Individuals with heart disease and depressive symptoms suffer from higher death rates; higher rates of acute cardiac events, such as heart attacks; and faster progression of heart disease compared to those with heart disease who do not have depressive symptoms. These problems are much worse among people in rural populations.
Unfortunately, people in rural populations with heart disease and depressive symptoms do not receive needed therapy for depressive symptoms because of lack of mental health providers in rural areas, worries about stigma, and difficulty accessing mental health care because of multiple barriers to traveling to get care. To overcome these barriers, we will compare the impact of two types of online cognitive behavioral therapy—face-to-face videoconferencing versus self-administered internet-based---and usual care on depressive symptoms to provide patients and healthcare providers with needed information about which is more effective and to increase the number of patients adequately treated.
*All proposed projects, including requested budgets and project periods, are approved subject to a programmatic and budget review by PCORI staff and the negotiation of a formal award contract.