Partnership to Develop and Pilot-Test a Peer Program to Reduce Depressive Symptoms in Men with Physical Disabilities



 DESCRIPTION (provided by applicant): Previously we developed, tested and disseminated a highly effective peer counseling program to reduce depressive symptoms in women with physical disabilities in partnership with Oregon Centers for Independent Living (CILs). Our academic-disability community partnership created Healing Pathways using community- based participatory research methods and we have sustained our partnership over 9 years. Healing Pathways is currently publicly funded and offered by four of the seven CILs in Oregon. The success of Healing Pathways is a direct result of community investment in and ownership of the program. We propose replicating this model to address depression in men with physical disabilities (MPDs). Depression is a common secondary condition in MPDs, occurring at rates between 37-64%. This is 2-3 times the rate of depression found in non-disabled men. MPDs with depression are at greater risk for decreased physical functioning, unemployment, social isolation, decreased life satisfaction, institutionalization, and death compared to men in the general population. To build on the success of Healing Pathways and to begin to address the serious problem of depressive symptoms in MPDs our academic disability community partnership proposes a community-engaged, exploratory sequential, mixed methods study to achieve the following three specific aims 1) Adapt the Healing Pathways program to meet the needs of MPDs with depressive symptoms; 2) Conduct a pilot study to assess the feasibility and acceptability of the peer program; and 3) Estimate the effect size of the peer program for depressive symptoms. The long-term goal of this program of research is to improve mental health outcomes in people with physical disabilities by partnering with members of this community. The outcomes of the proposed study will collectively inform the development of a future randomized controlled trial of the peer program designed to treat depressive symptoms in MPDs. The proposed study addresses several public health goals including Healthy People 2020 goal DH18 to reduce the proportion of people with disabilities who report serious emotional distress, and the President's New Freedom Commission on Mental Health goals 1-3, to understand that mental health is essential to overall health, promote mental health treatments that are consumer-driven, and eliminate disparities in mental health care.