Please select the eligibility criteria that correspond to the clinical trial below.
Title: Treating Depression in African American Elders: A Community-Academic Partnership
Brief Summary: The specific primary aims of the study are to:

1. Test the immediate effect of the intervention at 4-months on depression in urban African American older adults (primary trial outcome; between group comparison). Hypothesis: Participants in the intervention group will report fewer depressive symptoms in comparison to control group participants receiving usual care.
2. Test the maintenance effect of the intervention at 8-months on depression (within group comparison). Hypothesis: Participants in the intervention group will maintain reduced symptom presentation from 4 to 8 months.
3. Evaluate acceptability (social validity) of the intervention and extent of engagement in activities by study participants (both intervention and wait-list control subjects).

A secondary aim of this study is to assess the feasibility of conducting a clinical trial embedded in a community service setting and its dissemination using a community-academic partnership. We also propose three exploratory aims. First, we seek to evaluate the mechanisms of action, or pathways, by which treatment gains are obtained (Gitlin et al., 2000). Given that behavioral activation represents conceptually the key active ingredient of the proposed intervention, we plan to evaluate its mediational effect. Second, we seek to evaluate whether the intervention has a differential treatment effect based on a study participant's gender, age, and living arrangement (alone or with others). Given that previous research suggests that participant characteristics may moderate depressive symptoms and treatment outcomes, these exploratory analyses will provide insight as to whether this particular treatment benefits some groups more than others. Third, we seek to evaluate whether the intervention has short and long-term effects on quality of life, functional difficulty, and self-efficacy to manage day-to-day tasks. Previous research has shown that depressive symptoms exacerbate functional decline such that minimizing distress may have the added value of enhancing function and perceived efficacy for this group over time.


Options:
A: Inclusion Criteria:

* Diagnosis of diabetes and/or heart disease
* Poor disease control (defined as an HbA1c level of at least 8.5%, blood pressure greater than 140/90 mm Hg, LDL cholesterol greater than 130 mg/dL)
* Diagnosis of major depressive disorder

Exclusion Criteria:

* History of psychosis
* At high risk for suicide
* Cognitive impairment
* Current alcohol or substance abuse disorder
* Does not own a telephone
* Currently seeking psychiatric care
* Pregnant or breastfeeding
* Currently enrolled in a Group Health Cooperative disease management program
* Terminal illness
* Plans to leave Group Health Cooperative in less than a year
* Does not speak English
B: Inclusion Criteria:

* Patients currently receiving primary care at Portland VAMC
* Diagnosed musculoskeletal chronic pain condition lasting at least 3 months
* Currently experiencing moderate to severe symptoms as per screening
* Willingness to complete 6 and 12 month interviews
* Regular access to a telephone

Exclusion Criteria:

* Dementia or cognitive disturbance
* Diagnoses of fibromyalgia, chronic fatigue or somatization disorder Terminal illness
* Designated guardian
* Drug-seeking behavior flag in medical record
C: Inclusion Criteria:

* African American
* ≥55 years of age
* English speaking
* Cognitively intact (MMSE \>24)
* Depressed as measured by a score ≥5 on the PHQ-9
* Must have a telephone
* Planning to live in the area for 8 months

Exclusion Criteria:

* Not African American
* \<55 years of age
* Does not speak English
* MMSE\<24
* Not depressed as measures by a score of \<5 on the PHQ-9
* Does not have a telephone
* Does not plan to live in the area for 8 months
D: Inclusion Criteria:

* Age above 18;
* Suffering from a Common Mental Disorder (as defined by an a priori cut-off score on the 12 item General Health Questionnaire)
* Resident in the state (Goa) for the subsequent 12 months
* Not requiring urgent medical/surgical attention (e.g hospital admission)

Exclusion Criteria:

* Suffering from a cognitive or sensory impairment which makes participation in the evaluation difficult
* Not speaking Konkani, Marathi, Hindi or English

Answer: C