Feasibility of Telehealth Problem-Solving Therapy for Depressed Homebound Older Adults
|Depression||Behavioral: Tele-Problem-Solving Therapy Behavioral: In-Person PST Behavioral: Attention control|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Health Services Research
|Official Title:||Telehealth Problem-Solving Therapy for Depressed Homebound Older Adults|
- 24-item Hamilton Rating Scale for Depression (HAMD) [ Time Frame: Measured at 2, 12, and 24 weeks ]
- 12-item World Health Organization Disability Assessment Schedule (WHO-DAS-II) [ Time Frame: Measured at 2, 12, and 24 weeks ]
|Study Start Date:||June 2009|
|Study Completion Date:||May 2013|
|Primary Completion Date:||May 2013 (Final data collection date for primary outcome measure)|
Participants will receive problem-solving therapy (PST) delivered via teleconferencing (tele-PST).
Behavioral: Tele-Problem-Solving Therapy
Six sessions of tele-PST
Active Comparator: 2
Participants will receive problem-solving therapy (PST) delivered in-person.
Behavioral: In-Person PST
Six sessions of in person PST
Placebo Comparator: 3
Participants will receive monitoring phone calls.
Behavioral: Attention control
Six weekly telephone calls
Older people with disabilities who cannot leave their homes are at increased risk of depression or depressive symptoms. Short-term psychotherapy, without medications, has been found effective for treating this population of people. Problem-solving therapy (PST) is a brief, structured, cognitive-behavioral therapy that teaches people problem-solving and coping skills to deal with negative life events and daily problems. Previous research demonstrated that PST is an effective treatment for depression when delivered to older adults in their homes. The cost of service for these in-home visits, however, can be prohibitive for many older adults and social service providers. One way to extend treatment to more older adults is to deliver PST via teleconferencing (tele-PST). This study will test the feasibility and effectiveness of tele-PST in treating depression in homebound older adults.
This study will have two phases. Phase 1 will examine the feasibility of delivering treatment via teleconference. Participants in this phase will receive six weekly sessions of tele-PST and then complete a 2-week follow-up visit in which their depression, disability, and resourcefulness will be assessed. Logistical and procedural problems and acceptability of the treatment to participants will be used to guide modifications or adaptations made to tele-PST before conducting a larger, randomized trial in Phase 2.
Participation in Phase 2 will last 6 weeks, with follow-up visits lasting until 24 weeks after the conclusion of treatment. Participants will be randomly assigned to one of three groups: tele-PST, in-person PST, and attention control. Participants in the tele-PST group will receive six weekly sessions of PST via teleconference, and participants in the in-person PST group will receive six weekly sessions of PST from a study therapist in person. Both these groups will also receive six monthly maintenance calls from their study therapist after the completion of treatment. Participants in the attention group will receive six weekly phone calls followed by six monthly phone calls to monitor their health. All participants in Phase 2 will complete assessments at 2, 12, and 24 weeks following their treatment. These assessments will measure the adequacy of recruitment, enrollment, and retention strategies; the compliance rates and service delivery costs of tele-PST and in-person PST; and participants' depression, disability, and resourcefulness.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00903019
|United States, Texas|
|University of Texas at Austin|
|Austin, Texas, United States, 78712-0358|
|Principal Investigator:||Namkee G. Choi, PhD||University of Texas at Austin|