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

项目摘要 世界卫生组织估计，60岁以上的成年人中有六分之一是老年人。 在过去的一年里，虐待的受害者。我们的研究表明，近三分之一的 受害者有临床显著的抑郁症状，16%有自杀意念（Sirey et 例如，2015）。远程治疗是唯一一种针对老年虐待受害者的手动虚拟治疗 经历抑郁症在向受害者提供服务的同时， 来自提供安全规划、支持服务和法律的服务的虐待老人机构。远距离 在新的 约克市老龄部门（DFTA）。电信运营商战略的重点是增加 愉快和有益的活动，以减少抑郁症，目标设定和定义 行动步骤，以增加与安全有关的授权。在我们的随机对照试验项目中， 接受抗抑郁治疗的参与者的抑郁症状显著减少， 与转诊对照条件下的那些相比（Sirey等人，2021年）。我们的前期工作 在疫情期间，展示了虚拟交付的可行性和有效性， 通过视频（称为Tele-TMPT）向大量不同的受害者提供援助。 该项目将测试与视频传送相比，远程培训的有效性。 注意力控制条件（DepEd）我们将招募140名讲英语和西班牙语的长者 来自五个纽约市（NYC）虐待老人机构的虐待受害者。我们假设远程- CET参与者将经历更大的抑郁症状减少， 与注意力控制（DepEd）相比，安全相关授权增加。 虐待老人机构的工作人员将把同意研究人员的抑郁受害者介绍给研究人员。资格 虐待长者受害人如同意、有基线评估并符合纳入标准， 随机分配至Tele-Patient或DepEd。跟进评估将于 基线后第3、6、9和12周。经过培训的研究助理对研究假设设盲 将评估抑郁严重程度（MADRS）和安全相关赋权（MOVERS），以及 参与活动、社会孤立和刑事司法结果。协同 一个全国性的虐待老年人机构组织（NAPSA），我们将使用混合方法设计 与多个利益攸关方团体合作，收集关于 在全国范围内实施远程教育。Tele-PART已经证明了可行性， 可接受性和初步有效性。该项目将测试一个可扩展的手动治疗 有可能在全国范围内实施，为虐待老年人的抑郁受害者提供服务。

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.