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Gilbody S, Brabyn S, Lovell K, Kessler D, Devlin T, Smith L, Araya R, Barkham M, Bower P, Cooper C, Knowles S, Littlewood E, Richards DA, Tallon D, White D, Worthy G. Telephone-supported computerised cognitive-behavioural therapy: REEACT-2 large-scale pragmatic randomised controlled trial. Br J Psychiatry 2017; 210:362-367. [PMID: 28254959 DOI: 10.1192/bjp.bp.116.192435] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/29/2016] [Accepted: 11/03/2016] [Indexed: 01/23/2023]
Abstract
BackgroundComputerised cognitive-behavioural therapy (cCBT) for depression has the potential to be efficient therapy but engagement is poor in primary care trials.AimsWe tested the benefits of adding telephone support to cCBT.MethodWe compared telephone-facilitated cCBT (MoodGYM) (n = 187) to minimally supported cCBT (MoodGYM) (n = 182) in a pragmatic randomised trial (trial registration: ISRCTN55310481). Outcomes were depression severity (Patient Health Questionnaire (PHQ)-9), anxiety (Generalized Anxiety Disorder Questionnaire (GAD)-7) and somatoform complaints (PHQ-15) at 4 and 12 months.ResultsUse of cCBT increased by a factor of between 1.5 and 2 with telephone facilitation. At 4 months PHQ-9 scores were 1.9 points lower (95% CI 0.5-3.3) for telephone-supported cCBT. At 12 months, the results were no longer statistically significant (0.9 PHQ-9 points, 95% CI -0.5 to 2.3). There was improvement in anxiety scores and for somatic complaints.ConclusionsTelephone facilitation of cCBT improves engagement and expedites depression improvement. The effect was small to moderate and comparable with other low-intensity psychological interventions.
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Affiliation(s)
- Simon Gilbody
- Simon Gilbody, DPhil, FRCPsych, Sally Brabyn, MA, MSc, Department of Health Sciences, University of York, York; Karina Lovell, RN, MSc, PhD, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; David Kessler, MBBS, MRCPsych, MD, MRCGP, Academic Unit of Primary Health Care, University of Bristol, Bristol; Thomas Devlin, PhD, Lucy Smith, BA, PGDip, Department of Health Sciences, University of York, York; Ricardo Araya, PhD, MRCPsych, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, London; Michael Barkham, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield; Peter Bower, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Cindy Cooper, PhD, School of Health and Related Research, University of Sheffield and Clinical Trials Research Unit, University of Sheffield, UK; Sarah Knowles, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Elizabeth Littlewood, PhD, Department of Health Sciences, University of York, York; David A. Richards, RN, PhDhc, PhD, University of Exeter Medical School, University of Exeter, Exeter; Debbie Tallon, MSc, School of Social and Community Medicine, University of Bristol, Bristol; David White, MPH, Clinical Trials Research Unit, University of Sheffield, Sheffield; Gillian Worthy, MSc, York Trials Unit, University of York, York, UK
| | - Sally Brabyn
- Simon Gilbody, DPhil, FRCPsych, Sally Brabyn, MA, MSc, Department of Health Sciences, University of York, York; Karina Lovell, RN, MSc, PhD, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; David Kessler, MBBS, MRCPsych, MD, MRCGP, Academic Unit of Primary Health Care, University of Bristol, Bristol; Thomas Devlin, PhD, Lucy Smith, BA, PGDip, Department of Health Sciences, University of York, York; Ricardo Araya, PhD, MRCPsych, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, London; Michael Barkham, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield; Peter Bower, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Cindy Cooper, PhD, School of Health and Related Research, University of Sheffield and Clinical Trials Research Unit, University of Sheffield, UK; Sarah Knowles, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Elizabeth Littlewood, PhD, Department of Health Sciences, University of York, York; David A. Richards, RN, PhDhc, PhD, University of Exeter Medical School, University of Exeter, Exeter; Debbie Tallon, MSc, School of Social and Community Medicine, University of Bristol, Bristol; David White, MPH, Clinical Trials Research Unit, University of Sheffield, Sheffield; Gillian Worthy, MSc, York Trials Unit, University of York, York, UK
| | - Karina Lovell
- Simon Gilbody, DPhil, FRCPsych, Sally Brabyn, MA, MSc, Department of Health Sciences, University of York, York; Karina Lovell, RN, MSc, PhD, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; David Kessler, MBBS, MRCPsych, MD, MRCGP, Academic Unit of Primary Health Care, University of Bristol, Bristol; Thomas Devlin, PhD, Lucy Smith, BA, PGDip, Department of Health Sciences, University of York, York; Ricardo Araya, PhD, MRCPsych, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, London; Michael Barkham, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield; Peter Bower, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Cindy Cooper, PhD, School of Health and Related Research, University of Sheffield and Clinical Trials Research Unit, University of Sheffield, UK; Sarah Knowles, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Elizabeth Littlewood, PhD, Department of Health Sciences, University of York, York; David A. Richards, RN, PhDhc, PhD, University of Exeter Medical School, University of Exeter, Exeter; Debbie Tallon, MSc, School of Social and Community Medicine, University of Bristol, Bristol; David White, MPH, Clinical Trials Research Unit, University of Sheffield, Sheffield; Gillian Worthy, MSc, York Trials Unit, University of York, York, UK
| | - David Kessler
- Simon Gilbody, DPhil, FRCPsych, Sally Brabyn, MA, MSc, Department of Health Sciences, University of York, York; Karina Lovell, RN, MSc, PhD, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; David Kessler, MBBS, MRCPsych, MD, MRCGP, Academic Unit of Primary Health Care, University of Bristol, Bristol; Thomas Devlin, PhD, Lucy Smith, BA, PGDip, Department of Health Sciences, University of York, York; Ricardo Araya, PhD, MRCPsych, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, London; Michael Barkham, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield; Peter Bower, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Cindy Cooper, PhD, School of Health and Related Research, University of Sheffield and Clinical Trials Research Unit, University of Sheffield, UK; Sarah Knowles, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Elizabeth Littlewood, PhD, Department of Health Sciences, University of York, York; David A. Richards, RN, PhDhc, PhD, University of Exeter Medical School, University of Exeter, Exeter; Debbie Tallon, MSc, School of Social and Community Medicine, University of Bristol, Bristol; David White, MPH, Clinical Trials Research Unit, University of Sheffield, Sheffield; Gillian Worthy, MSc, York Trials Unit, University of York, York, UK
| | - Thomas Devlin
- Simon Gilbody, DPhil, FRCPsych, Sally Brabyn, MA, MSc, Department of Health Sciences, University of York, York; Karina Lovell, RN, MSc, PhD, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; David Kessler, MBBS, MRCPsych, MD, MRCGP, Academic Unit of Primary Health Care, University of Bristol, Bristol; Thomas Devlin, PhD, Lucy Smith, BA, PGDip, Department of Health Sciences, University of York, York; Ricardo Araya, PhD, MRCPsych, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, London; Michael Barkham, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield; Peter Bower, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Cindy Cooper, PhD, School of Health and Related Research, University of Sheffield and Clinical Trials Research Unit, University of Sheffield, UK; Sarah Knowles, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Elizabeth Littlewood, PhD, Department of Health Sciences, University of York, York; David A. Richards, RN, PhDhc, PhD, University of Exeter Medical School, University of Exeter, Exeter; Debbie Tallon, MSc, School of Social and Community Medicine, University of Bristol, Bristol; David White, MPH, Clinical Trials Research Unit, University of Sheffield, Sheffield; Gillian Worthy, MSc, York Trials Unit, University of York, York, UK
| | - Lucy Smith
- Simon Gilbody, DPhil, FRCPsych, Sally Brabyn, MA, MSc, Department of Health Sciences, University of York, York; Karina Lovell, RN, MSc, PhD, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; David Kessler, MBBS, MRCPsych, MD, MRCGP, Academic Unit of Primary Health Care, University of Bristol, Bristol; Thomas Devlin, PhD, Lucy Smith, BA, PGDip, Department of Health Sciences, University of York, York; Ricardo Araya, PhD, MRCPsych, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, London; Michael Barkham, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield; Peter Bower, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Cindy Cooper, PhD, School of Health and Related Research, University of Sheffield and Clinical Trials Research Unit, University of Sheffield, UK; Sarah Knowles, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Elizabeth Littlewood, PhD, Department of Health Sciences, University of York, York; David A. Richards, RN, PhDhc, PhD, University of Exeter Medical School, University of Exeter, Exeter; Debbie Tallon, MSc, School of Social and Community Medicine, University of Bristol, Bristol; David White, MPH, Clinical Trials Research Unit, University of Sheffield, Sheffield; Gillian Worthy, MSc, York Trials Unit, University of York, York, UK
| | - Ricardo Araya
- Simon Gilbody, DPhil, FRCPsych, Sally Brabyn, MA, MSc, Department of Health Sciences, University of York, York; Karina Lovell, RN, MSc, PhD, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; David Kessler, MBBS, MRCPsych, MD, MRCGP, Academic Unit of Primary Health Care, University of Bristol, Bristol; Thomas Devlin, PhD, Lucy Smith, BA, PGDip, Department of Health Sciences, University of York, York; Ricardo Araya, PhD, MRCPsych, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, London; Michael Barkham, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield; Peter Bower, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Cindy Cooper, PhD, School of Health and Related Research, University of Sheffield and Clinical Trials Research Unit, University of Sheffield, UK; Sarah Knowles, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Elizabeth Littlewood, PhD, Department of Health Sciences, University of York, York; David A. Richards, RN, PhDhc, PhD, University of Exeter Medical School, University of Exeter, Exeter; Debbie Tallon, MSc, School of Social and Community Medicine, University of Bristol, Bristol; David White, MPH, Clinical Trials Research Unit, University of Sheffield, Sheffield; Gillian Worthy, MSc, York Trials Unit, University of York, York, UK
| | - Michael Barkham
- Simon Gilbody, DPhil, FRCPsych, Sally Brabyn, MA, MSc, Department of Health Sciences, University of York, York; Karina Lovell, RN, MSc, PhD, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; David Kessler, MBBS, MRCPsych, MD, MRCGP, Academic Unit of Primary Health Care, University of Bristol, Bristol; Thomas Devlin, PhD, Lucy Smith, BA, PGDip, Department of Health Sciences, University of York, York; Ricardo Araya, PhD, MRCPsych, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, London; Michael Barkham, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield; Peter Bower, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Cindy Cooper, PhD, School of Health and Related Research, University of Sheffield and Clinical Trials Research Unit, University of Sheffield, UK; Sarah Knowles, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Elizabeth Littlewood, PhD, Department of Health Sciences, University of York, York; David A. Richards, RN, PhDhc, PhD, University of Exeter Medical School, University of Exeter, Exeter; Debbie Tallon, MSc, School of Social and Community Medicine, University of Bristol, Bristol; David White, MPH, Clinical Trials Research Unit, University of Sheffield, Sheffield; Gillian Worthy, MSc, York Trials Unit, University of York, York, UK
| | - Peter Bower
- Simon Gilbody, DPhil, FRCPsych, Sally Brabyn, MA, MSc, Department of Health Sciences, University of York, York; Karina Lovell, RN, MSc, PhD, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; David Kessler, MBBS, MRCPsych, MD, MRCGP, Academic Unit of Primary Health Care, University of Bristol, Bristol; Thomas Devlin, PhD, Lucy Smith, BA, PGDip, Department of Health Sciences, University of York, York; Ricardo Araya, PhD, MRCPsych, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, London; Michael Barkham, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield; Peter Bower, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Cindy Cooper, PhD, School of Health and Related Research, University of Sheffield and Clinical Trials Research Unit, University of Sheffield, UK; Sarah Knowles, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Elizabeth Littlewood, PhD, Department of Health Sciences, University of York, York; David A. Richards, RN, PhDhc, PhD, University of Exeter Medical School, University of Exeter, Exeter; Debbie Tallon, MSc, School of Social and Community Medicine, University of Bristol, Bristol; David White, MPH, Clinical Trials Research Unit, University of Sheffield, Sheffield; Gillian Worthy, MSc, York Trials Unit, University of York, York, UK
| | - Cindy Cooper
- Simon Gilbody, DPhil, FRCPsych, Sally Brabyn, MA, MSc, Department of Health Sciences, University of York, York; Karina Lovell, RN, MSc, PhD, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; David Kessler, MBBS, MRCPsych, MD, MRCGP, Academic Unit of Primary Health Care, University of Bristol, Bristol; Thomas Devlin, PhD, Lucy Smith, BA, PGDip, Department of Health Sciences, University of York, York; Ricardo Araya, PhD, MRCPsych, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, London; Michael Barkham, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield; Peter Bower, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Cindy Cooper, PhD, School of Health and Related Research, University of Sheffield and Clinical Trials Research Unit, University of Sheffield, UK; Sarah Knowles, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Elizabeth Littlewood, PhD, Department of Health Sciences, University of York, York; David A. Richards, RN, PhDhc, PhD, University of Exeter Medical School, University of Exeter, Exeter; Debbie Tallon, MSc, School of Social and Community Medicine, University of Bristol, Bristol; David White, MPH, Clinical Trials Research Unit, University of Sheffield, Sheffield; Gillian Worthy, MSc, York Trials Unit, University of York, York, UK
| | - Sarah Knowles
- Simon Gilbody, DPhil, FRCPsych, Sally Brabyn, MA, MSc, Department of Health Sciences, University of York, York; Karina Lovell, RN, MSc, PhD, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; David Kessler, MBBS, MRCPsych, MD, MRCGP, Academic Unit of Primary Health Care, University of Bristol, Bristol; Thomas Devlin, PhD, Lucy Smith, BA, PGDip, Department of Health Sciences, University of York, York; Ricardo Araya, PhD, MRCPsych, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, London; Michael Barkham, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield; Peter Bower, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Cindy Cooper, PhD, School of Health and Related Research, University of Sheffield and Clinical Trials Research Unit, University of Sheffield, UK; Sarah Knowles, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Elizabeth Littlewood, PhD, Department of Health Sciences, University of York, York; David A. Richards, RN, PhDhc, PhD, University of Exeter Medical School, University of Exeter, Exeter; Debbie Tallon, MSc, School of Social and Community Medicine, University of Bristol, Bristol; David White, MPH, Clinical Trials Research Unit, University of Sheffield, Sheffield; Gillian Worthy, MSc, York Trials Unit, University of York, York, UK
| | - Elizabeth Littlewood
- Simon Gilbody, DPhil, FRCPsych, Sally Brabyn, MA, MSc, Department of Health Sciences, University of York, York; Karina Lovell, RN, MSc, PhD, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; David Kessler, MBBS, MRCPsych, MD, MRCGP, Academic Unit of Primary Health Care, University of Bristol, Bristol; Thomas Devlin, PhD, Lucy Smith, BA, PGDip, Department of Health Sciences, University of York, York; Ricardo Araya, PhD, MRCPsych, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, London; Michael Barkham, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield; Peter Bower, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Cindy Cooper, PhD, School of Health and Related Research, University of Sheffield and Clinical Trials Research Unit, University of Sheffield, UK; Sarah Knowles, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Elizabeth Littlewood, PhD, Department of Health Sciences, University of York, York; David A. Richards, RN, PhDhc, PhD, University of Exeter Medical School, University of Exeter, Exeter; Debbie Tallon, MSc, School of Social and Community Medicine, University of Bristol, Bristol; David White, MPH, Clinical Trials Research Unit, University of Sheffield, Sheffield; Gillian Worthy, MSc, York Trials Unit, University of York, York, UK
| | - David A Richards
- Simon Gilbody, DPhil, FRCPsych, Sally Brabyn, MA, MSc, Department of Health Sciences, University of York, York; Karina Lovell, RN, MSc, PhD, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; David Kessler, MBBS, MRCPsych, MD, MRCGP, Academic Unit of Primary Health Care, University of Bristol, Bristol; Thomas Devlin, PhD, Lucy Smith, BA, PGDip, Department of Health Sciences, University of York, York; Ricardo Araya, PhD, MRCPsych, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, London; Michael Barkham, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield; Peter Bower, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Cindy Cooper, PhD, School of Health and Related Research, University of Sheffield and Clinical Trials Research Unit, University of Sheffield, UK; Sarah Knowles, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Elizabeth Littlewood, PhD, Department of Health Sciences, University of York, York; David A. Richards, RN, PhDhc, PhD, University of Exeter Medical School, University of Exeter, Exeter; Debbie Tallon, MSc, School of Social and Community Medicine, University of Bristol, Bristol; David White, MPH, Clinical Trials Research Unit, University of Sheffield, Sheffield; Gillian Worthy, MSc, York Trials Unit, University of York, York, UK
| | - Debbie Tallon
- Simon Gilbody, DPhil, FRCPsych, Sally Brabyn, MA, MSc, Department of Health Sciences, University of York, York; Karina Lovell, RN, MSc, PhD, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; David Kessler, MBBS, MRCPsych, MD, MRCGP, Academic Unit of Primary Health Care, University of Bristol, Bristol; Thomas Devlin, PhD, Lucy Smith, BA, PGDip, Department of Health Sciences, University of York, York; Ricardo Araya, PhD, MRCPsych, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, London; Michael Barkham, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield; Peter Bower, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Cindy Cooper, PhD, School of Health and Related Research, University of Sheffield and Clinical Trials Research Unit, University of Sheffield, UK; Sarah Knowles, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Elizabeth Littlewood, PhD, Department of Health Sciences, University of York, York; David A. Richards, RN, PhDhc, PhD, University of Exeter Medical School, University of Exeter, Exeter; Debbie Tallon, MSc, School of Social and Community Medicine, University of Bristol, Bristol; David White, MPH, Clinical Trials Research Unit, University of Sheffield, Sheffield; Gillian Worthy, MSc, York Trials Unit, University of York, York, UK
| | - David White
- Simon Gilbody, DPhil, FRCPsych, Sally Brabyn, MA, MSc, Department of Health Sciences, University of York, York; Karina Lovell, RN, MSc, PhD, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; David Kessler, MBBS, MRCPsych, MD, MRCGP, Academic Unit of Primary Health Care, University of Bristol, Bristol; Thomas Devlin, PhD, Lucy Smith, BA, PGDip, Department of Health Sciences, University of York, York; Ricardo Araya, PhD, MRCPsych, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, London; Michael Barkham, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield; Peter Bower, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Cindy Cooper, PhD, School of Health and Related Research, University of Sheffield and Clinical Trials Research Unit, University of Sheffield, UK; Sarah Knowles, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Elizabeth Littlewood, PhD, Department of Health Sciences, University of York, York; David A. Richards, RN, PhDhc, PhD, University of Exeter Medical School, University of Exeter, Exeter; Debbie Tallon, MSc, School of Social and Community Medicine, University of Bristol, Bristol; David White, MPH, Clinical Trials Research Unit, University of Sheffield, Sheffield; Gillian Worthy, MSc, York Trials Unit, University of York, York, UK
| | - Gillian Worthy
- Simon Gilbody, DPhil, FRCPsych, Sally Brabyn, MA, MSc, Department of Health Sciences, University of York, York; Karina Lovell, RN, MSc, PhD, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester; David Kessler, MBBS, MRCPsych, MD, MRCGP, Academic Unit of Primary Health Care, University of Bristol, Bristol; Thomas Devlin, PhD, Lucy Smith, BA, PGDip, Department of Health Sciences, University of York, York; Ricardo Araya, PhD, MRCPsych, Centre of Global Mental Health, London School of Hygiene and Tropical Medicine, London; Michael Barkham, PhD, Centre for Psychological Services Research, University of Sheffield, Sheffield; Peter Bower, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Cindy Cooper, PhD, School of Health and Related Research, University of Sheffield and Clinical Trials Research Unit, University of Sheffield, UK; Sarah Knowles, PhD, NIHR School for Primary Care Research, University of Manchester, Manchester; Elizabeth Littlewood, PhD, Department of Health Sciences, University of York, York; David A. Richards, RN, PhDhc, PhD, University of Exeter Medical School, University of Exeter, Exeter; Debbie Tallon, MSc, School of Social and Community Medicine, University of Bristol, Bristol; David White, MPH, Clinical Trials Research Unit, University of Sheffield, Sheffield; Gillian Worthy, MSc, York Trials Unit, University of York, York, UK
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