Cognitive Behavioral Faith-based Depression Intervention For African American Adults (CB-FAITH): An Effectiveness And Implementation Trial

项目摘要

PROJECT ABSTRACT Recent research shows the prevalence of depression symptoms in the US was more than 3-fold higher during COVID-19 compared with before the COVID-19 pandemic. Prevalence of depression among Blacks pre- COVID was 8.4% and during-COVID pandemic 24.2%. Although the prevalence of depression is comparable among Blacks and Whites, the difference is dramatically reversed for severe depression. African Americans/Blacks have higher symptom levels for chronicity and disability, 56.5% vs. 38.6% for Whites. These disparities are even more stark for African Americans in the Madison, Wisconsin the proposed research site. Blacks in Wisconsin are 50% more likely than Whites to report having frequent mental distress. Despite the burden of living with depression, African Americans do not seek mental health services at comparable rates to other demographic groups. National mental health service use data show Whites use at 23.0% and African Americans at 13.6% in the past 12 months. Culturally adapted treatments designed for African American adults have the potential to address and potentially stop these health disparities; research shows culturally adapted treatments to be four times more effective than standardized care. Despite growing literature indicating African Americans are more likely to use religious coping when experiencing mental illness, empirically validated culturally adapted faith-based depression interventions do not exist for this group. To address this gap, the PI forged transformative partnerships with the African American Council of Churches to develop a faith-based intervention: Cognitive Behavioral Faith Fellowship to Improve Thy Health (CB-FAITH). CB FAITH is spiritually- based whereby spiritual/religious themes, stories, and scripture are integrated in the core cognitive behavioral content. The 13-treatment modules focus on increasing knowledge of depression and healthy coping behaviors. It is designed to be co-delivered by African American licensed mental health clinicians and African American pastors at churches. We propose conducting a hybrid type 1 effectiveness-implementation trial employing a stepped wedge cluster randomized design with church groups as the unit of randomization, providing simultaneous testing of the intervention and assessment of barriers and facilitators to implementation of the intervention. The sample will be comprised of 10 groups, each with 12 individuals (N=120) who identify as African American men and women (age 25 and older) with clinical depression. Clinical outcomes will be measured at baseline, weeks 6 and 12 during the intervention, and post-intervention at 3 and 6 months. For the implementation arm of the study, we will use the RE-AIM conceptual framework to examine implementation. Use of surveys and semi-structured interviews focusing on RE-AIM concepts at individual and organizational level will be conducted during and at the end of the intervention implementation. Results of this trial has the potential to advance the AHRQ’s goal of achieving equity in the delivery of healthcare services. .