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PEERS Using Peer Mentors to Deliver Depression Care

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT04319094
Recruitment Status : Recruiting
First Posted : March 24, 2020
Last Update Posted : May 13, 2021
National Institute of Mental Health (NIMH)
Information provided by (Responsible Party):
Johns Hopkins University

Brief Summary:
Fifteen to twenty percent of older Americans (6 to 8 million people) suffer from depression but more than one-half do not receive any services, a burden disproportionately shared by low-income and minority older adults who receive few or no services. The investigators propose to test a community-based peer model of depression care called PEERS (a peer support program) that provides self-care support for minority and low-income older adults.

Condition or disease Intervention/treatment Phase
Depression Behavioral: PEERS Other: Social interaction Not Applicable

Detailed Description:
Depression is a major burden for minority and low-income older adults who are less likely to use mental health services, and development of new service delivery models is needed to improve the quality of life and address disparities to access for this group. The investigators propose to test the effectiveness of a peer-delivered depression care program that is embedded in the community and linked to the patient's primary care clinic. The investigators will carry out a randomized controlled trial of the PEERS program in which peer mentors who have personal experience of depression meet individually with older adults recruited in the community for 8 weekly meetings focused on relief of depressive symptoms through self-care support and linkages to community resources. This group of low-income and minority older adults in the intervention will be compared to a group that receives non-peer visits that provide social interaction. The PEERS program takes a chronic disease self-management approach and is guided by the conceptual frameworks of social support, peer support, and social learning. The investigators will conduct an analysis of mediation to understand the mechanism of peer support, by measuring factors such as self-efficacy and loneliness that may be responsible for the intervention effect. The investigators' goal is to use peer-delivered depression care to decrease the mental health morbidity of at-risk low-income and minority adults. The potential public health impact is high because the investigators' project seeks to increase access to depression for a vulnerable group of older adults who often do not get care and leverages an existing workforce of peer workers whose services are reimbursed in many states.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 160 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Health Services Research
Official Title: Using Peer Mentors to Provide Self Care Support to Low Income and Minority Older Adults
Actual Study Start Date : February 17, 2020
Estimated Primary Completion Date : April 3, 2023
Estimated Study Completion Date : April 3, 2023

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: PEERS
Peer mentors who have experience of depression are trained and supervised to deliver depression care. Peers will meet with depressed older adults for 8 weekly meeting lasting approximately 45 minutes. Peer mentors will provide social support defined as emotional, informational and appraisal support that includes coping strategies. Peers will be supervised by a mental health professional.
Behavioral: PEERS
Peer mentors deliver depression care that include social support and coping skills, focused on goal setting and small behavioral changes.

Active Comparator: Social interaction
A study staff member will provide eight weekly social interaction visits and phone calls to the depressed older adult.
Other: Social interaction
Study staff will provide a combination of 8 social interaction visits and phone calls to the participants randomized to this condition.

Primary Outcome Measures :
  1. Depression as assessed by the Patient Health Questionnaire-9 [ Time Frame: 12 months ]
    Depression will be assessed with the Patient Health Questionnaire (PHQ)-9. There are 9 items in the questionnaire and scores range from 0 to 27. A score of 5 indicates mild depressive symptoms, 10 - 14 indicates moderate depression, 15-19 indicates moderately severe depression, 20-27 indicates severe depression.

Information from the National Library of Medicine

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Ages Eligible for Study:   50 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • 50 years and older
  • depressive symptoms with Patient Health Questionnaire-9 scores > 5
  • belong to an underserved population, defined as annual income less than 200% of the federal poverty level ($24,120) and/or self-identified ethnic minority
  • able to communicate in English
  • willing to give informed consent.

Exclusion Criteria:

  • meet diagnostic criteria for mania or hypomania
  • meet diagnostic criteria for psychotic syndrome
  • meet diagnostic criteria for substance abuse or dependence
  • acutely suicidal
  • a score on the Mini-Mental State Examination (MMSE) <24
  • currently taking an antidepressant medication with dosage change in the past 3 months
  • receiving active psychotherapy

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT04319094

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Contact: Jin Hui Joo, MD 410-502-4110
Contact: James Caracoglia, MA 443-883-1706

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United States, Maryland
Johns Hopkins Bayview Medical Center Recruiting
Baltimore, Maryland, United States, 21224
Contact: Jin Hui Joo, MD MA    410-550-2282   
Johns Hopkins Hospital Recruiting
Baltimore, Maryland, United States, 21287
Contact: Jin hui Joo, MD    410-502-4110   
Contact: Trina Brooks, MA    410-955-0512   
Sub-Investigator: Joseph Gallo, MD         
Sub-Investigator: Melissa Davey-Roth, PHD         
Sponsors and Collaborators
Johns Hopkins University
National Institute of Mental Health (NIMH)
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Principal Investigator: Jin Hui Joo, MD Johns Hopkins University
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Responsible Party: Johns Hopkins University Identifier: NCT04319094    
Other Study ID Numbers: IRB00211072
R01MH123165 ( U.S. NIH Grant/Contract )
First Posted: March 24, 2020    Key Record Dates
Last Update Posted: May 13, 2021
Last Verified: May 2021

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Depressive Disorder
Behavioral Symptoms
Mood Disorders
Mental Disorders