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Multicenter Study
. 2022 Nov;57(11):2781-2790.
doi: 10.1002/ppul.26101. Epub 2022 Aug 17.

Feasibility and acceptability of a CF-specific cognitive-behavioral preventive intervention for adults integrated into team-based care

Deborah Friedman  1 , Beth A Smith  2   3 , Amanda Bruce  4 , Carolyn E Schwartz  5   6 , Hang Lee  7 , Hanna Pinsky  8 , Elizabeth Gootkind  8 , Margot Hardcastle  8 , Nicole Shea  2 , Christine M Roach  2 , Caitlin Miller  2 , Deepika Polineni  9 , Matthias Salathe  9 , Alexandra L Quittner  10 , Anna M Georgiopoulos  1
Affiliations
Multicenter Study

Feasibility and acceptability of a CF-specific cognitive-behavioral preventive intervention for adults integrated into team-based care

Deborah Friedman et al. Pediatr Pulmonol. 2022 Nov.

Abstract

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.

Keywords: anxiety; cognitive-behavioral therapy; cystic fibrosis; depression; prevention; quality of life.

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References

REFERENCES

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