2/3 Lay-delivered Behavioral Activation in Senior Centers

2/3 老年人中心的非专业行为激活

• 批准号: 10524018
• 负责人: JO ANNE SIREY
• 金额: $ 36万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-12-15 至 2025-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10524018
• 关键词: Address; Aging; Area; Behavioral; Characteristics; Client; Clinical; Clinical Trials; Communities; Dementia; Depressed mood; Depression screen; Diagnostic; Effectiveness; Elderly; Eligibility Determination; Funding; Geography; Health; Health Personnel; Individual; Infrastructure; Intervention; Label; Light; Mental Depression; Mental Health; Mental disorders; Modeling; National Institute of Mental Health; New York City; Nutritional; Outcome; Participant; Population; Provider; Psychoses; Randomized; Recreation; Reporting; Resources; Rewards; Safety; Sample Size; Service setting; Services; Severities; Site; Supervision; Testing; Time; Vulnerable Populations; Work; World Health Organization Disability Assessment Schedule; clinically significant; community setting; cost; depressive symptoms; disability; effective intervention; effectiveness testing; effectiveness trial; ethnic diversity; experience; geriatric mental health; improved; non-demented; practice setting; psychosocial; randomized effectiveness trial; recruit; response; satisfaction; skills; social; sociodemographic factors; sociodemographics; volunteer

ABSTRACT In response to large numbers of senior center clients who suffer untreated depression and the dearth of geriatric mental health providers, we have partnered with senior center stakeholders to simplify Behavioral Activation (BA) to match the skill set of lay volunteers (“Do More, Feel Better”; DMFB). The lay delivery model: 1. makes use of existing volunteer resources that can address the insufficient workforce; and 2. has potential for being an acceptable and sustainable delivery model. However, the capacity of this model to engage the same target (increased activity) and to yield comparable clinical outcomes as professionally-delivered interventions is yet to be determined in a fully-powered trial. This Collaborative R01 proposes fully powered randomized effectiveness trial testing the effect of DMFB in comparison to professionally-delivered BA (MSW BA) on increased activity level (target) and decreased depressive symptoms. The specific aims are to: 1. Test the effectiveness of DMFB, in comparison to MSW BA, for depressed (PHQ- 9>10 and Ham-D>14) older adults (>60) on increasing overall activity level (target) and reducing depression symptoms; and 2. test whether increased activity level predicts greater reduction in depression severity and whether increased activity's impact on depression is non-inferior across conditions. Client participants will be a total of 288 older (>60 years) non-psychotic, non-demented individuals with elevated depressive symptoms from 6 Seattle, 6 New York City, and 6 Tampa area senior centers serving economically and ethnically diverse communities. Eligible clients will be randomized within senior center to either DMFB (n=144) or MSW BA (n=144). Two lay volunteers and 2 MSWs per center will provide the intervention. Our proposal responds to the 2012 IOM report which highlighted the dearth of mental health providers for older adults and the need to develop a workforce of nontraditional providers. DMFB is a streamlined BA intervention that has high potential for sustainability by making use of an untapped volunteer resource and supervision infrastructure within senior centers. Our findings will identify effective interventions for an underserved and difficult to engage population, our partners in aging services would be pleased to implement either delivery format of BA to activate depressed older adults.

抽象的 为了回应遭受未经治疗抑郁症和死亡的大量高级中心客户 老年心理健康提供者，我们与高级中心利益相关者合作，简化行为 激活（BA）与外行志愿者的技能相匹配（“做更多，感觉更好”； DMFB）。 外行交付模型：1。利用现有的志愿资源，可以解决不足 劳动力； 2。具有成为可接受和可持续的交付模式的潜力。但是，容量 该模型可以参与相同的目标（增加活动）并产生可比的临床结果 专业交付的干预措施尚未在全面的试验中确定。 该协作R01提案完全动力的随机有效性试验测试DMFB在 与专业交付的BA（MSW BA）的活动水平提高（目标）并改善 抑郁症状。 具体目的是：1。与MSW BA相比，测试DMFB的有效性（phq-）（PHQ-） 9> 10和HAM-D> 14）老年人（> 60）在增加总体活动水平（目标）并减少抑郁症 符号； 2。测试活动水平是否增加抑郁严重程度的减少和 在各种条件下，活动对抑郁的影响是否增加是非内部的。 客户参与者总共将有288岁（> 60岁）的非精神病性，非痴呆的人升高 来自6个西雅图，6个纽约市和6个坦帕地区高级中心的抑郁症状 和种族多元化的社区。合格的客户将在高级中心内随机分配给任何一个DMFB （n = 144）或MSW BA（n = 144）。每个中心两名外行志愿者和2 MSW将提供干预。 我们的建议回应2012年的IOM报告，该报告强调了心理健康提供者的死亡 成人以及需要发展非传统提供者的劳动力。 DMFB是简化的BA干预 通过利用未开发的志愿者资源和监督，这具有很高的可持续性潜力 高级中心内的基础设施。我们的发现将确定服务不足的有效干预措施 很难吸引人口，我们的老龄化服务合作伙伴很高兴实施任一交付 BA的格式激活抑郁的老年人。