Leveraging Adult Protective Service Interaction to Offer Evidence-Based Treatment for Depression in Elder Neglect/Self Neglect

Обзор

The purpose of this study is to test the feasibility and acceptability of an evidence-based treatment for depression delivered over an ipad, computer, or smartphone can help Adult Protective Services (APS) clients with their activities of daily living to evaluate whether reductions on measures of depression and apathy (a) mediate reduced Elder Neglect/Self Neglect (EN/SN) behaviors; and (b) whether secondary posited mediating mechanisms are also active in impacting depression and apathy

Вмешательства

• Поведенческое APS Treatment as Usual
  APS agencies conduct in-home investigations of alleged abuse and neglect against disabled and older adults. Investigations result in short-term stop-gap measures, primarily brief case-management centering on referral linkage to community-based services and provision of resource allocation. No direct psychological services or treatments are provided by APS, however referral to other services is also standard.
• Поведенческое Intervention-Behavioral Activation (BA)
  Participants will be will be guided through 8 one-hour sessions via home telehealth by the study community health worker. Each weekly \< 60 minute BA session will include modules focusing on 1) Psychoeducation for depression and techniques for self-management, including pharmacologic and psychosocial treatment options; 2) Introduction of BA and guided problem-solving techniques to enhance self efficacy for managing depression and other chronic illnesses; 3) BA and problem-solving techniques to s

Первичные конечные точки

• Change in depression as assessed by the Patient Depression Questionnaire (PHQ-9) [Срок оценки: baseline, post-treatment ( 8 weeks after baseline), and 3 months]
• Change in apathy as assessed by the Apathy Motivations Index (AMI) [Срок оценки: baseline, post-treatment ( 8 weeks after baseline), and 3 months]
• Change in Elder Neglect/Self Neglect (EN/SN) as evidenced by study developed goal attainment scale [Срок оценки: baseline, post-treatment ( 8 weeks after baseline), and 3 months]

Вторичные конечные точки (2)

• Change in social connection as assessed by the Lubben Social Network Scale [Срок оценки: baseline, post-treatment ( 8 weeks after baseline), and 3 months]
• Change in social isolation as assessed by Patient-Reported Outcomes Measurement Information System (PROMIS 8) [Срок оценки: baseline, post-treatment ( 8 weeks after baseline), and 3 months]

Критерии участия

Критерии включения

• APS Case in APS Region VI- Must have open case
• PHQ 9 score- Must have score of nine (9) or more

Критерии исключения

• Previous mental health diagnosis of bipolar disorder, psychotic disorders, and moderate to severe dementia
• Assessment of Consent Proxy- Those who need assessment of consent proxy
• Suicidal Intent (as indexed by PhQ-9 question 9)- Those scoring 2 or 3
• Current Alcohol and Drug Dependency- As evidenced by Cut down, Annoyed, Guilty, and Eye-opener (CAGE) score of 3 or more

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

США · 1 центр

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

Идентификаторы

NCT: NCT06910267 · HSC-MS-24-1021 · 1P30AG086563-01

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

Открыть это исследование на ClinicalTrials.gov ↗