Social Worker-led Mindfulness-based Intervention for Older People
NCT Number: NCT06528132
Status: RECRUITING
Study Type: INTERVENTIONAL
Phases: NA
Conditions: Depressive Symptoms
Interventions: BEHAVIORAL: Mindfulness-based intervention (MBI) (enhanced with peer supporters)|BEHAVIORAL: Experimental: social worker-led MBI (without peer supporters)
Sponsor: The University of Hong Kong
Collaborators: The Hong Kong Jockey Club Charities Trust|Christian Family Service Centre|The Mental Health Association of Hong Kong|The Salvation Army, Hong Kong and Macau Command|Haven of Hope Hospital|Hong Kong Sheng Kung Hui|Tung Wah Group of Hospitals|Aberdeen Kai-fong Welfare Association|Hong Kong Society for the Aged|The Neighbourhood Advice-Action Council
Sex: ALL
Age: ADULT, OLDER_ADULT
Enrollment: 207
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: NONE|Primary Purpose: TREATMENT
Start Date: 2024-07-23
Completion Date: 2026-03-16
Locations: Hong Kong Society for the Aged, Eastern District, Hong Kong|HKSKH Lok Man Alice Kwok Integrated Service Centre, Kowloon City, Hong Kong|SKH Holy Carpenter Church, Kowloon City, Hong Kong|The Mental Health Association of Hong Kong, Kwun Tong, Hong Kong|Haven of Hope District Elderly Community Service, Sai Kung, Hong Kong|Wellness Zone - Integrated Community Centre for Mental Wellness, Sai Kung, Hong Kong|HKSKH Western District Elderly Community Centre, Sai Wan, Hong Kong|TWGHs Lok Hong Integrated Community Centre for Mental Wellness, Sai Wan, Hong Kong|Ｗang District Elderly Community Centre, Sha Tin, Hong Kong|Aberdeen Kai-fong Welfare Association, Southern District, Hong Kong|The Salvation Army Taipo Multi-Service Centre for Senior Citizens, Tai Po, Hong Kong|The Neighbourhood Advice-Action Council, Tuen Mun, Hong Kong|SKH Wong Tai Sin District Elderly Community Centre, Wong Tai Sin, Hong Kong

Summary:
Preliminary findings from a previous study conducted by the investigators suggest that a task-shared approach with modified mindfulness-based cognitive therapy (MBCT) supported by social workers is beneficial in managing depressive symptoms and improving mindful non-reactivity among older adults. However, the possibility for social workers to lead a mindfulness-based intervention (MBI) independently to improve its scalability and service accessibility remains unclear. The project aims to:

1. Evaluate the effectiveness of social worker-led MBI in improving depression in older adults with mild to moderate depressive symptoms as compared to care as usual;
2. Examine the effectiveness of incorporating peer supporters in social worker-led MBI compared to those without peer supporters;
3. To identify potential mechanisms of change in MBI for depressive symptoms.

Primary Outcome Measures: Change from baseline depression at Week 6 and Week 18, Depression will be measured by the validated Chinese version of the Patient Health Questionnaire (PHQ-9). The total score will be used, ranging from 0 to 27. Higher scores indicate higher levels of depressive symptoms., Baseline and Week 6, Week 18|Change from baseline anxiety at Week 6 and Week 18, Anxiety will be measured by the validated Chinese version of the Generalized Anxiety Disorder scale (GAD-7). The total score will be used, ranging from 0 to 21. Higher scores indicate higher levels of anxiety symptoms., Baseline and Week 6, Week 18
Other Outcome Measures: Change from baseline mindfulness at Week 6 and Week 18, Mindfulness will be measured by the Chinese validated Five Facet Mindfulness Questionnaire Short Form (FFMQ-SF). The total score of the FFMQ-SF (ranging from 20 to 100) as well as the sum (ranging from 4 to 20) of the five subscales (i.e., observe, describe, acting with awareness, nonjudging, and nonreactivity) will be used. Higher scores indicate higher mindfulness., Baseline and Week 6, Week 18|Change from baseline stress at Week 8 and Week 18, Stress will be measured by a single-item subjective level of stress (SLS-1), which is rated on a scale from 0 to 10. A higher score indicates a greater subjective level of stress, Baseline and Week 6, Week 18|Change from baseline quality of life at Week 6 and Week 18, Health-related quality of life will be measured by the European Quality of life 5 Dimensions 5 Level Version (EQ-5D-5L) in traditional Chinese. The measure assesses five dimensions of health (i.e., mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) at five levels (no problem, slight problems, moderate problems, severe problems, and extreme problems). An index value ranging from 0 to 1 will be used, with a score closer to 1 indicating a better health state. Current self-rated health will be measured using a visual analogue scale ranging from 0 to 100, with higher scores indicating better self-rated health., Baseline and Week 6, Week 18|Change from baseline self-compassion at Week 6 and Week 18, Self-compassion will be measured by the Chinese version of the Self-Compassion Scale-Short Form (SCS-SF). The total score will be used, ranging from 12 to 60. Higher scores indicate higher self-compassion., Baseline and Week 6, Week 18|Change from baseline rumination at Week 6 and Week 18, Rumination will be measured by the Brooding Subscale of the Ruminative Response Scale (RRS-10 Chinese version). The total score will be used, ranging from 5 to 20. Higher scores indicate a greater rumination tendency., Baseline and Week 6, Week 18|Change from baseline self-efficacy at Week 6 and Week 18, Self-efficacy will be measured by the Chinese version of the General Self-Efficacy Scale. The total score will be used, ranging from 10 to 40. Higher scores indicate greater self-efficacy., Baseline and Week 6, Week 18|Change from baseline resilience at Week 6 and Week 18, Resilience will be measured by the Chinese version of the 2-item Connor-Davidson Resilience Scale (CD-RISC2). The total score will be used, ranging from 0 to 8. Higher scores indicate higher resilience., Baseline and Week 6, Week 18|Change from baseline general health status at Week 6 and Week 18, General health status will be assessed using one non-comparative and two comparative questions pertaining to health. Health status will be measured on a scale ranging from 0 to 4. Higher scores indicate poorer health status., Baseline and Week 6, Week 18