Tai Chi Intervention for Chinese Americans With Depression
Condition: Depression
MeSH terms: Depression; Depressive Disorder
Study type: Interventional

Summary: 
      The purpose of this study is to conduct a pilot randomized controlled trial (RCT) that
      provides the feasibility, safety, and preliminary efficacy data required to design a large
      scale trial evaluating Tai Chi for Chinese Americans with major depressive disorder (MDD) who
      are not on antidepressant medications.
    

Detailed description: 
      Aim #1: To evaluate the feasibility and safety of conducting a RCT of Tai Chi for Chinese
      American adults with MDD who are not on antidepressant medications. The investigators
      hypothesize that: a) the investigators can develop a Tai Chi intervention and
      depression-related measurement protocol for Chinese Americans with MDD; b) the investigators
      will be able to recruit non-pharmacologically treated Chinese Americans with MDD to
      participate in a randomized controlled Tai Chi study; c) participants will be compliant with
      the Tai Chi intervention and all testing protocols; d) the Tai Chi intervention will be safe
      and study staff will be able to effectively monitor participants' depressive symptoms and
      assure their safety during the study.

      Aim #2: To collect preliminary data on the efficacy of a 12-week Tai Chi group intervention
      for Chinese Americans with MDD who are not on antidepressant medications to determine the
      effect size needed for a definitive RCT. The investigators hypothesize that at the conclusion
      of 12-weeks, Tai Chi participants, as compared to control subjects, will demonstrate a)
      greater improvement in depressive symptoms (Hamilton Depression Severity Index-17, Beck
      Depression Inventory), b) greater improvement in functional status, general health, and well
      being (Clinical Global Impressions Scale, The SF-36 Health Survey (SF-36®) for social
      functioning, Exercise Self-Efficacy, Mindfulness), and c) greater social support
      (Multidimensional Scale of Perceived Social Support).

      Aim #3: To characterize participants' experience in a trial of Tai Chi for Chinese Americans
      with MDD in order to optimally design a subsequent, more definitive study. Using mixed
      methods (qualitative and quantitative analyses), the investigators will identify the
      ethnocultural experience of Tai Chi among Chinese Americans with MDD, assess whether they
      view Tai Chi a more culturally acceptable alternative to conventional antidepressant therapy,
      explore the facilitators and barriers to adherence to the Tai Chi training protocol, identify
      characteristics of responders and non-responders to the Tai Chi intervention, and assess
      participants' willingness/intention to continue practice of Tai Chi beyond the study period.
      The investigators hypothesize that a) characteristics such as severity of illness, age,
      co-morbidities, and education level may distinguish responders from non-responders; b)
      participants with greater levels of class attendance and home practice will exhibit greater
      improvements in depressive symptoms; and c) participants who continue to practice Tai Chi
      after the 12-week training will maintain clinical improvements in depressive symptoms and a
      lower rate of relapse at the end of 3 additional months of follow-up compared to those who do
      not continue Tai Chi practice.
    

Intervention name(s): 12-week Tai Chi intervention; Education control group
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Tai Chi classes will be conducted weekly for one hour each for 12 weeks. Classes will begin with warm-up exercises designed to loosen the body, increase awareness of alignment and structural integration, improve efficiency of breathing, incorporate mindfulness and imagery into movement.; The education control group will meet twice weekly for 12 weeks for one hour, and research staff will present didactic information modified from psychoeducation curriculums created by the Benson Henry Institute and a stress reduction study for depressed minority patients.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Depression; Tai Chi; Alternative medicine; Mind body medicine