Intervention to Reduce Depression Among Elder Abuse Victims: Type 1 Hybrid Trial of Tele-PROTECT

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PROJECT ABSTRACT The World Health Organization estimates that 1 in 6 adults over the age of 60 has been a victim of abuse in the past year. Our research demonstrated that nearly one-third of these victims have clinically significant depressive symptoms and 16% have suicidal ideation (Sirey et al., 2015). Tele-PROTECT, is the only manualized, virtual therapy for elder abuse victims experiencing depression. It is offered to victims at the same time that they are receiving services from elder abuse agencies that offer safety planning, support services, and legal services. Tele- PROTECT was designed using a deployment-focused approach with our partners at the New York City Department for the Aging (DFTA). Tele-PROTECT strategies focus on increasing pleasurable and rewarding activities to reduce depression, and goal setting and defining the action steps to increase safety related empowerment. In our randomized controlled pilot project, participants receiving PROTECT had significant decreases in symptoms of depression as compared to those in the referral control condition (Sirey et al., 2021). Our preliminary work during the pandemic, demonstrated the feasibility and effectiveness of virtual delivery of PROTECT via video (called Tele-PROTECT) to a large sample of diverse victims. This project will test the effectiveness of Tele-PROTECT as compared to a video-delivered attention control condition (DepEd). We will recruit 140 English- and Spanish-speaking elder abuse victims from five New York City (NYC) elder abuse agencies. We hypothesize that Tele- PROTECT participants will experience greater decreases in depressive symptoms and greater increase in safety-related empowerment compared to an attention control (DepEd). Elder abuse agency staff will refer depressed victims who agree to research staff. Eligible elder abuse victims who consent, have a baseline assessment and meet inclusion criteria will be randomized to Tele-PROTECT or DepEd. Follow up assessments will be conducted at weeks 3, 6, 9, and 12 after baseline. Trained Research Assistants blinded to study hypotheses will assess depression severity (MADRS) and safety-related empowerment (MOVERS), as well as participation in activities, social isolation, and criminal justice outcomes. In collaboration with a national organization of elder abuse agencies (NAPSA), we will use a mixed methods design with multiple stakeholder groups to collect data on the barriers and facilitators to the implementation of Tele-PROTECT nationally. Tele-PROTECT has demonstrated feasibility, acceptability, and preliminary effectiveness. This project will test a scalable manualized therapy with the potential for national implementation to serve depressed victims of elder abuse.