Intervention to Reduce Depression Among Elder Abuse Victims: Type 1 Hybrid Trial of Tele-PROTECT

减少老年虐待受害者抑郁症的干预措施：Tele-PROTECT 1 型混合试验

• 批准号: 10645687
• 负责人: JO ANNE SIREY
• 金额: $ 52.18万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-07 至 2028-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10645687
• 关键词: Address; Adopted; Adult; Affect; Age; Aging; Agreement; Behavior Therapy; Behavioral; Blinded; Caring; Characteristics; Client; Clinical; Collaborations; Communities; Consent; Consolidated Framework for Implementation Research; Criminal Justice; Data; Depressed mood; Educational Intervention; Effectiveness; Elder Abuse; Elderly; Eligibility Determination; Emotional; Ensure; Ethnic Origin; Feeling suicidal; Gender; Goals; Injury; Intervention; Language; Legal; Manipulative Therapies; Manuals; Mediating; Mediator; Mental Depression; Methods; Modeling; National Institute of Mental Health; New York City; Outcome; Participant; Pilot Projects; Population; Premature Mortality; Process; Race; Randomized; Randomized, Controlled Trials; Research; Research Assistant; Research Training; Resolution; Rewards; Safety; Sampling; Services; Severities; Social isolation; Strategic Planning; Testing; Time; Translations; United States; Victimization; Vulnerable Populations; Woman; Work; World Health Organization; abuse victim; attentional control; clinical practice; clinically significant; depression education; depressive symptoms; design; effectiveness testing; effectiveness trial; empowerment; experience; follow up assessment; future implementation; hybrid type 1 trial; implementation facilitators; implementation outcomes; inclusion criteria; men; mortality; pandemic disease; practice setting; recruit; reduce symptoms; synergism; underserved community; video delivery; virtual; virtual delivery; virtual therapy; women of color

PROJECT ABSTRACT The World Health Organization estimates that 1 in 6 adults over the age of 60 has been a victim of abuse in the past year. Our research demonstrated that nearly one-third of these victims have clinically significant depressive symptoms and 16% have suicidal ideation (Sirey et al., 2015). Tele-PROTECT, is the only manualized, virtual therapy for elder abuse victims experiencing depression. It is offered to victims at the same time that they are receiving services from elder abuse agencies that offer safety planning, support services, and legal services. Tele- PROTECT was designed using a deployment-focused approach with our partners at the New York City Department for the Aging (DFTA). Tele-PROTECT strategies focus on increasing pleasurable and rewarding activities to reduce depression, and goal setting and defining the action steps to increase safety related empowerment. In our randomized controlled pilot project, participants receiving PROTECT had significant decreases in symptoms of depression as compared to those in the referral control condition (Sirey et al., 2021). Our preliminary work during the pandemic, demonstrated the feasibility and effectiveness of virtual delivery of PROTECT via video (called Tele-PROTECT) to a large sample of diverse victims. This project will test the effectiveness of Tele-PROTECT as compared to a video-delivered attention control condition (DepEd). We will recruit 140 English- and Spanish-speaking elder abuse victims from five New York City (NYC) elder abuse agencies. We hypothesize that Tele- PROTECT participants will experience greater decreases in depressive symptoms and greater increase in safety-related empowerment compared to an attention control (DepEd). Elder abuse agency staff will refer depressed victims who agree to research staff. Eligible elder abuse victims who consent, have a baseline assessment and meet inclusion criteria will be randomized to Tele-PROTECT or DepEd. Follow up assessments will be conducted at weeks 3, 6, 9, and 12 after baseline. Trained Research Assistants blinded to study hypotheses will assess depression severity (MADRS) and safety-related empowerment (MOVERS), as well as participation in activities, social isolation, and criminal justice outcomes. In collaboration with a national organization of elder abuse agencies (NAPSA), we will use a mixed methods design with multiple stakeholder groups to collect data on the barriers and facilitators to the implementation of Tele-PROTECT nationally. Tele-PROTECT has demonstrated feasibility, acceptability, and preliminary effectiveness. This project will test a scalable manualized therapy with the potential for national implementation to serve depressed victims of elder abuse.

项目摘要 世界卫生组织估计，60 岁以上的成年人中，有六分之一患有糖尿病 去年遭受虐待的受害者。我们的研究表明，其中近三分之一 受害者有临床上显着的抑郁症状，16% 有自杀意念（Sirey 等 等，2015）。 Tele-PROTECT，是针对老年虐待受害者的唯一手动虚拟治疗 正在经历抑郁症。它是在受害者接受服务的同时提供给他们的 来自提供安全规划、支持服务和法律服务的虐待老年人机构。电话- PROTECT 的设计采用以部署为中心的方法，与我们的合作伙伴在 New 约克市老龄事务局 (DFTA)。远程保护策略侧重于增加 减少抑郁的愉快且有益的活动，以及设定目标和定义 增加安全相关授权的行动步骤。在我们的随机对照试点项目中， 接受 PROTECT 治疗的参与者的抑郁症状显着减轻， 与转诊控制条件下的患者相比（Sirey 等人，2021）。我们的前期工作 疫情期间，展示了虚拟交付的可行性和有效性 通过视频（称为远程保护）对大量不同受害者进行保护。 该项目将测试 Tele-PROTECT 与视频传输相比的有效性 注意力控制条件（DepEd）。我们将招募140名会说英语和西班牙语的长者 来自纽约市五个虐待老年人机构的虐待受害者。我们假设远程 PROTECT 参与者的抑郁症状将得到更大程度的减轻，并且 与注意力控制相比，安全相关的授权有所增加（DepEd）。 虐待老年人机构的工作人员会将同意的抑郁症受害者转介给研究人员。有资格的 同意、进行基线评估并符合纳入标准的老年虐待受害者将 被随机分配到 Tele-PROTECT 或 DepEd。后续评估将在 基线后第 3、6、9 和 12 周。训练有素的研究助理对研究假设一无所知 还将评估抑郁症严重程度 (MADRS) 和安全相关赋权 (MOVERS) 参与活动、社会孤立和刑事司法结果。与合作 作为全国性虐待老年人机构组织 (NAPSA)，我们将使用混合方法设计 与多个利益相关者团体合作，收集有关阻碍和促进因素的数据 在全国范围内实施 Tele-PROTECT。 Tele-PROTECT 已证明可行性， 可接受性和初步有效性。该项目将测试可扩展的手动疗法 有可能在全国范围内实施，为虐待老年人的抑郁受害者提供服务。