Peer to Peer Delivery of Behavioral Activation

Study Overview
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Brief Summary
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The goal of this study is to test the feasibility, acceptability and preliminary impact of peer-delivered Behavioral Activation (BA) for depressed older adults (60+) who are Naturally Occurring Retirement Communities (NORC) residents or senior center participants.

Detailed Description
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This project focuses on helping to solve a growing problem in health care today. Through increased screening in the older adult population, detection of depression has increased which has established a growing need for mental health resources. Unfortunately, there are limited resources to keep up with the steady increase of individuals in need. Training peers to work with older depressed adults in techniques such as behavioral activation provides an alternative model to help moderate the increased need and provide a unique intervention of care. Developing an innovative peer facilitated program has the potential to enhance the delivery of quality health care. The specific aims of the study are 1) to train peer coaches and implement Peer to Peer in the community 2) to examine depression ratings over time.

Official Title
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Peer to Peer Delivery of Behavioral Activation

Conditions
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Depression

Intervention / Treatment
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* Behavioral: Peer to Peer
* Other: Standard Mental Health Referral


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 60 and older Member of Lenox Hill Senior Center, St. Peter's Senior Center, or Beth Abe Score of 10+ on Patient Health Questionnaire (PHQ-9) Exclusion Criteria: Presence of alcohol abuse, substance abuse, psychotic disorder, or bipolar disorder as observed on the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID) Inability to speak English Dementia: Mini Mental State Examination (MMSE) score below 24 High suicide risk, i.e. intent or plan to attempt suicide

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Peer to Peer<br>These individuals will receive a standard mental health referral to a community agency and in addition meet with a trained peer coach for 12 weekly meetings. | Behavioral: Peer to Peer<br>* 12 weekly sessions of peer-delivered behavioral activation<br>|
| Active Comparator: Referral<br>These individuals will receive a standard mental health referral to a community agency. | Other: Standard Mental Health Referral<br>* Standard mental health referral to a community agency<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of Peer to Peer Coaches Who Undergo Behavioral Activation Training and Achieve Certification | Proportion of Peer to Peer coaches who undergo Behavioral Activation training and achieve certification | 4 weeks prior to Baseline | 
| Number of Peer to Peer Clients Who Attend > 80% of Behavioral Activation Sessions | Number of Peer to Peer clients who attend > 80% of Behavioral Activation sessions | 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in Hamilton Depression Rating Scale Scores | Hamilton Depression Rating Scale mean change scores from baseline to 12 weeks. This scale measures severity of depressive symptoms (range=0-76), with higher scores indicating more sever depressive symptomatology. | Baseline and 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Depression