"Do More, Feel Better": Pilot RCT of Lay-Delivered Behavioral Activation for Depressed Senior Center Clients.
"Do More, Feel Better": Pilot RCT of Lay-Delivered Behavioral Activation for Depressed Senior Center Clients.
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DOI：
10.1016/j.beth.2021.11.005
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发表时间：
2022-05
期刊：
影响因子：
3.7
通讯作者：
Mosser, Brittany A
中科院分区：
文献类型：
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作者：
Raue, Patrick J;Hawrilenko, Matt;Corey, Mariah;Lin, John;Chen, Shiyu;Mosser, Brittany A
这项试验性随机对照试验（RCT）测试了“做得更多，做得更好”（DMFB），这是一项针对抑郁症老年中心客户的行为激活干预措施。该研究检查：1。培训年长的非专业志愿者忠诚度的可行性;以及2.干预的可接受性、安全性和影响。在四个高级中心的21名非专业志愿者接受了DMFB培训。五十六名抑郁症患者被随机分配接受9次由社会工作者提供的DMFB或行为激活（MSW BA）。在基线和第3、6和9周进行总体客户活动水平（BADS）和抑郁严重程度（HAM-D）的研究评估。81%接受培训的非专业志愿者在DMFB获得正式认证。接受每种干预的抑郁患者报告了高水平的满意度，并在9周的活动水平（d ≥ 1.35）和抑郁严重程度（d ≥ 3.34）方面表现出较大的临床显著变化。治疗组之间的活动水平（dMSW = 0.16; 95% CI，-0.70至1.02）和抑郁（dMSW = 0.14; 95% CI，-0.63至0.91）差异非常小。活动水平的增加与抑郁症的减少相关（β =-0.42; 95%CI，-0.55至-0.30）。这两种干预措施似乎都能通过增加活动水平和降低抑郁症的严重程度来达到预期的效果。“做得更多，感觉更好”显示了由监督的非专业志愿者提供的循证行为干预的潜力，并可以帮助解决劳动力不足的问题，以满足社区居住的老年人的心理健康需求。
This pilot randomized control trial (RCT) tested “Do More, eel Better” (DMFB), a lay-delivered Behavioral Activation intervention for depressed senior center clients. The study examined: 1. the feasibility of training older lay volunteers to fidelity; and 2. the acceptability, safety, and impact of the intervention. Twenty-one lay volunteers at four senior centers were trained in DMFB. Fifty-six depressed clients were randomized to receive 9 sessions of DMFB or Behavioral Activation delivered by social workers (MSW BA). Research assessments of overall client activity level (BADS) and depression severity (HAM-D) were conducted at baseline and weeks 3, 6, and 9. Eighty-one percent of lay volunteers who underwent training were formally certified in DMFB. Depressed clients receiving each intervention reported high levels of satisfaction and showed large and clinically significant changes in 9-week activity level (d ≥ 1.35) and depression severity (d ≥ 3.34). Differences between treatment groups were very small for both activity level (dMSW = 0.16; 95% CI, −0.70 to 1.02) and depression (dMSW = 0.14; 95% CI, −0.63 to 0.91). Increases in activity level were associated with decreases in depression (β = −0.42; 95% CI, −0.55 to −0.30). Both interventions appeared to work as intended by increasing activity level and reducing depression severity. “Do More, Feel Better” shows the potential of evidence-based behavioral interventions delivered by supervised lay volunteers, and can help address the insufficient workforce available to meet the mental health needs of community-dwelling older adults.