Peer Enhanced Depression Care: Using Peer Mentors to Provide Self-Care Support to Low-Income and Minority Older Adults

同伴加强抑郁症护理：利用同伴导师为低收入和少数族裔老年人提供自我护理支持

• 批准号: 10203811
• 负责人: MELISSA Ann DAVEY-ROTHWELL
• 金额: $ 60.12万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-23 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10203811
• 关键词: Active Listening; Address; Administrator; Adult; Affect; American; Appointment; Caring; Charge; Chronic Disease; Clinic; Clinical; Communication; Communities; Coping Skills; Depressed mood; Development; Effectiveness; Elderly; Emotional; Enrollment; Face; Funding; Future; Goals; Health; Health Resources; Health system; Healthcare; Hybrids; Individual; Intervention; Interview; Knowledge; Link; Loneliness; Low income; Measures; Mediating; Mediation; Mediator of activation protein; Medical; Mental Depression; Mental Health; Mental Health Services; Minority; Minority Groups; Modeling; Morbidity - disease rate; National Institute of Mental Health; Outcome; Patients; Pilot Projects; Population; Positioning Attribute; Primary Care Physician; Primary Health Care; Process; Psychosocial Assessment and Care; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Recovery; Relationship-Building; Reporting; Research Design; Research Personnel; Resources; Risk; Self Care; Self Efficacy; Self Management; Service delivery model; Services; Social Interaction; Social Workers; Social isolation; Social support; Supervision; Testing; Training; Transportation; Trust; Visit; Vulnerable Populations; aged; base; behavioral health; career; community organizations; comorbidity; depression model; depressive symptoms; disability; effectiveness testing; experience; health disparity; implementation fidelity; implementation intervention; implementation process; improved; informant; information gathering; intervention effect; knowledge base; low socioeconomic status; medical specialties; meetings; mentoring community; mortality; novel; novel strategies; patient oriented; patient response; peer; peer coaching; peer support; primary care setting; programs; recruit; skills; social learning; stakeholder perspectives; success; theories

Project Summary Depression is a major burden for minority and low-income older adults who are less likely to use mental health services, and development of new service delivery models is needed to improve the quality of life and address disparities to access for this group. We propose to test the effectiveness of a peer- delivered depression care program that is embedded in the community and linked to the patient's primary care clinic. Our first aim will be to carry out a randomized controlled trial of the Peer Enhanced Depression Care program in which peer mentors who have personal experience of depression meet individually with older adults recruited in the community for 8 weekly meetings focused on relief of depressive symptoms through self-care support and linkages to community resources. This group of low-income and minority older adults in the intervention will be compared to a group that receives non- peer visits that provide social interaction. The Peer Enhanced Depression Care program takes a chronic disease self-management approach and is guided by the conceptual frameworks of social support, peer support, and social learning. Our second aim is to understand mediators such as self-efficacy and loneliness that may be responsible for the intervention effect. Our third aim is to evaluate the implementation of the intervention by conducting interviews with stakeholders, including older adults who received the intervention, peer mentors, social workers, the older adult's primary care physicians and health system administrators to obtain their perspectives on barriers and facilitators to implementation as well as the impact of the Peer Program. Our goal is to use peer-delivered depression care to decrease the mental health morbidity of at-risk low-income and minority adults. The potential public health impact is high because our project seeks to increase access to depression for a vulnerable group of older adults who often do not get care and leverages an existing workforce of peer workers whose services are reimbursed in many states.

项目概要 抑郁症是少数民族和低收入老年人的主要负担，他们不太可能使用心理疗法 需要开发新的服务提供模式来改善生活质量 并解决该群体的访问差异。我们建议测试同行的有效性 提供嵌入社区并与患者的情况相关的抑郁症护理计划 初级保健诊所。我们的首要目标是对同行增强进行随机对照试验 抑郁症护理计划，其中有抑郁症个人经历的同伴导师会面 单独与社区中招募的老年人举行 8 次每周会议，重点关注缓解 通过自我护理支持和与社区资源的联系来缓解抑郁症状。这组 干预中的低收入和少数族裔老年人将与接受非干预的群体进行比较 提供社交互动的同伴访问。同伴增强抑郁症护理计划需要长期的 疾病自我管理方法，并以社会支持、同伴等概念框架为指导 支持和社会学习。我们的第二个目标是了解自我效能感和自我效能感等中介因素。 孤独可能是造成干预效果的原因。我们的第三个目标是评估 通过与包括老年人在内的利益相关者进行访谈来实施干预措施 接受干预的人、同伴导师、社会工作者、老年人的初级保健医生 和卫生系统管理员了解他们对障碍和促进因素的看法 实施情况以及同行计划的影响。我们的目标是利用同伴传递的抑郁症 关心降低高危低收入和少数族裔成年人的心理健康发病率。潜力 公共卫生影响很大，因为我们的项目旨在增加弱势群体患抑郁症的机会 一群经常得不到护理并利用现有同伴工人劳动力的老年人群体 他们的服务在许多州都有报销。