Depression and Pain Perseverance Through Empowered Recovery Intervention (DAPPER)

Johns Hopkins University

Status: Completed

Conditions: Aging; Depressive Symptoms; Frailty; Pain

Treatments: Behavioral: DAPPER

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT04091347

IRB00226182

P30AG021334 (U.S. NIH Grant/Contract)

75206 (Other Grant/Funding Number)

Details and patient eligibility

About

African American women who are 50 years of age and older with depressive symptoms, pain and difficulty with mobility will participate in the DAPPER intervention study that includes 8 nurse visits in participants' homes to help participants with participants' pain and mood.

Full description

The proposed intervention is called Depression and Pain Perseverance through Empowered Recovery (DAPPER). The investigators are adapting the Get Busy Get Better intervention by adding components (e.g. nurse visits and person directed goals) from the CAPABLE study for this intervention. The investigator will further develop the intervention through this two-phase pilot test. The aims of this pilot project are to 1) test the Depression and Pain Perseverance through Empowered Recovery (DAPPER) program for feasibility and acceptability. Specifically, the investigators will test the effect size of DAPPER on pain and depressive symptoms from baseline to 12 weeks (compare intervention to wait list control group) and then at 24 weeks to compare the intervention group to wait list control group once again. 2) estimate preliminary effect sizes for DAPPER in reduction pain and depressive symptoms, 3) measure effect sizes and feasibility of measuring cytokines and heart rate variability (HRV).

Enrollment: 34 patients

Sex: Female

Ages: 50+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Self-report pain >3 out of a 0 -10 scale that has lasted longer than 3 months and keeps subjects from doing at least one activity that subjects would like to do
• Self-Identify as African American/Black female
• Live in a community dwelling
• Score a 5 or higher on the PHQ-9 (depression measure) at least two times during a two week period (screening call and then at first data collection visit)
• Must be pre-frail (one or two criteria on frailty phenotype) or frail (three or more of the criteria on frailty phenotype)
• One ADL or IADL limitation

Exclusion criteria

• Hospitalized > 3 times in the last year
• Participating in physical therapy
• Have a terminal diagnosis (<1 year expected survival)
• > moderate intellectual impairment (5-7 errors) based on the Short Portable Mental Status Questionnaire (SPMSQ)
• Unable to speak or understand English

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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34 participants in 2 patient groups

Intervention Arm

Experimental group

Description:

The intervention group will receive the intervention for 12 weeks. The wait list control group will have outcomes measured but will not receive the intervention at this time.

Treatment:

Behavioral: DAPPER

Wait List Control Arm

Active Comparator group

Description:

Once the intervention group has completed the intervention the wait list control group will complete the intervention.

Treatment:

Behavioral: DAPPER