Skip to main content

Main menu

  • Home
  • Content
    • Current Issue
    • Online First
    • Multimedia
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • The Issue in Brief (Plain Language Summaries)
    • Call for Papers
  • Info for
    • Authors
    • Reviewers
    • Media
    • Job Seekers
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • RSS
    • Email Alerts
    • Journal Club
  • Contact
    • Feedback
    • Contact Us
  • Careers

User menu

  • My alerts

Search

  • Advanced search
Annals of Family Medicine
  • My alerts
Annals of Family Medicine

Advanced Search

  • Home
  • Content
    • Current Issue
    • Online First
    • Multimedia
    • Collections
    • Past Issues
    • Articles by Subject
    • Articles by Type
    • Supplements
    • The Issue in Brief (Plain Language Summaries)
    • Call for Papers
  • Info for
    • Authors
    • Reviewers
    • Media
    • Job Seekers
  • About
    • Annals of Family Medicine
    • Editorial Staff & Boards
    • Sponsoring Organizations
    • Copyrights & Permissions
    • Announcements
  • Engage
    • Engage
    • e-Letters (Comments)
    • Subscribe
    • RSS
    • Email Alerts
    • Journal Club
  • Contact
    • Feedback
    • Contact Us
  • Careers
  • Follow annalsfm on Twitter
  • Visit annalsfm on Facebook
Research ArticleOriginal Research

Treating Subthreshold Depression in Primary Care: A Randomized Controlled Trial of Behavioral Activation With Mindfulness

Samuel Y. S. Wong, Yu Ying Sun, Aaroy T. Y. Chan, Maria K. W. Leung, David V. K. Chao, Carole C. K. Li, King K. H. Chan, Wai Kwong Tang, Trevor Mazzucchelli, Alma M. L. Au and Benjamin H. K. Yip
The Annals of Family Medicine March 2018, 16 (2) 111-119; DOI: https://doi.org/10.1370/afm.2206
Samuel Y. S. Wong
The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Yu Ying Sun
The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Aaroy T. Y. Chan
The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Maria K. W. Leung
The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
David V. K. Chao
The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Carole C. K. Li
The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
King K. H. Chan
The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Wai Kwong Tang
The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Trevor Mazzucchelli
The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Alma M. L. Au
The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Benjamin H. K. Yip
The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Wong, Sun, T.Y. Chan, Yip); Fanling Family Medicine Centre, Hospital Authority, Hong Kong, China (Leung); United Christian Hospital, Hospital Authority, Hong Kong, China (Chao); Kowloon East Cluster, Hospital Authority, Hong Kong, China (Li); Kowloon Central Cluster, Hospital Authority, Hong Kong, China (K.H. Chan); Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China (Tang); School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia (Mazzucchelli); Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Au)
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • eLetters
  • PDF
Loading

Article Figures & Data

Figures

  • Tables
  • Additional Files
  • Figure 1
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 1

    Flow chart of the randomized controlled trial.

    BAM = behavioral activation with mindfulness.

Tables

  • Figures
  • Additional Files
    • View popup
    Table 1

    Characteristics of Patients Overall and by Group

    CharacteristicTotal (N=231)BAM Group (n=115)Usual Care Group (n=116)Test Statistic, t or χ2
    Age, mean (SD), y54.0 (12.0)55.3 (10.4)52.7 (13.3)1.676
    Sex, No. (%)
     Male16 (6.9)6 (5.2)10 (8.6)1.038
     Female215 (93.1)109 (94.8)106 (91.4)
    Education, No. (%)
     Primary or less72 (31.2)36 (31.3)36 (31.0)0.423
     Middle school113 (48.9)58 (50.4)55 (47.4)
     Diploma or more46 (19.9)21 (18.3)25 (21.6)
    Occupation, No. (%)
     Housewife89 (38.5)44 (38.3)45 (38.8)1.176
     Retired54 (23.4)24 (20.9)30 (25.9)
     Employed or self-employed74 (32.0)39 (33.9)35 (30.2)
     Part-time or other14 (6.1)8 (7.0)6 (5.2)
    Marital status, No. (%)
     Single38 (16.7)16 (14.0)22 (19.3)8.899a
     Married166 (72.8)92 (80.7)74 (64.9)
     Live alone24 (10.5)6 (5.3)18 (15.8)
    Income, No. (%)
     <$5,00075 (33.2)39 (34.5)36 (31.9)1.128
     $5,000-$10,00051 (22.6)24 (21.2)27 (23.9)
     $10,000–$20,00074 (32.7)35 (31.0)39 (34.5)
     >$20,00026 (11.5)15 (13.3)11 (9.7)
    PHQ-9 score, mean (SD)b7.35 (1.41)7.38 (1.40)7.32 (1.43)0.342
    Health conditions, No. (%)
     Diabetes26 (11.3)15 (13.0)11 (9.5)0.733
     Hypertension91 (39.4)51 (44.3)40 (34.5)2.354
     Rheumatoid arthritis30 (13.0)16 (13.9)14 (12.1)0.174
     Cancer18 (7.8)13 (11.3)5 (4.3)3.932a
    • BAM = behavioral activation with mindfulness; PHQ-9 = 9-item Patient Health Questionnaire.

    • ↵a Difference between groups was significant (P <.05).

    • ↵b Possible range is 0 to 27; higher scores indicate more severe depression.

    • View popup
    Table 2

    Outcomes in the BAM Group and Usual Care Group at Various Time Points

    OutcomeTime PointBAM Group, Mean (SD) (n=115)Usual Care Group, Mean (SD) (n=116)Modified Intention-to-Treat AnalysisImputed Data AnalysisPer-Protocol Analysis
    Between-Group Difference (95% CI)P ValueBetween-Group Difference (95% CI)P ValueBetween-Group Difference (95% CI)P Value
    BDI-II scorea,bT019.18 (8.35)17.68 (9.52)–––
    T115.41 (9.53)17.28 (9.83)−3.57 (−5.38 to −1.78)<.001−3.21 (−5.02 to −1.40)<.001−3.78 (−5.93 to −1.63).001
    T215.04 (10.29)16.57 (10.47)−2.97 (−5.35 to −0.59).02−2.32 (−4.65 to 0.01).051−3.29 (−5.84 to −0.74).01
    T314.45 (10.40)16.90 (10.84)−3.85 (−6.36 to −1.34).003−3.06 (−5.48 to −0.64).01−3.96 (−6.58 to −1.35).003
    SF-12: PCS scoreb,cT040.19 (8.66)41.75 (9.75)––––
    T140.16 (8.86)41.26 (9.96)0.22 (−1.70 to 2.13).82−0.03 (−1.92 to 1.86).970.50 (−1.89 to 2.88).68
    T239.61 (8.98)40.00 (9.46)0.72 (−1.68 to 3.13).550.21 (−2.04 to 2.45).860.29 (−2.31 to 2.90).83
    T339.19 (8.67)40.15 (10.20)0.18 (−2.30 to 2.65).89−0.10 (−2.44 to 2.25).94−0.10 (−2.71 to 2.51).94
    SF12: MCS scoreb,cT040.24 (8.81)40.99 (10.11)–––
    T142.96 (9.62)40.95 (9.84)3.22 (1.09 to 5.35).0032.99 (0.85 to 5.13).0063.09 (0.48 to 5.70).02
    T242.02 (9.27)41.33 (8.87)1.43 (−1.05 to 3.91).261.12 (−1.24 to 3.48).351.85 (−0.87 to 4.58).18
    T342.81 (10.00)42.24 (9.14)1.41 (−1.22 to 4.04).291.12 (−1.33 to 3.58).371.27 (−1.50 to 4.04).37
    ACCQ scoredT013.87 (6.58)13.31 (5.90)–––
    T117.30 (6.14)14.63 (6.44)2.62 (1.13 to 4.11).0012.47 (0.98 to 3.97).0012.41 (0.59 to 4.24).01
    T216.20 (6.62)16.09 (7.31)0.13 (−1.75 to 2.00).900.42 (−1.43 to 2.28).65−0.26 (−2.34 to 1.82).81
    T317.07 (7.11)16.11 (7.26)1.01 (−1.08 to 3.09).341.15 (−0.87 to 3.17).261.12 (−1.12 to 3.36).32
    SDS scoreb,eT011.70 (9.23)11.03 (8.68)–––
    T111.58 (9.39)10.87 (8.69)0.24 (−1.98 to 2.46).830.37 (−1.80 to 2.54).740.49 (−2.14 to 3.11).71
    T29.14 (8.14)9.92 (8.59)−1.27 (−3.63 to 1.08).29−0.38 (−2.59 to 1.84).74−1.72 (−4.28 to 0.84).19
    T310.58 (9.30)11.15 (9.91)−1.23 (−3.83 to 1.37).35−0.62 (−2.99 to 1.76).61−1.21 (−3.93 to 1.50).38
    STAI-S scorefT048.03 (9.42)47.71 (10.17)–––
    T146.26 (11.54)47.68 (9.33)−2.18 (−4.44 to −0.08).059−1.87 (−4.15 to 0.41).11−1.19 (−3.83 to 1.46).38
    T246.27 (10.54)47.37 (9.41)−1.64 (−4.17 to 0.89).20−1.30 (−3.73 to 1.13).29−1.65 (−4.45 to 1.15).25
    T345.99 (10.43)47.70 (10.56)−2.50 (−5.20 to 0.19).07−1.72 (−4.30 to 0.86).19−2.08 (−4.97 to 0.81).16
    STAI-T scorefT047.76 (8.18)46.87 (8.70)–––
    T146.75 (9.38)47.43 (8.15)−1.56 (−3.48 to 0.36).11−1.25 (−3.13 to 0.63).19−1.73 (−3.98 to 0.53).13
    T246.47 (8.92)47.22 (8.52)−1.69 (−3.87 to 0.49).13−1.15 (−3.18 to 0.88).26−1.97 (−4.31 to 0.38).099
    T347.17 (8.97)48.14 (8.48)−1.99 (−4.27 to 0.30).09−1.40 (−3.65 to 0.84).22−1.80 (−4.14 to 0.53).13
    • ACCQ = Activity and Circumstantial Change Questionnaire; BAM = behavioral activation with mindfulness; BDI-II: Beck Depression Inventory-II; MCS = mental component summary; PCS = physical component summary; SDS = Sheehan Disability Scale; SF-12 = 12-item Medical Outcomes Study Short-Form Health Survey; STAI-S = State Trait Anxiety Inventory–State; STAI-T = State Trait Anxiety Inventory–Trait; T0 = baseline; T1 = end of intervention; T2 = 5-month follow-up; T3=12-month follow-up.

    • Note: Major depressive disorder at T3 was present in 9 patients (10.8%) in the BAM group and 26 patients (26.8%) in the usual care group (P =.01). Analysis conducted using observed data, and P value obtained by logistic regression analysis with cancer history and marital status as covariates.

    • ↵a Possible range for total scores is 0 to 63; higher scores indicate more severe depression.

    • ↵b P values for group effect were calibrated by analysis of covariance (ANCOVA) approach, with baseline value, cancer history, and marital status as covariates.

    • ↵c Possible range is 0 to 100; higher scores indicate better self-reported health.

    • ↵d Possible range is 8 to 40; higher scores indicate greater positive change.

    • ↵e Possible range is 0 to 40; higher scores indicate more functional impairment.

    • ↵f Possible range is 20 to 80; higher scores indicate greater anxiety.

Additional Files

  • Figures
  • Tables
  • Supplemental Appendixes

    Supplemental Appendix, Table, Figures

    Files in this Data Supplement:

    • Supplemental data: Appendixes - PDF File
  • The Article in Brief

    Treating Subthreshold Depression in Primary Care: A Randomized Controlled Trial of Behavioral Activation With Mindfulness

    Samuel Y. S. Wong , and colleagues

    Background Subthreshold (minor) depression is common among primary care patients. The aim of this study was to evaluate the effectiveness of group behavioral activation focused on mindfulness training to treat subthreshold depression in primary care.

    What This Study Found Among primary care patients with subthreshold depression, mindfulness meditation training reduces the incidence of major depression and improves depression symptoms. A randomized controlled trial of adults with subthreshold depression compared a usual care group in which there was no psychological intervention (n=116) with a behavioral activation group focused on mindfulness training (n=115). Intervention participants were invited to attend weekly two-hour mindfulness training sessions for eight consecutive weeks. At 12 months, there was a statistically significant difference in the incidence of major depressive disorder between groups (11 percent in the mindfulness group compared to 27 percent in usual care). Mindfulness training also had a small effect in reducing depression symptoms. Other secondary outcomes demonstrated no significant change.

    Implications

    • The authors suggest that, for patients with subthreshold depression who have not had a major depressive episode in the past six months, mindfulness training is a feasible method of preventing major depression.
    • The authors plan future research into the cost-effectiveness, health service use implications, and acceptability of mindfulness training.
PreviousNext
Back to top

In this issue

The Annals of Family Medicine: 16 (2)
The Annals of Family Medicine: 16 (2)
Vol. 16, Issue 2
March/April 2018
  • Table of Contents
  • Index by author
  • Back Matter (PDF)
  • Front Matter (PDF)
  • In Brief
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on Annals of Family Medicine.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Treating Subthreshold Depression in Primary Care: A Randomized Controlled Trial of Behavioral Activation With Mindfulness
(Your Name) has sent you a message from Annals of Family Medicine
(Your Name) thought you would like to see the Annals of Family Medicine web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
4 + 14 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
Citation Tools
Treating Subthreshold Depression in Primary Care: A Randomized Controlled Trial of Behavioral Activation With Mindfulness
Samuel Y. S. Wong, Yu Ying Sun, Aaroy T. Y. Chan, Maria K. W. Leung, David V. K. Chao, Carole C. K. Li, King K. H. Chan, Wai Kwong Tang, Trevor Mazzucchelli, Alma M. L. Au, Benjamin H. K. Yip
The Annals of Family Medicine Mar 2018, 16 (2) 111-119; DOI: 10.1370/afm.2206

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Get Permissions
Share
Treating Subthreshold Depression in Primary Care: A Randomized Controlled Trial of Behavioral Activation With Mindfulness
Samuel Y. S. Wong, Yu Ying Sun, Aaroy T. Y. Chan, Maria K. W. Leung, David V. K. Chao, Carole C. K. Li, King K. H. Chan, Wai Kwong Tang, Trevor Mazzucchelli, Alma M. L. Au, Benjamin H. K. Yip
The Annals of Family Medicine Mar 2018, 16 (2) 111-119; DOI: 10.1370/afm.2206
Reddit logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • INTRODUCTION
    • METHODS
    • RESULTS
    • DISCUSSION
    • Acknowledgments
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • eLetters
  • PDF

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • In This Issue: Refining Care and its Frameworks
  • Google Scholar

More in this TOC Section

  • Investigating Patient Experience, Satisfaction, and Trust in an Integrated Virtual Care (IVC) Model: A Cross-Sectional Survey
  • Patient and Health Care Professional Perspectives on Stigma in Integrated Behavioral Health: Barriers and Recommendations
  • Evaluation of the Oral Health Knowledge Network’s Impact on Pediatric Clinicians and Patient Care
Show more Original Research

Similar Articles

Subjects

  • Domains of illness & health:
    • Mental health
  • Methods:
    • Quantitative methods

Keywords

  • behavioral activation
  • mindfulness
  • subthreshold depression
  • prevention
  • primary care
  • randomized controlled trial

Content

  • Current Issue
  • Past Issues
  • Past Issues in Brief
  • Multimedia
  • Articles by Type
  • Articles by Subject
  • Multimedia
  • Supplements
  • Online First
  • Calls for Papers

Info for

  • Authors
  • Reviewers
  • Media
  • Job Seekers

Engage

  • E-mail Alerts
  • e-Letters (Comments)
  • RSS
  • Journal Club
  • Submit a Manuscript
  • Subscribe
  • Family Medicine Careers

About

  • About Us
  • Editorial Board & Staff
  • Sponsoring Organizations
  • Copyrights & Permissions
  • Contact Us
  • eLetter/Comments Policy

© 2023 Annals of Family Medicine