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 为了应对大量患有抑郁症且缺乏治疗的老年中心客户 老年心理健康提供者，我们与高级中心利益相关者合作，以简化行为 激活（BA）以匹配非专业志愿者的技能（“做得更多，感觉更好”；DMFB）。 外行服务模式：1.利用现有的志愿者资源，解决不足的问题 劳动力； 2. 有潜力成为可接受且可持续的交付模式。然而，容量 该模型的目的是为了达到相同的目标（增加活性）并产生可比的临床结果 专业干预措施尚未在全面的试验中确定。 该协作 R01 提出了全面的随机有效性试验，测试 DMFB 在 与专业提供的 BA (MSW BA) 相比，活动水平（目标）增加，活动水平降低 抑郁症状。 具体目标是： 1. 与 MSW BA 相比，测试 DMFB 对抑郁症 (PHQ- 9>10 和 Ham-D>14) 老年人 (>60) 提高总体活动水平（目标）和减少抑郁 症状; 2. 测试活动水平的增加是否预示着抑郁症严重程度的更大程度降低 增加活动对抑郁症的影响是否在不同条件下均不较差。 客户参与者将是总共 288 名年龄较大（> 60 岁）的非精神病、非痴呆个体，患有高 来自西雅图 6 个、纽约市 6 个和坦帕地区 6 个经济服务老年人中心的抑郁症状 和种族多元化的社区。符合资格的客户将在高级中心内随机分配到 DMFB (n=144) 或 MSW BA (n=144)。每个中心有两名非专业志愿者和 2 名社会工作者将提供干预服务。 我们的提案是对 2012 年 IOM 报告的回应，该报告强调了老年人心理健康服务提供者的缺乏 成年人以及培养非传统服务提供者劳动力的需要。 DMFB 是一种简化的 BA 干预 通过利用未开发的志愿者资源和监督，具有很大的可持续性潜力 老年人中心内的基础设施。我们的研究结果将为服务不足和服务不足的地区确定有效的干预措施 很难让人口参与，我们的老龄化服务合作伙伴将很乐意实施任一交付 BA 的形式可以激活抑郁的老年人。