Depression in Old Age
Conditions
Brief summary
The goal of this intervention study is to design and learn whether peer support that is delivered through video chats and texts can decrease depression among older adults. Participants will be assigned to a peer support program where they will receive 8 video chats with a peer mentor who provide social support and supportive texts over 8 weeks.
Detailed description
PEERS plus is a psychosocial intervention being developed to reduce depression among older adults. In this intervention peer mentors who are also 50 years of age and older and who have experiential knowledge of depression provide depression care. Older adults with depression will be recruited and assigned to the peer support program. This will consist of 8 weekly peer mentor - older adult video chats that provide emotional support and sharing of self-care skills for depression. Supportive texts will be sent on a weekly basis to older adults by peer mentors. These texts will provide encouragement, affirmations and information about mental health resources. Peer mentors are trained and supervised by a mental health professional during the 8 week period. We will assess at baseline, post study and 3 months after the intervention.
Interventions
BEHAVIORALPeers plus
Peer support intervention in which peer mentors who have experiential knowledge of depression deliver social support through video chats and texts to older adults with depression.
Sponsors
National Institute of Mental Health (NIMH)
Massachusetts General Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
A cohort of 20 older adults will be assigned to the Peer plus program for 8 weeks, without a comparison group.
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. 50 years and older 2. PHQ-9 score \> 5, 3. on the same antidepressant dose for at least 3 months 4. if receiving psychotherapy, frequency is at most once a month 5. able to communicate in English 6. able to give informed consent.
Exclusion criteria
1. meet diagnostic criteria for mania or hypomania 2. active suicidal ideation 3. meet diagnostic criteria for psychotic syndrome 4. meet diagnostic criteria for substance abuse or dependence 5. cognitive impairment, with a score on the Short Blessed Test \> 9.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intervention Feasibility | 18 months | Proportion of the participants who complete 80% of their weekly meetings with the peer coach. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Patient Health Questionnaire-9 | We assessed PHQ-9 scores as changes across three timepoints: baseline, post study and 3 month follow up. We ran a mixed-effects longitudinal model to examine how PHQ-9 scores changed over 5 months (8 week intervention and 3 month follow up). | Depression will be assessed with the Patient Health Questionnaire (PHQ-9). The PHQ-9 score is summed from 9 items in the questionnaire, and scores range from 0 to 27. A higher score indicates a worse outcome in depression. A score of 5 indicates mild depressive symptoms, 10 - 14 indicates moderate depression, 15-19 indicates moderately severe depression, and 20-27 indicates severe depression. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Peer Support Peer mentors who have experienced depression provide social support through video chats and texts for 8 weeks.
Peers plus: Peer support intervention in which peer mentors who have experiential knowledge of depression deliver social support through video chats and texts to older adults with depression. | 34 |
| Total | 34 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Ineligible | 1 |
| Overall Study | Withdrawal by Subject | 9 |
Baseline characteristics
| Characteristic | Peer Support |
|---|---|
| Age, Continuous | 66.62 years |
| Ethnicity (NIH/OMB) Hispanic or Latino | 1 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 33 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Patient Health Questionnaire-9 | 11.32 units on a scale STANDARD_DEVIATION 5.36 |
| Race/Ethnicity, Customized Asian | 2 Participants |
| Race/Ethnicity, Customized Black | 9 Participants |
| Race/Ethnicity, Customized Multiracial | 2 Participants |
| Race/Ethnicity, Customized White | 21 Participants |
| Region of Enrollment United States | 34 Participants |
| Sex: Female, Male Female | 31 Participants |
| Sex: Female, Male Male | 3 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 34 |
| other Total, other adverse events | 0 / 34 |
| serious Total, serious adverse events | 0 / 34 |
Outcome results
Primary
Intervention Feasibility
Proportion of the participants who complete 80% of their weekly meetings with the peer coach.
Time frame: 18 months
Population: Peer mentors who have experienced depression provide social support through video chats and texts for 8 weeks.~Peers plus: Peer support intervention in which peer mentors who have experiential knowledge of depression deliver social support through video chats and texts to older adults with depression.
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Peer Support | Intervention Feasibility | 28 Participants |
Other Pre-specified
Patient Health Questionnaire-9
Depression will be assessed with the Patient Health Questionnaire (PHQ-9). The PHQ-9 score is summed from 9 items in the questionnaire, and scores range from 0 to 27. A higher score indicates a worse outcome in depression. A score of 5 indicates mild depressive symptoms, 10 - 14 indicates moderate depression, 15-19 indicates moderately severe depression, and 20-27 indicates severe depression.
Time frame: We assessed PHQ-9 scores as changes across three timepoints: baseline, post study and 3 month follow up. We ran a mixed-effects longitudinal model to examine how PHQ-9 scores changed over 5 months (8 week intervention and 3 month follow up).
Population: Sample sizes varied across the three timepoints due to participant attrition. Some individuals chose not to proceed with the intervention after completing the baseline assessment, while others were lost to follow-up by the post-intervention or 3-month follow-up assessments.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Peer Support | Patient Health Questionnaire-9 | Baseline | 11.32 score on a scale | Standard Deviation 5.36 |
| Peer Support | Patient Health Questionnaire-9 | Post Study | 9.71 score on a scale | Standard Deviation 5.59 |
| Peer Support | Patient Health Questionnaire-9 | 3 Month Follow Up | 8.29 score on a scale | Standard Deviation 4.84 |
Comparison: Null hypothesis: there is no difference in the mean Patient Health Questionnaire-9 (PHQ-9) scores from baseline to post-intervention for all study participants.p-value: 0.02595% CI: [-3.336, -0.23]Mixed Models Analysis
Comparison: Null hypothesis: there is no difference in the mean Patient Health Questionnaire-9 (PHQ-9) scores from baseline to 3-month for all study participants.p-value: 0.00595% CI: [-4.057, -0.784]Mixed Models Analysis
Comparison: Null hypothesis: There is no difference in the mean Patient Health Questionnaire-9 (PHQ-9) scores over time for all study participants.p-value: 0.00495% CI: [-0.9039, -0.1897]Mixed Models Analysis