Evaluation of an Integrated Microfinance and Depression Care Program for Women (LIFE-DM)

RanD

Status: Completed

Conditions: Depression

Treatments: Other: Treatment as Usual; Behavioral: Integrated Depression/Microfinance Group; Other: Livelihood Support

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT02069301

5R34MH094648-02 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The study evaluates LIFE-DM, an integrated microfinance and collaborative care intervention by comparing it to enhanced treatment as usual (national guideline antidepressant care and referral to microfinance resources) in Vietnam. Intervention effects at baseline, 6 month, and 12 month follow-up on patient outcomes, including depression, anxiety, quality of life, functioning, self-efficacy, satisfaction, and income will be compared across the two conditions.

Full description

Depression is one of the largest contributors to the world's health burden. Prior work in the Partners in Care study has shown that evidence-based service delivery programs for depression can improve health outcomes in depressed patients, and especially in minorities, largely overcoming disparities in outcomes from care between whites and minorities. Effective treatments exist, but they do not reach many depressed individuals, especially in resource-poor communities--ethnic minorities, rural residents in the United States, and individuals in most of the developing world.

Women, in particular, are at risk for depression and poverty. Integrating programs that treat depression and address livelihood concerns may improve engagement in depression treatment and improve mental health and functioning for patients in low-resource settings. The proposed study would integrate depression care with existing "microfinance" programs, which provide poverty-alleviation services including small loans, savings programs, and vocational training to women.

This project will (1) conduct qualitative studies of barriers and facilitators of women's successful use of existing depression care and microfinance programs; (2) adapt and integrate the depression care and microfinance services; (3) train Women's Union facilitators to deliver the integrated depression care and microfinance program; and conduct evaluation of LIFE-DM program to assess acceptability, feasibility, and preliminary effectiveness. The non-randomized control trial compares the integrated microfinance and collaborative care intervention with enhanced treatment as usual (national guideline antidepressant care and referral to microfinance resources) at the Women's Union in Danang city in Vietnam.

Enrollment: 166 patients

Sex: Female

Ages: 18 to 55 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• depression, low-income

Exclusion criteria

• psychosis, mania, substance abuse, high suicide risk, physical disabilities, significant cognitive impairments

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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166 participants in 2 patient groups

Integrated Depression/Microfinance Group

Experimental group

Description:

LIFE-DM is a Depression and Microfinance integrated program using behavior activation and problem solving therapy applied to both depression and livelihood. Livelihood support include microfinance loans, personal finance, and income-generation skills.

Treatment:

Other: Livelihood Support

Behavioral: Integrated Depression/Microfinance Group

Other: Treatment as Usual

Treatment as Usual

Other group

Description:

Currently treatment as usual in this province includes national guidelines for antidepressant care for depression and referral for microfinance/livelihood programs

Treatment:

Other: Treatment as Usual