Social Worker-led Mindfulness-based Intervention for Older People

Официальное название

Social Worker-led Mindfulness-based Intervention for Managing Depressive Symptoms in Community-dwelling Older Adults in Hong Kong: A Randomised Controlled Trial

Обзор

Preliminary findings from a previous study conducted by the investigators suggest that a task-shared approach with modified mindfulness-based cognitive therapy (MBCT) supported by social workers is beneficial in managing depressive symptoms and improving mindful non-reactivity among older adults. However, the possibility for social workers to lead a mindfulness-based intervention (MBI) independently to improve its scalability and service accessibility remains unclear. The project aims to: 1. Evaluate the effectiveness of social worker-led MBI in improving depression in older adults with mild to moderate depressive symptoms as compared to care as usual; 2. Examine the effectiveness of incorporating peer supporters in social worker-led MBI compared to those without peer supporters; 3. To identify potential mechanisms of change in MBI for depressive symptoms.

Подробное описание

Mindfulness-based cognitive therapy (MBCT) is a promising approach to managing a series of health and psychological conditions among older adults. To increase its acceptability, feasibility, and scalability, MBCT has been adapted and delivered in a variety of formats. Apart from delivering the intervention in person by a certified mindfulness teacher, MBCT has been adapted to be self-taught, delivered online, or partially led by social workers.

In a previous study conducted by the investigators, it was found that a task-shared approach with modified MBCT supported by social workers is effective in producing change in older adults' mental health and mindfulness. However, whether social workers are competent to lead a mindfulness-based intervention (MBI) informed by MBCT on their own and produce effective changes in outcome measures pertaining to mental health remains unclear.

Furthermore, the effects of incorporating peer supporters into mental health interventions are unclear. The uses and implementation of peer support across mental health contexts vary greatly and the effects are mixed. In a pilot study on men with advanced prostate cancer, it has been suggested that the presence of peer support in modified mindfulness-based cognitive therapy group intervention may reinforce intervention effects. Furthermore, in an online intervention for older adults with elevated depressive symptoms, peer support has been found to improve engagement and adherence to the intervention. However, in a systematic review and meta-analysis, it has been found that while incorporating one-to-one peer support in mental health services has a modest positive impact on self-reported psychosocial outcomes such as self-rated recovery and empowerment, there is no evidence for improvement in clinical outcomes.

With the growing older people population and a need for greater social welfare capacity to promote older adults' well-being, the current study aims to examine the effectiveness of social worker-led MBI informed by MBCT in improving depression in older adults with mild to moderate depressive symptoms. In addition, the effectiveness of incorporating peer supporters into the intervention will be examined.

Вмешательства

• Поведенческое Mindfulness-based intervention (MBI) (enhanced with peer supporters)
  Mindfulness-based intervention combines mindfulness meditation with cognitive behavioural therapy (CBT) elements to reduce or prevent recurrent major depressive disorders. On-site support and regular follow-up by peer supporters.
• Поведенческое Experimental: social worker-led MBI (without peer supporters)
  Mindfulness-based intervention combines mindfulness meditation with cognitive behavioural therapy (CBT) elements to reduce or prevent recurrent major depressive disorders.

Первичные конечные точки

• Change from baseline depression at Week 6 and Week 18 [Срок оценки: Baseline and Week 6, Week 18]
• Change from baseline anxiety at Week 6 and Week 18 [Срок оценки: Baseline and Week 6, Week 18]

Критерии участия

Критерии включения

• 60 years or older
• have depressive symptoms of mild level or above, as indicated by scoring 5-14 on PHQ-9
• can give informed consent to participate

Критерии исключения

• known history of autism, intellectual disability, schizophrenia-spectrum disorder, bipolar disorder, Parkinson's disease, or dementia
• current abuse of drugs or alcohol
• difficulty in communication
• imminent suicidal risk
• timing or training is unsuitable for the participant

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Лечение

Центры проведения

Гонконг · 13 центров

• Hong Kong Society for the Aged — Eastern District
• HKSKH Lok Man Alice Kwok Integrated Service Centre — Kowloon City
• SKH Holy Carpenter Church — Kowloon City
• The Mental Health Association of Hong Kong — Kwun Tong
• Haven of Hope District Elderly Community Service — Sai Kung
• Wellness Zone - Integrated Community Centre for Mental Wellness — Sai Kung
• HKSKH Western District Elderly Community Centre — Sai Wan
• TWGHs Lok Hong Integrated Community Centre for Mental Wellness — Sai Wan
• … и ещё 5 центров

Публикации

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• Lei X, Zhong M, Liu Y, Xi C, Ling Y, Zhu X, Yao S, Yi J. Psychometric properties of the 10-item ruminative response scale in Chinese university students. BMC Psychiatry. 2017 Apr 28;17(1):152. doi: 10.1186/s12888-017-1318-y. PMID 28454569
• Meng R, Yu Y, Chai S, Luo X, Gong B, Liu B, Hu Y, Luo Y, Yu C. Examining psychometric properties and measurement invariance of a Chinese version of the Self-Compassion Scale - Short Form (SCS-SF) in nursing students and medical workers. Psychol Res Behav Manag. 2019 Aug 30;12:793-809. doi: 10.2147/PRBM.S216411. eCollection 2019. PMID 31565007
• Montero-Marin J, Taylor L, Crane C, Greenberg MT, Ford TJ, Williams JMG, Garcia-Campayo J, Sonley A, Lord L, Dalgleish T, Blakemore SJ; MYRIAD team; Kuyken W. Teachers "Finding Peace in a Frantic World": An Experimental Study of Self-Taught and Instructor-Led Mindfulness Program Formats on Acceptability, Effectiveness, and Mechanisms. J Educ Psychol. 2021 Nov;113(8):1689-1708. doi: 10.1037/edu0000 PMID 34912129
• Ni MY, Li TK, Yu NX, Pang H, Chan BH, Leung GM, Stewart SM. Normative data and psychometric properties of the Connor-Davidson Resilience Scale (CD-RISC) and the abbreviated version (CD-RISC2) among the general population in Hong Kong. Qual Life Res. 2016 Jan;25(1):111-6. doi: 10.1007/s11136-015-1072-x. Epub 2015 Jul 22. PMID 26198665
• Smit D, Miguel C, Vrijsen JN, Groeneweg B, Spijker J, Cuijpers P. The effectiveness of peer support for individuals with mental illness: systematic review and meta-analysis. Psychol Med. 2023 Aug;53(11):5332-5341. doi: 10.1017/S0033291722002422. Epub 2022 Sep 6. PMID 36066104

Идентификаторы

NCT: NCT06528132 · EA220105A

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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