3/3 Lay-delivered Behavioral Activation in Senior Centers
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Principal Investigator: AMBER M GUM Organization: UNIVERSITY OF SOUTH FLORIDA Fiscal Year: 2024 Award: $565,489 Funding agency: National Institute of Mental Health ABSTRACT In response to large numbers of senior center clients who suffer untreated depression and the dearth of geriatric mental health providers, we have partnered with senior center stakeholders to simplify Behavioral Activation (BA) to match the skill set of lay volunteers (“Do More, Feel Better”; DMFB). The lay delivery model: 1. makes use of existing volunteer resources that can address the insufficient workforce; and 2. has potential for being an acceptable and sustainable delivery model. However, the capacity of this model to engage the same target (increased activity) and to yield comparable clinical outcomes as professionally-delivered interventions is yet to be determined in a fully-powered trial. This Collaborative R01 proposes fully powered randomized effectiveness trial testing the effect of DMFB in comparison to professionally-delivered BA (MSW BA) on increased activity level (target) and decreased depressive symptoms. The specific aims are to: 1. Test the effectiveness of DMFB, in comparison to MSW BA, for depressed (PHQ- 9>10 and Ham-D>14) older adults (>60) on increasing overall activity level (target) and reducing depression symptoms; and 2. test whether increased activity level predicts greater reduction in depression severity and whether increased activity’s impact on depression is non-inferior across conditions. Client participants will be a total of 288 older (>60 years) non-psychotic, non-demented individuals with elevated depressive symptoms from 6 Seattle, 6 New York City, and 6 Tampa area senior centers serving economically and ethnically diverse communities. Eligible clients will be randomized within senior center to either DMFB (n=144) or MSW BA (n=144). Two lay volunteers and 2 MSWs per center will provide the intervention. Our proposal responds to the 2012 IOM report which highlighted the dearth of mental health providers for older adults and the need to develop a workforce of nontraditional providers. DMFB is a streamlined BA intervention that has high potential for sustainability by making use of an untapped volunteer resource and supervision infrastructure within senior centers. Our findings will identify effective interventions for an underserved and difficult to engage population, our partners in aging services would be pleased to implement either delivery format of BA to activate depressed older adults. Terms: <Address><Aging><Amentia><Area><Behavioral><Characteristics><Client><Clinical><Clinical Trials><Communities><Dementia><Depressed mood><Depression screen><Diagnostic><Effectiveness><Eligibility><Eligibility Determination><Emotional Depression><Funding><Geography><Health><Health Care Providers><Health Personnel><Healthcare Providers><Healthcare worker><Individual><Infrastructure><Intervention><Intervention Strategies><Label><Light><Mental Depression><Mental Health><Mental Hygiene><Mental disorders><Mental health disorders><Modeling><NIMH><National Institute of Mental Health><New York City><Nutritional><Older Population><Outcome><Participant><Photoradiation><Population><Protocol Screening><Provider><Psychiatric Disease><Psychiatric Disorder><Psychological Health><Psychoses><Randomized><Recreation><Reporting><Research Resources><Resources><Rewards><Safety><Sample Size><Service setting><Services><Severities><Site><Supervision><Testing><Time><Vulnerable Populations><WHODAS><Work><World Health Organization Disability Assessment Schedule><clinical significance><clinically significant><community setting><cost><depressed><depression><depression screening><depression symptom><depressive><depressive symptoms><disability><effective intervention><effectiveness testing><effectiveness trial><ethnic diversity><ethnically diverse><experience><geriatric mental health><health care personnel><health care worker><health provider><health workforce><healthcare personnel><improved><interventional strategy><medical personnel><mental illness><non-demented><nondemented><nutritious><older adult><older adulthood><older groups><older individuals><older person><practice setting><psychiatric illness><psychological disorder><psychosocial><randomisation><randomization><randomized effectiveness trial><randomly assigned><recruit><response><sadness><satisfaction><skills><social><socio-demographic factors><socio-demographics><sociodemographic factors><sociodemographics><treatment provider><volunteer><vulnerable group><vulnerable individual><vulnerable people>