Improving Adult Protective Services Client Outcomes: A Stepped-Care Social and Mental Health Engagement Program

Overview

The purpose of this study is to ascertain the feasibility and effectiveness of an 8-week social engagement program aimed at reducing depression and increasing social engagement among seniors who are transitioning out of Adult Protective Services (APS) for either elder abuse or self-neglect.

Interventions

• Behavioral Stepped-care social and mental health engagement
  Each student will be matched to an older adult and the students will make one call o the older adult which lasts upto 1 hour each week for 8 weeks. Ending each call, the student will assess symptoms of depression anxiety through questionnaires. If the participant responds yes on two consecutive calls to any of these questions, they will be asked if they would like to receive a call from the University of Texas Health Science Center Trauma and Resilience Center to discuss free counseling services
• Behavioral APS Usual care
  Participants will receive a phone call for data collection. Then they will be offered to receive an abbreviated version of the stepped-care social and mental health engagement intervention, lasting only 6-weeks with the option to continue calls if agreeable between the student and older adult.

Primary outcome measures

• Change in social isolation assessed by the Duke Social Support Index (DSSI-6) [Time frame: baseline, 4-week and 8-week follow-up]
• Change in loneliness as assessed by the University of California Los Angeles (UCLA )loneliness scale [Time frame: baseline, 4-week and 8-week follow-up]
• Change in depression as assessed by the PATIENT HEALTH QUESTIONNAIRE (PHQ-9) [Time frame: baseline, 4-week and 8-week follow-up]
• Recurrence of Elder mistreatment (EM) [Time frame: From participant's first call to 1 month post final call]
• Recurrence of self neglect (SN) [Time frame: From participant's first call to 1 month post final call]

Secondary outcome measures (4)

• Change in anxiety as assessed by the Generalized Anxiety Disorder scale (GAD-7) [Time frame: baseline, 4-week and 8-week follow-up]
• Change in resilience as assessed by the Brief Resilience Scale [Time frame: baseline, 4-week and 8-week follow-up]
• Change in Anxiety as Assessed by the Generalized Anxiety Disorder 2-Item Scale (GAD-2) [Time frame: baseline, 4-week and 8-week follow-up]
• Change in Depressive Symptoms as Assessed by the Patient Health Questionnaire-2 (PHQ-2) [Time frame: baseline, 4-week and 8-week follow-up]

Eligibility criteria

Inclusion criteria

Older Adults

• an APS validated EM/SN case
• able to provide informed consent
• able to speaks English or Spanish
• able to hear sufficiently using the telephone
• transitioning out of APS intervention (i.e. in the case closure phase of the APS service).

Student

• college or university student
• enrolled in a health-related program
• commit to making 8-weekly consecutive calls
• complete the required 1-hour training and assessment.

Exclusion criteria

Older Adults

• Individuals needing a proxy to consent
• suspected or confirmed decision-making capacity impairments or uncontrolled psychiatric illnesses such as schizophrenia, paranoia, delusion, or delirium

Student

-only engaging in the program to fulfill some educational requirement

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Supportive care

Study locations

United States · 1 center

• The University of Texas Health Science Center at Houston — Houston

Identifiers

NCT: NCT06257095 · HSC-MS-23-0344

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗