Symposia
Dissemination & Implementation Science
Patrick Raue, Ph.D. (he/him/his)
Professor
University of Washington, Seattle
Seattle, Washington
Amber Gum, Ph.D. (she/her/hers)
Professor
University of South Florida
Tampa, Florida
Jo Anne Sirey, Ph.D. (she/her/hers)
Professor
Weill Medical College
White Plains, New York
Introduction: Older adult volunteers represent an underutilized resource for addressing the unmet mental health needs of community-dwelling older adults. The aims of this presentation are to: a) describe the methods of an ongoing three-site RCT comparing a streamlined version of lay-delivered Behavioral Activation (BA) called “Do More, Feel Better” (DMFB) to clinician-delivered BA for depressed senior center clients; and b) present preliminary findings regarding recruitment, coach training, virtual delivery, and client experiences.
Methods: Across three sites (University of Washington, Weill Cornell Medicine, and University of South Florida), 288 depressed older adults are being recruited, randomized to receive 9 sessions of DMFB or BA, and assessed on primary outcomes (Behavioral Activation for Depression Scale, Hamilton Rating Scale for Depression) and qualitative interviews at baseline, 3, 6, 9, 24, and 36 weeks. Training for both conditions involves didactics, demonstration, and role play, followed by delivering the intervention with one “certification” client reviewed and approved by external fidelity raters. Providers then participate in regular weekly supervision, and all client sessions are audio-recorded with one session per client randomly selected for independent review. All assessment and intervention activities have been conducted virtually to date, transitioning into hybrid delivery based on senior center and clients’ preferences.
Results: In the first 20 months, 95 clients have been randomized and 18 coaches and 24 clinicians have been trained and certified. All coaches and clinicians who completed training were certified and have been retained in the study. Qualitative interviews with coaches indicate numerous positive aspects of participating (e.g., satisfaction from helping others, learning specific DMFB skills). Coaches identified primary challenges of learning how to use the virtual platform and other technical difficulties; facilitators of their successful delivery of DMFB include technical training and on-call support, and regular supervision. Clients report numerous benefits based on qualitative interviews, increased activity levels, and lower depressive symptoms.
Conclusions: We designed Do More, Feel Better to address the lack of available and acceptable mental health services for community-dwelling older adults. This study will lend empirical support for dissemination of the lay-delivered Do More, Feel Better intervention in senior centers and other aging service organizations.