title: A home-based intervention to reduce depressive symptoms and improve quality of life in older African Americans: a randomized trial.
abstract: BACKGROUND
  Effective care models for treating older African Americans with depressive symptoms are needed.
  
  
  OBJECTIVE
  To determine whether a home-based intervention alleviates depressive symptoms and improves quality of life in older African Americans.
  
  
  METHODS
  Parallel, randomized trial stratified by recruitment site. Interviewers assessing outcomes were blinded to treatment assignment. (ClinicalTrials.gov: NCT00511680).
  
  
  METHODS
  A senior center and participants' homes from 2008 to 2010.
  
  
  METHODS
  African Americans aged 55 years or older with depressive symptoms.
  
  
  METHODS
  A multicomponent, home-based intervention delivered by social workers or a wait-list control group that received the intervention at 4 months.
  
  
  METHODS
  Self-reported depression severity at 4 months (primary outcome) and depression knowledge, quality of life, behavioral activation, anxiety, function, and remission at 4 and 8 months.
  
  
  RESULTS
  Of 208 participants (106 and 102 in the intervention and wait-list groups, respectively), 182 (89 and 93, respectively) completed 4 months and 160 (79 and 81, respectively) completed 8 months. At 4 months, participants in the intervention group showed reduced depression severity (difference in mean change in Patient Health Questionnaire-9 score from baseline, -2.9 [95% CI, -4.6 to -1.2]; difference in mean change in Center for Epidemiologic Studies Depression Scale score from baseline, -3.7 [CI, -5.4 to -2.1]); improved depression knowledge, quality of life, behavioral activation, and anxiety (P < 0.001); and improved function (P = 0.014) compared with wait-list participants. More intervention than wait-list participants entered remission at 4 months (43.8% vs. 26.9%). After treatment, control participants showed benefits similar in magnitude to those of participants in the initial intervention group. Those in the initial intervention group maintained benefits at 8 months.
  
  
  CONCLUSIONS
  The study had a small sample, short duration, and differential withdrawal rate.
  
  
  CONCLUSIONS
  A home-based intervention delivered by social workers could reduce depressive symptoms and enhance quality of life in most older African Americans.
  
  
  BACKGROUND
  National Institute of Mental Health.
authors.forename: Laura N
authors.initials: LN
authors.lastname: Gitlin
authors.forename: Lynn Fields
authors.initials: LF
authors.lastname: Harris
authors.forename: Megan C
authors.initials: MC
authors.lastname: McCoy
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Chernett
authors.forename: Laura T
authors.initials: LT
authors.lastname: Pizzi
authors.forename: Eric
authors.initials: E
authors.lastname: Jutkowitz
authors.forename: Edward
authors.initials: E
authors.lastname: Hess
authors.forename: Walter W
authors.initials: WW
authors.lastname: Hauck
mesh_terms: D000339:Affect; D001741:Black or African American; D000368:Aged; D001007:Anxiety; D003863:Depression / Q000208:ethnology* / Q000628:therapy*; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016037:Single-Blind Method; D014850:Waiting Lists
references.citation: Med Care. 1999 Oct;37(10):1034-45
references.pmid: 10524370
references.citation: Int J Geriatr Psychiatry. 2009 Dec;24(12):1325-34
references.pmid: 19391184
references.citation: Arch Psychiatr Nurs. 2005 Feb;19(1):3-9
references.pmid: 15765366
references.citation: J Am Geriatr Soc. 2007 Dec;55(12):1903-11
references.pmid: 18081668
references.citation: JAMA. 1997 Jan 1;277(1):25-31
references.pmid: 8980206
references.citation: J Am Geriatr Soc. 2004 May;52(5):741-8
references.pmid: 15086655
references.citation: JAMA. 2004 Apr 7;291(13):1569-77
references.pmid: 15069044
references.citation: Am J Geriatr Psychiatry. 2010 Jun;18(6):460-3
references.pmid: 21217557
references.citation: Gerontologist. 2008 Dec;48(6):828-38
references.pmid: 19139256
references.citation: J Gen Intern Med. 2001 Sep;16(9):606-13
references.pmid: 11556941
references.citation: BMC Geriatr. 2012 Feb 10;12:4
references.pmid: 22325065
references.citation: PLoS Med. 2008 Feb;5(2):e45
references.pmid: 18303940
references.citation: JAMA. 2010 Jan 6;303(1):47-53
references.pmid: 20051569
references.citation: Am J Prev Med. 2007 Sep;33(3):175-81
references.pmid: 17826575
references.citation: Am J Geriatr Psychiatry. 2012 Nov;20(11):973-84
references.pmid: 22643600
references.citation: Am J Public Health. 2012 Feb;102(2):319-28
references.pmid: 22390446
references.citation: Arch Gen Psychiatry. 2003 Oct;60(10):1009-14
references.pmid: 14557146
references.citation: Am J Psychiatry. 2005 Apr;162(4):718-24
references.pmid: 15800144
references.citation: Psychosom Med. 2002 May-Jun;64(3):510-9
references.pmid: 12021425
references.citation: Am J Geriatr Psychiatry. 2008 Dec;16(12):948-56
references.pmid: 19038893
references.citation: Home Health Care Serv Q. 2006;25(1-2):115-48
references.pmid: 16803741
references.citation: Arch Gerontol Geriatr. 2012 Nov-Dec;55(3):522-9
references.pmid: 22483200
references.citation: Br J Psychiatry. 2010 Dec;197(6):463-7
references.pmid: 21119152
references.citation: Eval Rev. 2004 Feb;28(1):28-51
references.pmid: 14750290
references.citation: Med Care. 2005 Apr;43(4):381-90
references.pmid: 15778641
references.citation: Am J Geriatr Psychiatry. 2001 Spring;9(2):113-35
references.pmid: 11316616
references.citation: Med Care. 2003 Apr;41(4):479-89
references.pmid: 12665712
references.citation: JAMA. 2012 Mar 14;307(10):1033-4
references.pmid: 22416097
references.citation: Ann Intern Med. 2007 May 15;146(10):689-98
references.pmid: 17502629
references.citation: Int J Public Health. 2007;52(3):135-6
references.pmid: 17958277
references.citation: Am J Psychiatry. 2005 Jan;162(1):184-6
references.pmid: 15625220
references.citation: Am J Geriatr Psychiatry. 2010 Jun;18(6):491-501
references.pmid: 21217560
references.citation: Am J Alzheimers Dis Other Demen. 2006 Oct-Nov;21(5):304-11
references.pmid: 17062548
references.citation: Neurology. 2010 Jul 6;75(1):35-41
references.pmid: 20603483
references.citation: Int J Geriatr Psychiatry. 2011 Dec;26(12):1211-20
references.pmid: 21308789
references.citation: J Health Soc Behav. 2003 Sep;44(3):353-69
references.pmid: 14582313
references.citation: J Am Geriatr Soc. 2010 Jan;58(1):154-60
references.pmid: 20122047
references.citation: Clin Psychol Rev. 2003 Oct;23(5):699-717
references.pmid: 12971906
references.citation: N Engl J Med. 2013 Feb 7;368(6):493-6
references.pmid: 23343039
references.citation: JAMA. 2002 Dec 11;288(22):2836-45
references.pmid: 12472325
references.citation: J Am Geriatr Soc. 2003 Dec;51(12):1808-9
references.pmid: 14687363