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NCT04621877NARecruiting

Lay-Delivered Behavioral Activation in Senior Centers

University of Washington

Start Date

1/27/2021

Completion Date

12/1/2025

Summary

In response to large numbers of senior center clients who suffer untreated depression and the dearth of geriatric mental health providers, the investigators have simplified Behavioral Activation to be delivered by lay volunteers ("Do More, Feel Better"; DMFB). The focus of Behavioral Activation is to guide clients to reengage in daily pleasant and rewarding activities, and reduce depressive symptoms. If the investigators can show that the lay delivery model has positive impact in comparison to MSW-delivered Behavioral Activation, the investigators will have identified an effective intervention that can be used by a large untapped workforce of older adult volunteers across the nation.

Detailed Description

This Collaborative R01 application (UW, Cornell, USF) proposes to conduct an effectiveness trial of lay-delivered Behavioral Activation ("Do More, Feel Better"; DMFB), in comparison to MSW-delivered Behavioral Activation (MSW BA), for depressed (PHQ-9\>10 and Ham-D\>14) older (60+) senior center clients. The primary aim tests the effectiveness of DMFB, in comparison to MSW BA, on increasing overall activity level (target) and reducing depression symptoms. The investigators will test whether increased activity level predicts greater reduction in depression severity and whether increased activity's impact on depression is non-inferior across conditions. Secondarily, the investigators will test hypotheses associated with overall functioning, satisfaction with treatment, and client-level moderators. Lastly the investigators will explore longer-term client outcomes, delivery cost, and preparing for sustainability by exploring client, provider, and center factors related to intervention fidelity.

Eligibility Criteria

Age Range: 60 years to No maximum

Client Participants (anticipated enrollment: 288) Inclusion Criteria: Referral to study (stage 1): 1. Age ≥ 60 years. 2. Attends one of 18 participating Seattle, NYC, or Tampa area senior centers. 3. Patient Health Questionnaire (PHQ-9) score of ≥10 via routine screening. Research assessment (stage 2): 1. Clinically-assessed HAM-D\>14 2. Mini-Mental Status Exam (MMSE) ≥ 24 OR modified Telephone Interview for Cognitive Status (mTICS) ≥ 19 3. Off antidepressants or on a stable dose for 12 weeks. 4. Capacity to provide written consent for both research assessment and the BA intervention. Client Participants Exclusion Criteria: 1. Current active suicidal ideation. 2. Presence of psychiatric diagnoses other than unipolar, non-psychotic major depression or generalized anxiety disorder by SCID-V (Structure Clinical Interview for DSM-V). 3. Severe or life-threatening medical illness (e.g., end stage organ failure). 4. Inability to speak English or Spanish Volunteer Participants (anticipated enrollment: 36) Inclusion Criteria 1. Age ≥ 60 years. 2. Attends one of the participating Seattle, NYC, or Tampa-area senior centers. Volunteer Participants Exclusion Criteria 1. Current major depressive disorder, alcohol or substance abuse, or manic, hypomanic, or psychotic symptoms (SCID-V); 2. Mini-Mental Status Exam (MMSE) ≥ 24 OR modified Telephone Interview for Cognitive Status (mTICS) ≥ 19; 3. Inability to speak and read English or Spanish Clinician Participants (anticipated enrollment: 36) Inclusion Criteria 1. Master's degree in social work, counseling, marriage/family, or other clinical mental health degree 2. English or Spanish Speaking 3. Capacity to provide consent for all study procedures 4. Willing to audio record study sessions for supervision and evaluation Clinician Participants Exclusion Criteria 1. Non-English or Non-Spanish speaking 2. Does not hold a Master's degree in social work, counseling, marriage/family, or other clinical mental health degree 3. Unable to provide consent 4. Unwilling to audio record study sessions for supervision and evaluation

Interventions

BEHAVIORAL

Volunteer-delivered Behavioral Activation

BEHAVIORAL

Master's level clinician-delivered Behavioral Activation

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Conditions

Depression

Locations

Brandon Senior Center

Brandon, Florida 33510

United States

Gardenville Dining & Activity Center

Gibsonton, Florida 33534

United States

Ruskin Senior Center

Ruskin, Florida 33570

United States

JL Young Apartments (Senior Housing)

Tampa, Florida 33604

United States

Oaks at Riverview Senior Center

Tampa, Florida 33604

United States

Jewish Towers Senior Housing

Tampa, Florida 33609

United States

Town 'n Country Senior Center

Tampa, Florida 33615

United States

Progress Village Senior Center

Tampa, Florida 33619

United States

Diana Jones Senior Center

Brooklyn, New York 11206

United States

Edie Windsor SAGE Center

New York, New York 10001

United States

Hudson Guild Senior Center

New York, New York 10011

United States

Lincoln Square Senior Center

New York, New York 10023

United States

Goddard Riverside Community Center and NORC

New York, New York 10024

United States

Carver Senior Center

New York, New York 10029

United States

Dyckman Senior Center

New York, New York 10034

United States

Stanley M. Isaacs Neighborhood Center

New York, New York 10128

United States

SAGE Center Brooklyn at Stonewall House

New York, New York 11201

United States

Enumclaw Senior Center

Enumclaw, Washington 98022

United States

Greenwood Senior Center

Seattle, Washington 98103

United States

West Seattle Senior Center

Seattle, Washington 98116

United States

Southeast Seattle Senior Center

Seattle, Washington 98118

United States

GenPride Senior Center

Seattle, Washington 98122

United States

Casa Latina

Seattle, Washington 98144

United States

Centro de la Raza

Seattle, Washington 98144

United States

Pt Defiance Senior Center

Tacoma, Washington 98407

United States