为了便于复制,我们检查了交货特性,可接受性,以及基于家庭干预的抑郁结果,忙碌起来变得更好,帮助老年人战胜蓝调(GBGB)GBGB,之前在随机试验中测试过,减少抑郁症状和提高非洲裔美国人的生活质量。
在随后的两次筛查中,共有208名55岁以上的非洲裔美国人患者健康问卷(PHQ-9)得分≥5分被随机分配立即或4个月后接受GBGB。GBGB涉及多达10个家庭会议,包括护理管理,转介/联系,抑郁症教育/症状识别,应力降低,和行为激活。干预人员记录了分娩特征(剂量,强度)和感知的会议可接受性。基线和后测试用于表征参与者并检查剂量/强度和抑郁评分之间的关联。在8个月时检查参与者的满意度和感知的收益。
在208名参与者中,181(87%,平均年龄=69.6)有治疗数据。其中,165例(91.2%)有≥3次治疗(最小剂量)。参与者平均进行8.1次(SD=2.6),平均每次65.4分钟(SD=18.3)。提供了最多的行为激活和护理管理(平均六个疗程,平均持续时间分别为17.9和22.2分钟),尽管所有参与者都接受了每种治疗成分。GBGB被干预主义者和参与者认为是高度可接受和有益的。更多的课程和时间与更多的症状减少相关。
参与者高度接受GBGB治疗成分。未来的实施和可持续性挑战包括人员配备,培训要求,报销限制,相互竞争的机构方案优先事项,以及对其他群体的普遍性。
To facilitate replication, we examined delivery characteristics, acceptability, and depression outcomes of a home-based intervention, Get Busy Get Better, Helping Older Adults Beat the Blues (GBGB). GBGB, previously tested in a randomized trial, reduced depressive symptoms and enhanced quality of life in African Americans.
A total of 208 African Americans aged above 55 years with Patient Health Questionnaire (PHQ-9) scores ≥5 on two subsequent screenings were randomized to receive GBGB immediately or 4 months later. GBGB involves up to 10 home sessions consisting of care management, referral/linkage, depression education/symptom recognition, stress reduction, and behavioral activation. Interventionists recorded delivery characteristics (dose, intensity) and perceived acceptability of sessions. Baseline and post-tests were used to characterize participants and examine associations between dose/intensity and depression scores. Participant satisfaction and perceived benefits were examined at 8 months.
Of 208 participants, 181 (87%, mean age = 69.6) had treatment data. Of these, 165 (91.2%) had ≥3 treatment sessions (minimal dose). Participants had on average 8.1 sessions (SD = 2.6) for an average of 65.4min (SD = 18.3) each. Behavioral activation and care management were provided the most (average of six sessions for average duration = 17.9 and 22.2min per session respectively), although all participants received each treatment component. GBGB was perceived as highly acceptable and beneficial by interventionists and participants. More sessions and time in program were associated with greater symptom reduction.
GBGB treatment components were highly acceptable to participants. Future implementation and sustainability challenges include staffing, training requirements, reimbursement limitations, competing agency programmatic priorities, and generalizability to other groups.