Leveraging Adult Protective Service Interaction to Offer Evidence-Based Treatment for Depression in Elder Neglect/Self Neglect

NCT06910267 | Not Yet Recruiting

• 2 other identifiers: HSC-MS-24-10211P30AG086563-01
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to test the feasibility and acceptability of an evidence-based treatment for depression delivered over an ipad, computer, or smartphone can help Adult Protective Services (APS) clients with their activities of daily living to evaluate whether reductions on measures of depression and apathy (a) mediate reduced Elder Neglect/Self Neglect (EN/SN) behaviors; and (b) whether secondary posited mediating mechanisms are also active in impacting depression and apathy

Conditions

Depression in Old Age

Keywords

Elder neglect; Self neglect

Outcome Measures

Primary Outcomes (3)

• Change in depression as assessed by the Patient Depression Questionnaire (PHQ-9)

  This is 9 item questionnaire and each is scored from 0 (not at all) to 3 (nearly every day), for a maximum score of 27, higher score indicating more depression

  baseline, post-treatment ( 8 weeks after baseline), and 3 months

• Change in apathy as assessed by the Apathy Motivations Index (AMI)

  This is an 18 item questionnaire and each item is scored on a scale from 0(completely true) to 4(completely untrue), for a maximum score of 72, with higher scores indicating greater apathy

  baseline, post-treatment ( 8 weeks after baseline), and 3 months

• Change in Elder Neglect/Self Neglect (EN/SN) as evidenced by study developed goal attainment scale

  Participants will be given a list of 19 common daily activities and will be asked to pick one or more activities form the list that they would like to start doing or do more regularly each day or week.Each activity will be then scored based on the following scoring criteria, higher score indicating better outcome : (Much less than expected)-2 (Somewhat less than expected)-1 (Expected client outcome)0 (Somewhat better than expected)+1 (Much better than expected)+2

  baseline, post-treatment ( 8 weeks after baseline), and 3 months

Secondary Outcomes (2)

• Change in social connection as assessed by the Lubben Social Network Scale

  baseline, post-treatment ( 8 weeks after baseline), and 3 months

• Change in social isolation as assessed by Patient-Reported Outcomes Measurement Information System (PROMIS 8)

  baseline, post-treatment ( 8 weeks after baseline), and 3 months

Study Arms (2)

APS Treatment as Usual

ACTIVE COMPARATOR

Behavioral: APS Treatment as Usual

Intervention-Behavioral Activation (BA)

EXPERIMENTAL

Behavioral: Intervention-Behavioral Activation (BA)

Interventions

APS Treatment as Usual BEHAVIORAL

APS agencies conduct in-home investigations of alleged abuse and neglect against disabled and older adults. Investigations result in short-term stop-gap measures, primarily brief case-management centering on referral linkage to community-based services and provision of resource allocation. No direct psychological services or treatments are provided by APS, however referral to other services is also standard.

APS Treatment as Usual

Intervention-Behavioral Activation (BA) BEHAVIORAL

Participants will be will be guided through 8 one-hour sessions via home telehealth by the study community health worker. Each weekly \< 60 minute BA session will include modules focusing on 1) Psychoeducation for depression and techniques for self-management, including pharmacologic and psychosocial treatment options; 2) Introduction of BA and guided problem-solving techniques to enhance self efficacy for managing depression and other chronic illnesses; 3) BA and problem-solving techniques to support medication management and adherence strategies; 4) BA to develop strategies and techniques for communicating with health providers and/or support resources to foster positive mood and self management; and 5) Developing a relapse prevention plan, which includes identifying triggers for lower functioning, support resources, and practice of BA techniques.

Intervention-Behavioral Activation (BA)

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)

You may qualify if:

• APS Case in APS Region VI- Must have open case
• PHQ 9 score- Must have score of nine (9) or more

You may not qualify if:

• Previous mental health diagnosis of bipolar disorder, psychotic disorders, and moderate to severe dementia
• Assessment of Consent Proxy- Those who need assessment of consent proxy
• Suicidal Intent (as indexed by PhQ-9 question 9)- Those scoring 2 or 3
• Current Alcohol and Drug Dependency- As evidenced by Cut down, Annoyed, Guilty, and Eye-opener (CAGE) score of 3 or more

Sponsors & Collaborators

• The University of Texas Health Science Center, Houston: lead
• National Institute on Aging (NIA): collaborator

Study Sites (1)

The University of Texas Health Science Center at Houston

Houston, Texas, 77030, United States

Location

Study Officials

• Leila Wood, PhD, MSSW

  The University of Texas Health Science Center, Houston

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Leila Wood, PhD, MSSW

CONTACT

(713) 486-2700; Leila.G.Wood@uth.tmc.edu

Jason Burnett

CONTACT

(713) 873-4685; Jason.Burnett@uth.tmc.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: professor

Study Record Dates

• First Submitted: March 24, 2025
• First Posted: April 4, 2025
• Study Start: July 21, 2025
• Primary Completion: March 31, 2026
• Study Completion: March 31, 2026
• Last Updated: July 2, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)