Volunteer-Delivery of Behavioral Activation for Senior Center Clients

志愿者-为老年中心客户提供行为激活

• 批准号: 9769136
• 负责人: PATRICK J RAUE
• 金额: $ 12.46万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9769136
• 关键词: Administrator; Age; Aging; Area; Behavioral; Case Series; Client; Clinical; Communities; Community Practice; Data; Databases; Depressed mood; Development; Dose; Effectiveness; Effectiveness of Interventions; Elderly; Hamilton Rating Scale for Depression; Health; Health Personnel; Individual; Intervention; Manuals; Mental Depression; Mental Health; Mental disorders; Methods; Modeling; National Institute of Mental Health; New York City; Nutritional; Outcome; Participant; Population; Procedures; Protocols documentation; Provider; Randomized; Reporting; Research; Resources; Rewards; Safety; Services; Standardization; Supervision; Target Populations; Testing; Time; Training; Uncertainty; Work; base; clinically significant; comparative; cost effective; depressive symptoms; design; effective therapy; effectiveness research; efficacy study; ethnic diversity; experience; geriatric depression; geriatric mental health; improved; metropolitan; non-demented; patient safety; practice setting; preference; programs; psychosocial; public health relevance; response; side effect; skills; social; treatment duration; volunteer

Abstract of 1R34MH111849-01 Volunteer-Delivery of Behavioral Activation for Senior Center Clients Abstract ABSTRACT In response to large numbers of senior center clients who suffer untreated depression and the dearth of geriatric mental health providers, we partnered with the NYC Department for the Aging (DFTA) to simplify Behavioral Activation to match the skill set of age-matched lay volunteers available to senior centers (Volunteer BA). The Volunteer BA delivery model: 1. Makes use of existing volunteer resources; 2. has potential for being an acceptable and sustainable delivery model; 3. is expected to engage BA targets; but 4. its capacity to yield comparable outcomes is yet to be determined. This R34 proposes developmental work on delivering Volunteer BA in senior centers, so as to arrive to a sustainable intervention with standardized procedures. We follow with a small RCT testing the comparative impact of Volunteer BA versus MSW-provided BA on increased client activity (the target) and reduced depressive symptoms (clinical outcome). In this effectiveness design, we propose: 1. increased activity as the “target” of the BA intervention's effectiveness; 2. delivery of interventions via manuals and research supervision will result in reaching the target of increased activity; and 3. increased activity will predict improved client depression outcome. The specific aims are to: 1. Assess degree of intervention fit by refining and standardizing procedures for volunteer selection, training, and supervision; refining and standardizing procedures for engaging clients in BA; and matching procedures with senior center staff preferences; 2. Conduct a case series to standardize the intervention by determining whether the intervention represents a sufficient “dose” to produce target engagement; and 3. Conduct a small RCT to establish the feasibility, acceptability, safety and preliminary impact of the intervention. The client participants will be a total of 54 older (>60 years) non-psychotic, non-demented individuals with elevated depressive symptoms from 4 Seattle metropolitan area senior centers serving economically and ethnically diverse communities. For the case series, 3 volunteers at one center will provide 12 weekly sessions to 2 depressed clients each (n=6 total). For the RCT, 3 volunteers and 1 MSW per center will provide either Volunteer or standard BA, respectively. Eligible clients will be randomized within senior centers to either Volunteer BA (n=36) or MSW-delivered BA (n=12). Our proposal responds to the 2012 IOM report which highlighted the dearth of mental health providers for older adults and the need to develop a workforce of nontraditional providers. Our findings will set the stage for a definitive study on the effectiveness of Volunteer BA for an underserved and difficult to engage population, and will provide further support for aging service agencies to invest effort in senior volunteer training and supervision procedures.

摘要 1R34MH111849-01 志愿者-为老年中心客户提供行为激活 抽象的 摘要 为了应对大量患有抑郁症且未经治疗的老年中心客户以及缺乏老年心理健康服务提供者的情况，我们与纽约市老龄部门 (DFTA) 合作，简化行为激活，以匹配年龄匹配的非专业志愿者的技能组合可供老年人中心使用（志愿者 BA）。 志愿者 BA 交付模式： 1. 利用现有志愿者资源； 2. 具有成为可接受且可持续的交付模式的潜力； 3. 有望吸引 BA 目标；但 4. 其产生可比较结果的能力尚待确定，该 R34 建议在老年中心开展志愿者 BA 的开发工作，以便通过标准化程序实现可持续干预。志愿者 BA 与 MSW 提供的 BA 在增加客户活动（目标）和减少抑郁症状（临床结果）方面的比较 在此有效性设计中，我们建议： 1. 增加活动作为 BA 干预有效性的“目标”；实施干预措施通过手册和研究监督将达到增加活动的目标；以及 3. 增加活动将预测改善客户抑郁症的结果 具体目标是： 1. 通过完善和标准化志愿者选择、培训程序来评估干预适合程度。和监督；完善和标准化客户参与 BA 的程序；并将程序与高级中心工作人员的偏好进行匹配； 3. 行为一项小型随机对照试验，旨在确定干预措施的可行性、可接受性、安全性和初步影响，客户参与者将是来自 4 个西雅图都市区的 54 名患有严重抑郁症状的老年（> 60 岁）非精神病、非痴呆个体。对于服务于经济和种族多元化社区的老年人中心，一个中心的 3 名志愿者将每周为 2 名抑郁症患者提供 12 次治疗（总共 6 名）。对于 RCT，每个中心有 3 名志愿者和 1 名 MSW。中心将分别提供志愿者或标准 BA，符合资格的客户将在高级中心内被随机分配到志愿者 BA (n=36) 或 MSW 提供的 BA (n=12)。老年人心理健康提供者的缺乏以及培养非传统提供者队伍的需要，我们的研究结果将为关于志愿者 BA 对服务不足和难以参与的人群的有效性进行明确的研究奠定基础，并将为老年人提供进一步的支持。老龄服务机构要投入精力进行老年人志愿者培训和监督程序。

项目成果

"Do More, Feel Better": Pilot RCT of Lay-Delivered Behavioral Activation for Depressed Senior Center Clients.

• DOI: 10.1016/j.beth.2021.11.005
• 发表时间: 2022-05
• 期刊: BEHAVIOR THERAPY
• 影响因子: 3.7
• 作者: Raue, Patrick J;Hawrilenko, Matt;Corey, Mariah;Lin, John;Chen, Shiyu;Mosser, Brittany A
• 通讯作者: Mosser, Brittany A