Wellbeing intervention for chronic kidney disease (WICKD)

A randomised controlled trial study protocol

Kylie M. Dingwall, Tricia Nagel, Jaquelyne T. Hughes, David J. Kavanagh, Alan Cass, Kirsten Howard, Michelle Sweet, Sarah Brown, Cherian Sajiv, Sandawana W. Majoni

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Abstract

Background: Incidence of end stage kidney disease (ESKD) for Indigenous Australians is especially high in remote and very remote areas of Australia (18 and 20 times the rate of comparable non-Indigenous people). Relocating away from family and country for treatment, adjusting to life with a chronic condition and time lost to dialysis cause grief and sadness which have immense impact on quality of life and challenges treatment adherence. We describe the first randomised controlled trial to address both chronic disease and mental health in Indigenous people with ESKD, which is the first to test the effectiveness of a culturally adapted e-mental health intervention in this population. It builds on an existing program of mental health research with demonstrated efficacy - the Aboriginal and Islander Mental Health Initiative (AIMhi) - to test the newly developed electronic motivational care planning (MCP) therapy - the AIMhi Stay Strong App.

Methods: This is a 3-arm, waitlist, single-blind randomised controlled trial testing the efficacy of the Stay Strong App in improving psychological distress, depressive symptoms, quality of life and treatment adherence among Indigenous clients undergoing haemodialysis for ESKD in Alice Springs and Darwin with follow up over two periods of 3 months (total of 6 months observation). The study compares the efficacy of MCP using the AIMhi Stay Strong App with two control groups (control app intervention and treatment as usual) on participant-reported psychological distress (the primary outcome) using the Kessler Distress Scale (K10); depressive symptoms using the adapted Patient Health Questionnaire (PHQ-9); quality of life using the EuroQoL instrument (EQ5D) and adherence to dialysis treatment planning through file audit. Participants are randomised to receive MCP either at baseline (early treatment) or after 3 months (delayed treatment). The study also examines the cost effectiveness of this therapy in this setting through examination of health care service utilisation across groups during the first 3 months.

Discussion: This project will contribute much needed evidence on the efficacy of an electronic wellbeing intervention for Indigenous people with ESKD - a group in which distress is likely to be unacceptably high, yet relatively untreated.

Original languageEnglish
Article number2
Pages (from-to)1-7
Number of pages7
JournalBMC Psychology
Volume7
Issue number1
DOIs
Publication statusPublished - 8 Jan 2019

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Clinical Protocols
Chronic Renal Insufficiency
Randomized Controlled Trials
Mental Health
Chronic Kidney Failure
Therapeutics
Quality of Life
Dialysis
Patient Acceptance of Health Care
Depression
Psychology
Grief
Health Services
Cost-Benefit Analysis
Renal Dialysis
Chronic Disease
Observation
Control Groups
Incidence
Health

Cite this

Dingwall, Kylie M. ; Nagel, Tricia ; Hughes, Jaquelyne T. ; Kavanagh, David J. ; Cass, Alan ; Howard, Kirsten ; Sweet, Michelle ; Brown, Sarah ; Sajiv, Cherian ; Majoni, Sandawana W. / Wellbeing intervention for chronic kidney disease (WICKD) : A randomised controlled trial study protocol. In: BMC Psychology. 2019 ; Vol. 7, No. 1. pp. 1-7.
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Wellbeing intervention for chronic kidney disease (WICKD) : A randomised controlled trial study protocol. / Dingwall, Kylie M.; Nagel, Tricia; Hughes, Jaquelyne T.; Kavanagh, David J.; Cass, Alan; Howard, Kirsten; Sweet, Michelle; Brown, Sarah; Sajiv, Cherian; Majoni, Sandawana W.

In: BMC Psychology, Vol. 7, No. 1, 2, 08.01.2019, p. 1-7.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Wellbeing intervention for chronic kidney disease (WICKD)

T2 - A randomised controlled trial study protocol

AU - Dingwall, Kylie M.

AU - Nagel, Tricia

AU - Hughes, Jaquelyne T.

AU - Kavanagh, David J.

AU - Cass, Alan

AU - Howard, Kirsten

AU - Sweet, Michelle

AU - Brown, Sarah

AU - Sajiv, Cherian

AU - Majoni, Sandawana W.

PY - 2019/1/8

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N2 - Background: Incidence of end stage kidney disease (ESKD) for Indigenous Australians is especially high in remote and very remote areas of Australia (18 and 20 times the rate of comparable non-Indigenous people). Relocating away from family and country for treatment, adjusting to life with a chronic condition and time lost to dialysis cause grief and sadness which have immense impact on quality of life and challenges treatment adherence. We describe the first randomised controlled trial to address both chronic disease and mental health in Indigenous people with ESKD, which is the first to test the effectiveness of a culturally adapted e-mental health intervention in this population. It builds on an existing program of mental health research with demonstrated efficacy - the Aboriginal and Islander Mental Health Initiative (AIMhi) - to test the newly developed electronic motivational care planning (MCP) therapy - the AIMhi Stay Strong App. Methods: This is a 3-arm, waitlist, single-blind randomised controlled trial testing the efficacy of the Stay Strong App in improving psychological distress, depressive symptoms, quality of life and treatment adherence among Indigenous clients undergoing haemodialysis for ESKD in Alice Springs and Darwin with follow up over two periods of 3 months (total of 6 months observation). The study compares the efficacy of MCP using the AIMhi Stay Strong App with two control groups (control app intervention and treatment as usual) on participant-reported psychological distress (the primary outcome) using the Kessler Distress Scale (K10); depressive symptoms using the adapted Patient Health Questionnaire (PHQ-9); quality of life using the EuroQoL instrument (EQ5D) and adherence to dialysis treatment planning through file audit. Participants are randomised to receive MCP either at baseline (early treatment) or after 3 months (delayed treatment). The study also examines the cost effectiveness of this therapy in this setting through examination of health care service utilisation across groups during the first 3 months. Discussion: This project will contribute much needed evidence on the efficacy of an electronic wellbeing intervention for Indigenous people with ESKD - a group in which distress is likely to be unacceptably high, yet relatively untreated.

AB - Background: Incidence of end stage kidney disease (ESKD) for Indigenous Australians is especially high in remote and very remote areas of Australia (18 and 20 times the rate of comparable non-Indigenous people). Relocating away from family and country for treatment, adjusting to life with a chronic condition and time lost to dialysis cause grief and sadness which have immense impact on quality of life and challenges treatment adherence. We describe the first randomised controlled trial to address both chronic disease and mental health in Indigenous people with ESKD, which is the first to test the effectiveness of a culturally adapted e-mental health intervention in this population. It builds on an existing program of mental health research with demonstrated efficacy - the Aboriginal and Islander Mental Health Initiative (AIMhi) - to test the newly developed electronic motivational care planning (MCP) therapy - the AIMhi Stay Strong App. Methods: This is a 3-arm, waitlist, single-blind randomised controlled trial testing the efficacy of the Stay Strong App in improving psychological distress, depressive symptoms, quality of life and treatment adherence among Indigenous clients undergoing haemodialysis for ESKD in Alice Springs and Darwin with follow up over two periods of 3 months (total of 6 months observation). The study compares the efficacy of MCP using the AIMhi Stay Strong App with two control groups (control app intervention and treatment as usual) on participant-reported psychological distress (the primary outcome) using the Kessler Distress Scale (K10); depressive symptoms using the adapted Patient Health Questionnaire (PHQ-9); quality of life using the EuroQoL instrument (EQ5D) and adherence to dialysis treatment planning through file audit. Participants are randomised to receive MCP either at baseline (early treatment) or after 3 months (delayed treatment). The study also examines the cost effectiveness of this therapy in this setting through examination of health care service utilisation across groups during the first 3 months. Discussion: This project will contribute much needed evidence on the efficacy of an electronic wellbeing intervention for Indigenous people with ESKD - a group in which distress is likely to be unacceptably high, yet relatively untreated.

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