Senior Peer Alliance for Rural Research On Wellness (SPARROW)

University of California San Francisco (UCSF)

Status: Completed

Conditions: MDD

Treatments: Behavioral: SG-PST; Behavioral: CM-PST

Study type: Interventional

Funder types: Other

Identifiers

NCT01913366

R01AG043584-01A1

Details and patient eligibility

About

Dr. Brooke Hollister, Ph.D. from the department of Social and Behavioral Sciences at the University of California, San Francisco is conducting a study comparing two types of interventions for treating depression in rural older adults.

Full description

If you are eligible to participate in the study after completing the screening assessment, and if you choose to continue on, we will randomize you (like a flip of a coin) to receive either 12 weeks of case management combined with problem solving therapy (CM-PST) with a social worker or 12 weeks of self-guided problem solving therapy (SG-PST) with support from a senior peer counselor.

As part of your participation in the study you will participate in three 1.5 hour assessment interviews of psychological and neuropsychological functioning (similar to your screening assessment) prior to your first week of treatment (baseline), two weeks after your final session (week 14), and three months after your final session (week 24). Additionally, you will participate in three shorter assessment interviews of psychological functioning, which will be conducted at weeks 3 and 6. These assessments will take approximately 30-45 minutes.

Enrollment: 105 patients

Sex: All

Ages: 60+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Residence in rural Tuolumne, Calaveras, San Joaquin or Stanislaus Counties;
• Diagnosis: Major depression, unipolar (by SCID ascertained DSM-IV criteria);
• Severity of depression: A PHQ-9>10 or a 24-Item HDRS>19;
• Need for social services: CANE score> 2, i.e. at least one unmet need;

Exclusion criteria

• Psychotic depression by SCID-IV, i.e., presence of delusions;
• High suicide risk, i.e. intent or plan to attempt suicide in near future;
• Presence of any Axis I psychiatric disorder or substance abuse other than unipolar major depression;
• Axis II diagnosis of antisocial personality (by SCID-P and DSM-IV);
• History of psychiatric disorders other than unipolar major depression or generalized anxiety disorder (including bipolar disorder, hypomania, and dysthymia);
• Dementia: MMSE below 24 or clinical diagnosis of dementia by DSM-IV;
• Acute/severe medical illness (delirium, metastatic cancer, de-compensated cardiac, liver or kidney failure, stroke or myocardial infarction) 3 months prior to entry; or use of drugs causing depression, (steroids, reserpine, alphamethyl-dopa, tamoxiphen, vincristine);
• Inability to perform any of the ADLs (MAI: ADL subscale) even with assistance (walking with a cane is not an exclusion criterion)
• Inability to speak English;
• Aphasia interfering with communication;

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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105 participants in 2 patient groups

CM-PST

Experimental group

Description:

If you are assigned to CM-PST, you will be working with the same care manager from your introductory session. The care manager will continue to work with you on your problem-solving plan. Additionally, you will receive case management services.

Treatment:

Behavioral: CM-PST

SG-PST

Experimental group

Description:

If you are assigned to SG-PST, you will continue to work on your problem-solving plan, using the self-guided materials provided to you during the introductory session. Additionally, you will be partnered with a senior peer counselor who will support you in your SG-PST efforts.

Treatment:

Behavioral: SG-PST