Depression
Conditions
Keywords
Depression
Brief summary
The goal of this study is to test the feasibility, acceptability and preliminary impact of peer-delivered Behavioral Activation (BA) for depressed older adults (60+) who are Naturally Occurring Retirement Communities (NORC) residents or senior center participants.
Detailed description
This project focuses on helping to solve a growing problem in health care today. Through increased screening in the older adult population, detection of depression has increased which has established a growing need for mental health resources. Unfortunately, there are limited resources to keep up with the steady increase of individuals in need. Training peers to work with older depressed adults in techniques such as behavioral activation provides an alternative model to help moderate the increased need and provide a unique intervention of care. Developing an innovative peer facilitated program has the potential to enhance the delivery of quality health care. The specific aims of the study are 1) to train peer coaches and implement Peer to Peer in the community 2) to examine depression ratings over time.
Interventions
BEHAVIORALPeer to Peer
12 weekly sessions of peer-delivered behavioral activation
OTHERStandard Mental Health Referral
Standard mental health referral to a community agency
Sponsors
National Institute of Mental Health (NIMH)
Weill Medical College of Cornell University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Age 60 and older * Member of Lenox Hill Senior Center, St. Peter's Senior Center, or Beth Abe * Score of 10+ on Patient Health Questionnaire (PHQ-9)
Exclusion criteria
* Presence of alcohol abuse, substance abuse, psychotic disorder, or bipolar disorder as observed on the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID) * Inability to speak English * Dementia: Mini Mental State Examination (MMSE) score below 24 * High suicide risk, i.e. intent or plan to attempt suicide
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of Peer to Peer Coaches Who Undergo Behavioral Activation Training and Achieve Certification | 4 weeks prior to Baseline | Proportion of Peer to Peer coaches who undergo Behavioral Activation training and achieve certification |
| Number of Peer to Peer Clients Who Attend > 80% of Behavioral Activation Sessions | 12 weeks | Number of Peer to Peer clients who attend \> 80% of Behavioral Activation sessions |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in Hamilton Depression Rating Scale Scores | Baseline and 12 weeks | Hamilton Depression Rating Scale mean change scores from baseline to 12 weeks. This scale measures severity of depressive symptoms (range=0-76), with higher scores indicating more sever depressive symptomatology. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Peer to Peer Coaches These individuals were eligible to provide the Behavioral Activation intervention. | 11 |
| Peer to Peer Clients These individuals will receive a standard mental health referral to a community agency and in addition meet with a trained peer coach for 12 weekly meetings.
Peer to Peer: 12 weekly sessions of peer-delivered behavioral activation | 8 |
| Referral Clients These individuals will receive a standard mental health referral to a community agency.
Standard Mental Health Referral: Standard mental health referral to a community agency | 10 |
| Total | 29 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Overall Study | Lost to Follow-up | 0 | 2 | 2 |
| Overall Study | Physician Decision | 4 | 0 | 0 |
Baseline characteristics
| Characteristic | Peer to Peer Coaches | Peer to Peer Clients | Referral Clients | Total |
|---|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 11 Participants | 8 Participants | 10 Participants | 29 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants | 0 Participants | 2 Participants | 2 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 11 Participants | 8 Participants | 8 Participants | 27 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 3 Participants | 1 Participants | 1 Participants | 5 Participants |
| Race (NIH/OMB) More than one race | 1 Participants | 0 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 7 Participants | 7 Participants | 9 Participants | 23 Participants |
| Region of Enrollment United States | 11 Participants | 8 Participants | 10 Participants | 29 Participants |
| Sex: Female, Male Female | 9 Participants | 5 Participants | 10 Participants | 24 Participants |
| Sex: Female, Male Male | 2 Participants | 3 Participants | 0 Participants | 5 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 8 | 0 / 10 |
| other Total, other adverse events | 0 / 8 | 0 / 10 |
| serious Total, serious adverse events | 2 / 8 | 1 / 10 |
Outcome results
Primary
Number of Peer to Peer Clients Who Attend > 80% of Behavioral Activation Sessions
Number of Peer to Peer clients who attend \> 80% of Behavioral Activation sessions
Time frame: 12 weeks
Population: Clients assigned to receive Peer BA
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Peer to Peer Coaches | Number of Peer to Peer Clients Who Attend > 80% of Behavioral Activation Sessions | 8 Participants |
Primary
Proportion of Peer to Peer Coaches Who Undergo Behavioral Activation Training and Achieve Certification
Proportion of Peer to Peer coaches who undergo Behavioral Activation training and achieve certification
Time frame: 4 weeks prior to Baseline
Population: This outcome analyzed Peer to Peer coaches who were eligible to provide the Behavioral Activation intervention
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Peer to Peer Coaches | Proportion of Peer to Peer Coaches Who Undergo Behavioral Activation Training and Achieve Certification | 7 Participants |
Secondary
Changes in Hamilton Depression Rating Scale Scores
Hamilton Depression Rating Scale mean change scores from baseline to 12 weeks. This scale measures severity of depressive symptoms (range=0-76), with higher scores indicating more sever depressive symptomatology.
Time frame: Baseline and 12 weeks
Population: Randomized clients
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Peer to Peer Coaches | Changes in Hamilton Depression Rating Scale Scores | -8.0 units on a scale | Standard Deviation 4.3 |
| Referral Clients | Changes in Hamilton Depression Rating Scale Scores | 0.0 units on a scale | Standard Deviation 7.5 |