Volunteer-Delivery of Behavioral Activation for Senior Center Clients

志愿者-为老年中心客户提供行为激活

• 批准号: 9769136
• 负责人: PATRICK J RAUE
• 金额: $ 12.46万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9769136
• 关键词: Administrator; Age; Aging; Area; Behavioral; Case Series; Client; Clinical; Communities; Community Practice; Data; Databases; Depressed mood; Development; Dose; Effectiveness; Effectiveness of Interventions; Elderly; Hamilton Rating Scale for Depression; Health; Health Personnel; Individual; Intervention; Manuals; Mental Depression; Mental Health; Mental disorders; Methods; Modeling; National Institute of Mental Health; New York City; Nutritional; Outcome; Participant; Population; Procedures; Protocols documentation; Provider; Randomized; Reporting; Research; Resources; Rewards; Safety; Services; Standardization; Supervision; Target Populations; Testing; Time; Training; Uncertainty; Work; base; clinically significant; comparative; cost effective; depressive symptoms; design; effective therapy; effectiveness research; efficacy study; ethnic diversity; experience; geriatric depression; geriatric mental health; improved; metropolitan; non-demented; patient safety; practice setting; preference; programs; psychosocial; public health relevance; response; side effect; skills; social; treatment duration; volunteer

Abstract of 1R34MH111849-01 Volunteer-Delivery of Behavioral Activation for Senior Center Clients Abstract ABSTRACT In response to large numbers of senior center clients who suffer untreated depression and the dearth of geriatric mental health providers, we partnered with the NYC Department for the Aging (DFTA) to simplify Behavioral Activation to match the skill set of age-matched lay volunteers available to senior centers (Volunteer BA). The Volunteer BA delivery model: 1. Makes use of existing volunteer resources; 2. has potential for being an acceptable and sustainable delivery model; 3. is expected to engage BA targets; but 4. its capacity to yield comparable outcomes is yet to be determined. This R34 proposes developmental work on delivering Volunteer BA in senior centers, so as to arrive to a sustainable intervention with standardized procedures. We follow with a small RCT testing the comparative impact of Volunteer BA versus MSW-provided BA on increased client activity (the target) and reduced depressive symptoms (clinical outcome). In this effectiveness design, we propose: 1. increased activity as the “target” of the BA intervention's effectiveness; 2. delivery of interventions via manuals and research supervision will result in reaching the target of increased activity; and 3. increased activity will predict improved client depression outcome. The specific aims are to: 1. Assess degree of intervention fit by refining and standardizing procedures for volunteer selection, training, and supervision; refining and standardizing procedures for engaging clients in BA; and matching procedures with senior center staff preferences; 2. Conduct a case series to standardize the intervention by determining whether the intervention represents a sufficient “dose” to produce target engagement; and 3. Conduct a small RCT to establish the feasibility, acceptability, safety and preliminary impact of the intervention. The client participants will be a total of 54 older (>60 years) non-psychotic, non-demented individuals with elevated depressive symptoms from 4 Seattle metropolitan area senior centers serving economically and ethnically diverse communities. For the case series, 3 volunteers at one center will provide 12 weekly sessions to 2 depressed clients each (n=6 total). For the RCT, 3 volunteers and 1 MSW per center will provide either Volunteer or standard BA, respectively. Eligible clients will be randomized within senior centers to either Volunteer BA (n=36) or MSW-delivered BA (n=12). 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. Our findings will set the stage for a definitive study on the effectiveness of Volunteer BA for an underserved and difficult to engage population, and will provide further support for aging service agencies to invest effort in senior volunteer training and supervision procedures.

摘要 1R34MH111849-01 为老年中心客户提供行为激活服务 摘要 摘要：为了应对大量患有未经治疗的抑郁症的老年中心客户和老年心理健康提供者的缺乏，我们与纽约市老龄化部门（DFTA）合作，简化行为激活，以匹配老年中心（志愿者BA）提供的年龄匹配的非专业志愿者的技能。志愿者学士学位交付模式：1。利用现有的志愿者资源; 2。具有成为可接受和可持续交付模式的潜力; 3.预计将与BA目标交战;但4.其产生可比结果的能力尚待确定。该R34建议在老年中心提供志愿者BA的发展工作，以便通过标准化程序实现可持续的干预。我们随后进行了一项小型随机对照试验，测试志愿者BA与医务人员提供的BA对增加客户活动（目标）和减少抑郁症状（临床结局）的比较影响。在此有效性设计中，我们提出：1。增加活动作为BA干预有效性的“目标”; 2.通过手册和研究监督提供干预措施将实现增加活动的目标; 3.增加活动将预测改善的客户抑郁结果。具体目标是：1.通过细化和标准化志愿者选择、培训和监督程序来评估干预匹配程度;细化和标准化BA客户参与程序;并将程序与高级中心工作人员的偏好相匹配; 2.通过确定干预是否代表产生目标接合的足够“剂量”来进行病例系列以标准化干预;以及3.进行一项小型随机对照试验，以确定干预的可行性、可接受性、安全性和初步影响。客户参与者将是来自4个西雅图大都会区老年中心的54名老年（>60岁）非精神病、非痴呆且抑郁症状加重的个体，这些老年中心为经济和种族多样化的社区提供服务。对于病例系列，一个中心的3名志愿者将为2名抑郁症患者提供12次每周一次的治疗（总共n=6）。对于RCT，3名志愿者和1名MSW/中心将分别提供志愿者或标准BA。合格的客户将在老年中心内随机分配到志愿者BA（n=36）或MSW提供的BA（n=12）。我们的建议是对2012年国际移民组织报告的回应，该报告强调了老年人心理健康提供者的缺乏以及发展非传统提供者队伍的必要性。我们的研究结果将为明确研究志愿者BA对服务不足和难以参与的人群的有效性奠定基础，并将为老龄服务机构提供进一步的支持，以投资于高级志愿者培训和监督程序。

项目成果

"Do More, Feel Better": Pilot RCT of Lay-Delivered Behavioral Activation for Depressed Senior Center Clients.

• DOI: 10.1016/j.beth.2021.11.005
• 发表时间: 2022-05
• 期刊: BEHAVIOR THERAPY
• 影响因子: 3.7
• 作者: Raue, Patrick J;Hawrilenko, Matt;Corey, Mariah;Lin, John;Chen, Shiyu;Mosser, Brittany A
• 通讯作者: Mosser, Brittany A