title: Activation and Self-Efficacy in a Randomized Trial of a Depression Self-Care Intervention.
abstract: In a sample of primary care participants with chronic physical conditions and comorbid depressive symptoms: to describe the cross-sectional and longitudinal associations of activation and self-efficacy with demographic, physical and mental health status, health behaviors, depression self-care, health care utilization, and use of self-care tools; and to examine the effects of a depression self-care coaching intervention on these two outcomes. Design/Study Setting. A secondary analysis of activation and self-efficacy data collected as part of a randomized trial to compare the effects of a telephone-based coached depression self-care intervention with a noncoached intervention. Activation (Patient Activation Measure) was measured at baseline and 6 months. Depression self-care self-efficacy was assessed at baseline, at 3 months, and at 6 months.
  
  
  
  In multivariable cross-sectional analyses (n = 215), activation and/or self-efficacy were associated with language, birthplace, better physical and mental health, individual exercise, specialist visits, and antidepressant nonuse. In longitudinal analyses (n = 158), an increase in activation was associated with increased medication adherence; an increase in self-efficacy was associated with use of cognitive self-care strategies and increases in social and solitary activities. There were significant improvements from baseline to 6 months in activation and self-efficacy scores both among coached and noncoached groups. The self-care coaching intervention did not affect 6-month activation or self-efficacy but was associated with quicker improvement in self-efficacy.
  
  
  
  Overall, the results for activation and self-efficacy were similar, although self-efficacy correlated more consistently than activation with depression-specific behaviors and was responsive to a depression self-care coaching intervention.
authors.affiliation: McGill University, Montreal, Quebec, Canada jane.mccusker@mcgill.ca.|St. Mary's Research Centre, Montreal, Quebec, Canada.
authors.forename: Jane
authors.initials: J
authors.lastname: McCusker
authors.affiliation: McGill University, Montreal, Quebec, Canada.|St. Mary's Research Centre, Montreal, Quebec, Canada.
authors.forename: Sylvie D
authors.initials: SD
authors.lastname: Lambert
authors.affiliation: McGill University, Montreal, Quebec, Canada.|St. Mary's Hospital Center, Montreal, Quebec, Canada.
authors.forename: Martin G
authors.initials: MG
authors.lastname: Cole
authors.affiliation: McGill University, Montreal, Quebec, Canada.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ciampi
authors.affiliation: McGill University, Montreal, Quebec, Canada.
authors.forename: Erin
authors.initials: E
authors.lastname: Strumpf
authors.affiliation: Université de Montréal, Montreal, Quebec, Canada.|Maisonneuve-Rosemont Hospital Research Centre, Montreal, Quebec, Canada.
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Freeman
authors.affiliation: St. Mary's Research Centre, Montreal, Quebec, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Belzile
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003071:Cognition; D015897:Comorbidity; D003863:Depression / Q000523:psychology* / Q000628:therapy*; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006305:Health Status Indicators; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012307:Risk Factors; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy
keywords: activation; chronic illness; depression; randomized trial; self-care; self-efficacy