed with depression reported a greater burden (B=.75) of COVID-19-related stressors. Those who reported ever being diagnosed with anxiety had higher odds of experiencing an employment disruption (OR=1.90) and a housing disruption …

Modifying Group Interpersonal Psychotherapy For Peripartum Adolescents In Sub-Saharan African Context: Reviewing Differential Contextual And Implementation Considerations, Manasi Kumar, Helen Verdeli, Shekhar Saxena, Inge Petersen, Keng Yen Huang, Caleb Othieno, Nancy Grote, Roslyn Law, Jurgen Unutzer, Mary Mckay

Brain and Mind Institute

Background: This study describes adaptation and modification of World Health Organization (WHO) recommended group interpersonal psychotherapy (IPT-G) for depressed peripartum adolescents. The adaptation process includes accommodating contextual factors and strategies to address intervention implementation barriers, such as engagement problems with adolescents, caregivers, and providers, and stigma and dearth of mental health specialists. The modifications include and adolescent relevant iterations to the therapy format and content.

Methods: A multi-stakeholder led two-stage intervention adaptation and modification process integrating mixed qualitative methods were used with pregnant and parenting adolescents, their partners, and health care workers. In-depth interviews focusing on personal, relationship, social, and …

An Abductive Argument From Depression And Anxiety To Christian Personal Holiness, Kelly Douglas Burchett

Masters Theses

The science on pathological depression and anxiety (D&A) describes religion and spirituality's (R/S) insulating and immunizing effects in roughly 72 to 85 percent of all relevant articles. But the descriptivism of science cannot assign any normative value to a theological worldview. Deductive logic favors theism via Leibnizian contingency, Kalām cosmology, objective morality, fine-tuning of the universe, and abstract conceptualism. The information in DNA, the irreducible complexity of intracellular machinery, the improbability of folded proteins, and the support for common modular design over common ancestry establish a design inference for all of life. Unguided naturalistic simulations fail to surmount the complexity …

Impact Of Covid-19 Pandemic On Women Interpersonal Violence Survivors, Melissa Fernandez

Theses and Dissertations

Women have a significant risk of experiencing interpersonal violence over the course of their lifetime. There has been some suggestion that this risk has been exacerbated by the isolation experienced during the COVID-19 pandemic. The proposed study will evaluate levels of stress associated with interpersonal violence during the COVID-19 pandemic. Depression, coronavirus anxiety, Posttraumatic symptoms, and COVID-19 stress levels will be evaluated. It is hypothesized that participants who experienced interpersonal violence (childhood abuse, physical assault, unwanted sexual experiences, and/or intimate partner violence) will endorse higher levels of COVID-19 stress, Posttraumatic symptoms, depression. These outcomes would be mediated by experiential avoidance. …

Exploring American Parents' Lived Experiences During The Covid-19 Pandemic: Ramifications For Well-Being, Astrida S. Kaugars, Lindsay E. Holly, Mary Tait, Debra L. Oswald

Psychology Faculty Research and Publications

Objective

The objective of this study was to document the direct impact of the COVID-19 pandemic on parents and families in the United States.

Methods

Parents’ experiences during the pandemic were examined using an online survey (N = 564) collected during May and June 2020.

Results

Parents reported experiencing a high frequency of COVID-19-related events (e.g., job loss and health concerns) and impact on their lives. Parents’ experiences with COVID-19, as well as self-reported perceived increase in home labor, experiences with assisting children with remote schooling, and work-life conflict were all significantly associated with higher levels of parental role …

Exploring American Parents’ Lived Experiences During The Covid-19 Pandemic: Ramifications For Well-Being, Astrida S. Kaugars, Lindsay E. Holly, Mary Tait, Debra L. Oswald

Psychology Faculty Research and Publications

Objective

The objective of this study was to document the direct impact of the COVID-19 pandemic on parents and families in the United States.

Methods

Parents’ experiences during the pandemic were examined using an online survey (N = 564) collected during May and June 2020.

Results

Parents reported experiencing a high frequency of COVID-19-related events (e.g., job loss and health concerns) and impact on their lives. Parents’ experiences with COVID-19, as well as self-reported perceived increase in home labor, experiences with assisting children with remote schooling, and work-life conflict were all significantly associated with higher levels of parental role …

Misinterpreted Orthodontic Procedure Leading On To Depression, Dr.Anusha Pogula, Dr.Kishor M Associate Professor, Psychiatry, Dr.Ashwini T.S

Digital Journal of Clinical Medicine

BACKGROUND: Oral health is an important issue that affects not only the teeth and mouth but also general health, appearance, and self-esteem. Risk of having infections including poor oral health and periodontal infections are the most proposed mechanisms of action of depression and anxiety on the human body by modification of the immune system function and increasing pro-inflammatory cytokines and induction of vascular inflammation. It is proposed that these two conditions can cause oral and dental problems since emotional changes can influence oral mucosa. Several researches have also shown a relationship between anxiety or depression and periodontal health.

CASE …

The Association Of Persistent Symptoms Of Depression And Anxiety With Recurrent Acute Coronary Syndrome Events: A Prospective Observational Study, Abdullah S. Alhurani, Ayman M. Hamdan-Mansour, Muayyad M. Ahmad, Gabrielle Mckee, Sharon O’Donnell, Frances O’Brien, Mary Mooney, Zyad T. Saleh, Debra K. Moser

Nursing Faculty Publications

The purpose of this study was to examine the role of persistent symptoms of depression and anxiety in a second acute coronary syndrome (ACS) event. Data presented in this study were from an RCT study. A follow-up for 24 months after baseline to detect a second ACS event among 1162 patients from five hospitals. Hierarchal Cox regression analyses were used. The results showed that persistent depression only (HR 2.27; 95% CI: 1.35–3.81; p = 0.002), and comorbid persistent depression and anxiety (HR 2.03; 95% CI: 1.03–3.98; p = 0.040) were the significant predictors of a second ACS event. Secondary education …

Treatment Preferences For Pharmacological Versus Psychological Interventions Among Primary Care Providers In Nepal: Mixed Methods Analysis Of A Pilot Cluster Randomized Controlled Trial., Anvita Bhardwaj, Dristy Gurung, Sauharda Rai, Bonnie N Kaiser, Cori L Cafaro, Kathleen J Sikkema, Crick Lund, Nagendra P Luitel, Brandon A. Kohrt

Psychiatry and Behavioral Sciences Faculty Publications

There is increasing evidence supporting the effectiveness of psychological interventions in low- and middle-income countries. However, primary care providers (PCPs) may prefer treating patients with medication. A secondary exploratory analysis of a pilot cluster randomized controlled trial was conducted to evaluate psychological vs. pharmacological treatment preferences among PCPs. Thirty-four health facilities, including 205 PCPs, participated in the study, with PCPs in 17 facilities assigned to a standard version of the mental health Gap Action Programme (mhGAP) training delivered by mental health specialists. PCPs in the other 17 facilities received mhGAP instruction delivered by specialists and people with lived experience of …

Cerebral Blood Flow And Brain Functional Connectivity Changes In Older Adults Participating In A Mindfulness-Based Stress Reduction Program, Aleeze Sattar Moss, Diane K. Reibel, Nancy Wintering, Faezeh Vedaei, Hannah Porter, Mohsen Khosravi, Justin Heholt, M. Alizadeh, Feroze Mohamed, Andrew B. Newberg

Department of Radiology Faculty Papers

There is a growing interest in the potential beneficial effects of mindfulness meditation training in protecting against age-related physical, emotional, and cognitive decline. The current prospective, single-center, single-arm study investigated if functional magnetic resonance imaging-based changes in cerebral blood flow and brain functional connectivity could be observed in 11 elderly adults (mean age 79) after participation in a Mindfulness-Based Stress Reduction (MBSR) program. The results showed significantly (p < 0.05) altered cerebral blood flow and functional connectivity in the cingulate gyrus, limbic structures, and subregions of the temporal and frontal lobes, similar to findings of other meditation-related studies in younger populations. Furthermore, these changes were also associated with significant improvements in depression symptoms. This study suggests that the MBSR program can potentially modify cerebral blood flow and connectivity in this population.

Effect Of Computer-Assisted Cognitive Behavior Therapy Vs Usual Care On Depression Among Adults In Primary Care: A Randomized Clinical Trial, Jesse H. Wright, Jesse J. Owen, Tracy D. Eells, Becky F. Antle, Laura B. Bishop, Renee Girdler, Lesley M. Harris, R. Brent Wright, Michael J. Wells, Rangaraj Gopalraj, Michael E. Pendleton, Shehzad Ali

Counseling Psychology: Faculty Scholarship

Importance Depression is a common disorder that may go untreated or receive suboptimal care in primary care settings. Computer-assisted cognitive behavior therapy (CCBT) has been proposed as a method for improving access to effective psychotherapy, reducing cost, and increasing the convenience and efficiency of treatment for depression.

Objectives To evaluate whether clinician-supported CCBT is more effective than treatment as usual (TAU) in primary care patients with depression and to examine the feasibility and implementation of CCBT in a primary care population with substantial numbers of patients with low income, limited internet access, and low levels of educational attainment.

Design, Setting, …