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It is unclear what session frequency is most effective in cognitive–behavioural therapy (CBT) and interpersonal psychotherapy (IPT) for depression.
Compare the effects of once weekly and twice weekly sessions of CBT and IPT for depression.
We conducted a multicentre randomised trial from November 2014 through December 2017. We recruited 200 adults with depression across nine specialised mental health centres in the Netherlands. This study used a 2 × 2 factorial design, randomising patients to once or twice weekly sessions of CBT or IPT over 16–24 weeks, up to a maximum of 20 sessions. Main outcome measures were depression severity, measured with the Beck Depression Inventory-II at baseline, before session 1, and 2 weeks, 1, 2, 3, 4, 5 and 6 months after start of the intervention. Intention-to-treat analyses were conducted.
Compared with patients who received weekly sessions, patients who received twice weekly sessions showed a statistically significant decrease in depressive symptoms (estimated mean difference between weekly and twice weekly sessions at month 6: 3.85 points, difference in effect size d = 0.55), lower attrition rates (n = 16 compared with n = 32) and an increased rate of response (hazard ratio 1.48, 95% CI 1.00–2.18).
In clinical practice settings, delivery of twice weekly sessions of CBT and IPT for depression is a way to improve depression treatment outcomes.
Since food banks have a strong influence on recipients’ diets, and seem to have difficulties in supporting healthy diets, improving the dietary quality of food parcels is important. Therefore, we aimed to assess whether improving the dietary quality of food parcels, using different strategies, can positively impact the actual dietary intake of Dutch food bank recipients.
Materials and methods:
This randomized cross-over controlled trial with four intervention conditions [1) Control (standard food parcel), 2) Snacks– (standard food parcel with replacement of snacks by staple foods), 3) FV + (standard food parcel plus the recommended daily amount of fruit and vegetables), 4) Snacks– + FV (standard food parcel with replacement of snacks by staple foods plus the recommended daily amount of fruit and vegetables)] included food bank recipients from three food banks. In total, 199 recipients were randomly allocated. At baseline, participants filled in a questionnaire and underwent anthropometric measurements. Dietary intake data were collected through 24-hour recalls after both intervention conditions at 4 and 8 weeks follow-up. Primary outcome was fruit and vegetable intake, secondary outcomes were dietary intakes of food groups and nutrients.
Multi-level linear regression analysis, using a two-level model showed a higher mean fruit intake in participants in the FV + condition than in participants in the Control condition (δ: 74 [40.3;107.6] g). Both mean fruit and mean vegetable intake were higher in participants in the Snacks– + FV + condition than in participants in the Control condition (fruit δ: 81.3 [56.5;106.2] g; vegetable: δ: 46.2 [17.5;74.9] g), as well as in the Snacks– condition (fruit: δ: 70.0 [38.8;101.1] g; vegetable δ: 62.2 [26.2; 98.2] g).
This study shows that improving the dietary content of food parcels can positively impact the dietary intake of Dutch food bank recipients. With this we can further develop effective strategies to improve dietary intake of food bank recipients.
This practical book is designed for applied researchers who want to use mixed models with their data. It discusses the basic principles of mixed model analysis, including two-level and three-level structures, and covers continuous outcome variables, dichotomous outcome variables, and categorical and survival outcome variables. Emphasizing interpretation of results, the book develops the most important applications of mixed models, such as the study of group differences, longitudinal data analysis, multivariate mixed model analysis, IPD meta-analysis, and mixed model predictions. All examples are analyzed with STATA, and an extensive overview and comparison of alternative software packages is provided. All datasets used in the book are available for download, so readers can re-analyze the examples to gain a strong understanding of the methods. Although most examples are taken from epidemiological and clinical studies, this book is also highly recommended for researchers working in other fields.