A Mixed Methods Effectiveness Study of a Peer Support Intervention for Older Adults During the COVID-19 Pandemic: Results of a Randomized Clinical Trial.

IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY
Jin Hui Joo, Alice Xie, Namkee Choi, Joseph J Gallo, Yunyang Zhong, Mingyue Ma, Joseph J Locascio, Uma Khemraj, Ryan A Mace, Phyllis Solomon
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Abstract

Objective: Low-income white older adults and those of color are at greater risk for depression but less likely to receive care. We evaluated the impact of a one-to-one peer support intervention compared to active control delivered by nonpeers for this population.

Design: Mixed methods, single-blind randomized controlled trial.

Setting: Community-based social service and aging organizations and geriatric primary care.

Participants: Low-income white older adults and those of color 50+ with depression.

Interventions: Peer Enhanced Depression Care and nonpeer, social interaction control.

Measurements: Primary outcome was depression (PHQ-9). Data were collected at baseline, postinterventions, 3, 6, 9, and 12 months. Poststudy interviews were conducted with both groups.

Results: Among 149 randomized participants, the mean age was 70, 84% were women, 52% Black and 41% White. Both groups experienced an average decrease of 3.7 (SE: 0.55, 95% CI: [-4.77, -2.63]) points in depression from baseline to postintervention and 2.56 (SE: 0.71, 95% CI: [-3.95, -1.17]) points from baseline to 12 months. Effect sizes at postintervention (Cohen's d = 0.81) and at 12-months (Cohen's d = 0.52) indicate large and medium effects, respectively. Both groups experienced decreases in loneliness and increases in adaptive coping and self-efficacy. Qualitative findings suggest the intervention group learned coping skills and experienced behavior change, whereas control group described a general positive experience.

Conclusions: Peer support intervention was not superior to social interactions delivered by nonpeers. Divergent quantitative and qualitative results suggest the need for additional effectiveness trials of peer support interventions outside of pandemic conditions. Trial Registration ClinicalTrials.gov Identifier: NCT04319094.

在 COVID-19 大流行期间对老年人进行同伴支持干预的混合方法有效性研究:随机临床试验结果。
目标:低收入白人老年人和有色人种老年人患抑郁症的风险更高,但接受治疗的可能性更小。我们评估了一对一同伴支持干预与非同伴提供的积极控制相比,对这一人群的影响:混合方法、单盲随机对照试验:地点:社区社会服务和老龄化组织以及老年初级保健机构:干预措施:同伴强化抑郁护理:干预措施:同伴抑郁强化护理和非同伴社会互动控制:主要结果是抑郁(PHQ-9)。在基线、干预后、3、6、9 和 12 个月时收集数据。研究后对两组参与者都进行了访谈:在 149 名随机参与者中,平均年龄为 70 岁,84% 为女性,52% 为黑人,41% 为白人。从基线到干预后,两组患者的抑郁程度平均下降了 3.7(SE:0.55,95% CI:[-4.77, -2.63])分,从基线到 12 个月,两组患者的抑郁程度平均下降了 2.56(SE:0.71,95% CI:[-3.95, -1.17])分。干预后(Cohen's d = 0.81)和干预 12 个月(Cohen's d = 0.52)的效应大小分别显示出较大和中等效应。两组的孤独感都有所下降,适应性应对和自我效能感都有所提高。定性研究结果表明,干预组学会了应对技巧并经历了行为改变,而对照组则描述了一般的积极体验:结论:同伴支持干预并不优于非同伴提供的社会互动。定量和定性结果的差异表明,有必要在大流行病之外对同伴支持干预措施进行更多的有效性试验。试验注册 ClinicalTrials.gov Identifier:NCT04319094。
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来源期刊
CiteScore
13.00
自引率
4.20%
发文量
381
审稿时长
26 days
期刊介绍: The American Journal of Geriatric Psychiatry is the leading source of information in the rapidly evolving field of geriatric psychiatry. This esteemed journal features peer-reviewed articles covering topics such as the diagnosis and classification of psychiatric disorders in older adults, epidemiological and biological correlates of mental health in the elderly, and psychopharmacology and other somatic treatments. Published twelve times a year, the journal serves as an authoritative resource for professionals in the field.
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