A Systems-Level Intervention for Rural Adults With Depression

Study Overview
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Brief Summary
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This study aims to test the effectiveness of a computer-assisted cognitive behavioral therapy for depression among rural adults. The intervention, called Raising Our Spirits Together (ROST), was developed via a community-based participatory approach and will be delivered in small groups, facilitated by local pastors. Groups will be held virtually, or in-person at two churches in rural Michigan. Eighty-four individuals will be recruited from Hillsdale, Michigan, to test the effect of ROST on depressive symptoms, compared to an Enhanced Control Condition (ECC).

Official Title
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A Systems-Level Intervention for Rural Adults With Depression

Conditions
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Depressive Symptoms

Intervention / Treatment
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* Behavioral: Raising Our Spirits Together
* Other: Enhanced Control Condition


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Must live in Hillsdale, Lenawee, Jackson, or Calhoun County, Michigan Positive screen for at least mild depressive symptoms based on the the Patient Health Questionnaire-9 (PHQ-9>=5) Exclusion Criteria: Non-English speaking Currently receiving cognitive behavioral therapy (CBT) for depression Ever completed a course of cognitive behavioral therapy (CBT; >=8 sessions) Diagnosis of a psychotic disorder Current use of opiates or freebase cocaine Prominent suicidal/homicidal ideation with imminent risk.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

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: Raising Our Spirits Together Intervention<br> | Behavioral: Raising Our Spirits Together<br>* Raising Our Spirits Together (ROST) is an 8-session computer-assisted cognitive behavioral therapy for depression. Core CBT content, including behavioral activation, cognitive restructuring, and problem solving, are delivered via the computer-assisted platform using video and text-based elements. The computer-assisted intervention is complemented by a workbook that includes in-session exercises as well as homework/action plans. ROST is delivered weekly, either virtually or in-person at a local church, and facilitated by a local pastor.<br>|
| Other: Enhanced Control Condition<br> | Other: Enhanced Control Condition<br>* The Enhanced Control Condition intervention consists of providing participants randomized to this condition with a self-help book for depression (The Depression Helpbook; Katon et al, 2008) that is widely used and found to be beneficial, a local resource guide, and referrals.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in self-report measure of depressive symptoms | Participants will self report depressive symptoms utilizing the Patient Health Questionnaire-9 (PHQ-9; range 0-27 with higher scores indicating worse outcome) | Outcome will be assessed at baseline, immediately post-treatment, and 12-weeks post-treatment |