title: Activity scheduling as a core component of effective care management for late-life depression.
abstract: BACKGROUND
  Activity scheduling is an established component of evidenced-based treatment for late-life depression in primary care. We examined participant records from the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) trial to identify activity scheduling strategies used in the context of successful depression care management (CM), associations of activity scheduling with self-reported activity engagement, and depression outcomes.
  
  
  METHODS
  This study used observational mixed methods analysis of 4335 CM session notes from 597 participants in the intervention arm of the IMPACT trial. Grounded theory was used to identify 17 distinct activity categories from CM notes. Logistic regression was used to evaluate associations between activity scheduling, activity engagement, and depression outcomes at 12 months. All relevant institutional review boards approved the research protocol.
  
  
  RESULTS
  Seventeen distinct activity categories were generated. Most patients worked on at least one social and one solitary activity during their course of treatment. Common activity categories included physical activity (32%), medication management (22%), active-non-physical (19%), and passive (14%) activities. We found significant, positive associations between activity scheduling, self-reported engagement in activities at 12 months, and depression outcomes at 12 months.
  
  
  CONCLUSIONS
  Older primary care patients in CM for depression worked on a wide range of activities. Consistent with depression theory that has placed emphasis on social activities, the data indicate a benefit for intentional social engagement versus passive social and solitary activities. Care managers should encourage patients to balance instrumental activities (e.g., attending to medical problems) with social activities targeting direct interpersonal engagement.
authors.affiliation: University of Washington School of Medicine, Seattle, WA, USA. griebe@uw.edu
authors.forename: Genevieve
authors.initials: G
authors.lastname: Riebe
authors.forename: Ming-Yu
authors.initials: MY
authors.lastname: Fan
authors.forename: Jürgen
authors.initials: J
authors.lastname: Unützer
authors.forename: Steven
authors.initials: S
authors.lastname: Vannoy
mesh_terms: D000203:Activities of Daily Living; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D003865:Major Depressive Disorder / Q000628:therapy*; D015444:Exercise; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D010346:Patient Care Management; D011998:Recreation; D012919:Social Behavior