Clinical trial NCT04863300: Collaborative Stepped-Care and Productive Ageing Program for Older People With Depressive Symptoms
Official title: Evaluation Study of a Collaborative Stepped-Care and Productive Ageing Model for Elderly Mental Wellness in Hong Kong
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Depressive Symptoms
Keywords: Collaborative stepped care
Peer support
Productive ageing
Early case identification
Indicated prevention
Early treatment
Recovery oriented
Lead sponsor: The University of Hong Kong
Sponsor class: OTHER
Collaborators: name: Aberdeen Kai-fong Welfare Association
name: Caritas Medical Centre, Hong Kong
name: Christian Family Service Centre
name: Haven of Hope Hospital
name: Hong Kong Christian Service
name: Hong Kong Sheng Kung Hui Lady MacLehose Centre
name: Hong Kong Sheng Kung Hui Welfare Council Limited
name: Hong Kong Young Women's Christian Association
name: New Life Psychiatric Rehabilitation Association
name: St. James' Settlement
name: The Hong Kong Society for the Aged
name: The Mental Health Association of Hong Kong
name: Neighbourhood Advice-Action Council
name: Tung Wah Group of Hospitals
First posted: 2021-04-28
Enrollment: 5239
Sex: ALL
Minimum age (years): 60
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: The intervention group will receive a collaborative stepped care programme provided by registered social workers and trained peer supporters from two types of NGOs (aged care or mental health service units) according to level of risks, symptom severity, and intervention response of the clients. Home visits or other format of contact will be delivered by trained peer supporters employed by NGOs to detect and engage hidden cases.
Primary purpose: PREVENTION

Brief summary: The Jockey Club Holistic Support Project for Elderly Mental Wellness (JC JoyAge) has developed and implemented a collaborative stepped care model for older persons at-risk of or with depression in four districts in Hong Kong since 2015 (Clinical Trials Identifier: NCT03593889). Results from JC JoyAge show that the collaborative stepped-care model is effective in improving older persons' mental wellness, and the specialised training and engagement of Peer Supporters are effective in building capacity in the community. The proposed impact extension programme lasts for four years (from 2020 to 2023), and the overall goal is to expand the JC JoyAge model to all 18 districts in Hong Kong, to provide integrated and evidence-based mental health services to older adults with subclinical depressive symptoms, with the hope of model adoption in regular service upon project completion.

Detailed description: This four-year extension project includes three main elements: 1) Trainings, including different programmes for social services staff, Mental Wellness Ambassadors, and Peer Supporters; 2) Implementation of JoyAge service model: standardized collaborative stepped-care and Peer Support programmes for prevention and early intervention of depression in older adults; and 3) Public awareness campaign: coordinated programmes to increase mental health literacy and raise public awareness.

Specific goals of the programmes through the above three elements include:

1. To implement JC JoyAge clinical protocol and guidelines to coordinate care among community mental health and aged care services centres for elderly mental wellness in 18 districts;
2. To engage vulnerable and at-risk older adults in the community through productive ageing activities and mental wellbeing self-management training;
3. To enhance the capacity of social service staff in handling elderly depression through specialized and infusion training and knowledge exchange;
4. To raise public awareness and elderly mental health literacy among family members, neighbours, community stakeholders, and the general public to encourage early detection/help-seeking on depressive risk of older adults; and
5. To establish evidence of the effectiveness and cost-effectiveness of JC JoyAge Phase II model.

Eligibility criteria: Inclusion Criteria:

* age 60 years or above; and
* have depressive symptoms of mild level or above; and
* able to give informed consent to participate

Exclusion Criteria:

* known history of autism, intellectual disability, schizophrenia-spectrum disorder, bipolar disorder, Parkinson's disease, or dementia; and
* (temporary exclusion criteria) imminent suicidal risk; and
* difficulty in communication

Primary outcomes:
measure: Change from Baseline Depression at 12 months
timeFrame: Baseline and 12-month follow-up
measure: Change from Baseline Anxiety at 12 months
timeFrame: Baseline and 12-month follow-up
measure: Change from Baseline Loneliness at 12 months
timeFrame: Baseline and 12-month follow-up
measure: Change from Baseline Self-harm Risk at 12 months
timeFrame: Baseline and 12-month follow-up
measure: Change from Baseline Service Usage at 12 months
timeFrame: Baseline and 12-month follow-up
Secondary outcomes:
measure: Change from Baseline Daily Activities at 12 months
timeFrame: Baseline and 12-month follow-up
measure: Change from Baseline Cognition at 12 months
timeFrame: Baseline and 12-month follow-up
measure: Change from Baseline Social Network at 12 months
timeFrame: Baseline and 12-month follow-up
measure: Change from Baseline Health-related Quality of Life at 12 months
timeFrame: Baseline and 12-month follow-up
measure: Change from Baseline Self-rated Health at 12 months
timeFrame: Baseline and 12-month follow-up
Other outcomes:
Locations:
city: Hong Kong
country: Hong Kong
facility: Aberdeen Kaifong Welfare Association Services Centre
city: Hong Kong
country: Hong Kong
facility: Baptist Oi Kwan Social Service Integrated Community Centre for Mental Wellness (Kwai Tsing)
city: Hong Kong
country: Hong Kong
facility: Baptist Oi Kwan Social Service
city: Hong Kong
country: Hong Kong
facility: Caritas Cheng Shing Fung District Elderly Centre (Sham Shui Po)
city: Hong Kong
country: Hong Kong
facility: Caritas District Elderly Centre - Yuen Long(Tin Chak Centre)
city: Hong Kong
country: Hong Kong
facility: Caritas Wellness Link - North District
city: Hong Kong
country: Hong Kong
facility: Caritas Wellness Link Tsuen Wan
city: Hong Kong
country: Hong Kong
facility: Chan Tseng Hsi Kwai Chung District Elderly Community Centre
city: Hong Kong
country: Hong Kong
facility: Christian Family Service Centre (Kwun Tong)
city: Hong Kong
country: Hong Kong
facility: Christian Family Service Centre Wellness Zone - Integrated Community Centre for Mental Wellness
city: Hong Kong
country: Hong Kong
facility: Chuk Yuen Canon Martin District Elderly Community Centre_Wai Yuen House
city: Hong Kong
country: Hong Kong
facility: Ellen Li District Elderly Community Centre - Yung Shing Shopping Centre
city: Hong Kong
country: Hong Kong
facility: Fong Shu Chuen District Elderly Community Centre
city: Hong Kong
country: Hong Kong
facility: H.K.S.K.H. Lady MacLehose Centre Dr. Lam Chik Suen District Elderly Community Centre
city: Hong Kong
country: Hong Kong
facility: H.K.S.K.H. Lok Man Alice Kwok Integrated Service Centre
city: Hong Kong
country: Hong Kong
facility: H.K.S.K.H. Western District Elderly Community Centre - Integrated Home Care Services Team
city: Hong Kong
country: Hong Kong
facility: Haven of Hope Christian Service
city: Hong Kong
country: Hong Kong
facility: Hong Kong Christian Service Bliss District Elderly Community Centre
city: Hong Kong
country: Hong Kong
facility: Jockey Club Wong Chi Keung District Elderly Community Centre - Aberdeen
city: Hong Kong
country: Hong Kong
facility: Neighbourhood Advice-action Council (Shan King) Community Nursing Services (CNS) Centre
city: Hong Kong
country: Hong Kong
facility: New Life Psychiatric Rehabilitation Association (Sha Tin)
city: Hong Kong
country: Hong Kong
facility: New Life Psychiatric Rehabilitation Association (Tuen Mun)
city: Hong Kong
country: Hong Kong
facility: New Life Psychiatric Rehabilitation Association (Yau Tsim Mong)
city: Hong Kong
country: Hong Kong
facility: New Life Psychiatric Rehabilitation Association Islands District
city: Hong Kong
country: Hong Kong
facility: New Life Psychiatric Rehabilitation Association The Wellness Centre (Tin Shui Wai)
city: Hong Kong
country: Hong Kong
facility: S.K.H. Holy Carpenter Church District Elderly Community Centre (Kowloon)
city: Hong Kong
country: Hong Kong
facility: Sage Eastern District Elderly Community Centre
city: Hong Kong
country: Hong Kong
facility: Sage Tsuen Wan District Elderly Community Centre
city: Hong Kong
country: Hong Kong
facility: Shun On District Elderly Community Centre
city: Hong Kong
country: Hong Kong
facility: St. James' Settlement Central & Western District Elderly Community Centre
city: Hong Kong
country: Hong Kong
facility: St. James' Settlement Wan Chai District Elderly Community Centre
city: Hong Kong
country: Hong Kong
facility: The Mental Health Association of Hong Kong Amity Place
city: Hong Kong
country: Hong Kong
facility: The Mental Health Association of Hong Kong Tai Po District
city: Hong Kong
country: Hong Kong
facility: The Neighbourhood Advice-Action Council
city: Hong Kong
country: Hong Kong
facility: The Neighbourhood Advice-Action Counil Tung Chung Intergrated Service Centre
city: Hong Kong
country: Hong Kong
facility: The Salvation Army Tai Po Multi-service Centre for Senior Citizens
city: Hong Kong
country: Hong Kong
facility: The Society of Rehabilitation and Crime Prevention, Hong Kong
city: Hong Kong
country: Hong Kong
facility: The Wellness Centre, New Life Psychiatric Rehabilitation Association (Kwai Chung)
city: Hong Kong
country: Hong Kong
facility: Tseung Kwan O Aged Care Complex, Jockey Club District Elderly Community Centre cum Day Care Unit
city: Hong Kong
country: Hong Kong
facility: Tung Wah Group of Hospitals Wilson T.S. Wang District Elderly Community Centre
city: Hong Kong
country: Hong Kong
facility: TWGHs Lok Hong Integrated Community Centre for Mental Wellness
city: Hong Kong
country: Hong Kong
facility: Wong Cho Tong District Elderly Community Centre
city: Hong Kong
country: Hong Kong
facility: YWCA Ming Yue District Elderly Community Centre
Study officials:
affiliation: The University of Hong Kong
name: Terry Lum, PhD
role: PRINCIPAL_INVESTIGATOR
References: