title: BE-ACTIV for depression in nursing homes: primary outcomes of a randomized clinical trial.
abstract: OBJECTIVE
  To report the primary outcomes of a cluster randomized clinical trial of Behavioral Activities Intervention (BE-ACTIV), a behavioral intervention for depression in nursing homes.
  
  
  METHODS
  Twenty-three nursing homes randomized to BE-ACTIV or treatment as usual (TAU); 82 depressed long-term care residents recruited from these nursing homes. BE-ACTIV participants received 10 weeks of individual therapy after a 2-week baseline. TAU participants received weekly research visits. Follow-up assessments occurred at 3- and 6-month posttreatment.
  
  
  RESULTS
  BE-ACTIV group participants showed better diagnostic recovery at posttreatment in intent-to-treat analyses adjusted for clustering. They were more likely to be remitted than TAU participants at posttreatment and at 3-month posttreatment but not at 6 months. Self-reported depressive symptoms and functioning improved in both groups, but there were no significant treatment by time interactions in these variables.
  
  
  CONCLUSIONS
  BE-ACTIV was superior to TAU in moving residents to full remission from depression. The treatment was well received by nursing home staff and accepted by residents. A large proportion of participants remained symptomatic at posttreatment, despite taking one or more antidepressants. The results illustrate the potential power of an attentional intervention to improve self-reported mood and functioning, but also the difficulties related to both studying and implementing effective treatments in nursing homes.
authors.affiliation: Department of Psychological and Brain Sciences, University of Louisville, Kentucky. smeeks@louisville.edu.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Meeks
authors.affiliation: Polisher Research Institute, Abramson Center for Jewish Life, North Wales, Pennsylvania.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Van Haitsma
authors.affiliation: Department of Psychiatry and Behavioral Science, University of Louisville, Kentucky.
authors.forename: Ben
authors.initials: B
authors.lastname: Schoenbachler
authors.affiliation: Department of Biostatistics and Epidemiology, Georgia Regents University, Augusta.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Looney
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001521:Behavior Therapy / Q000379:methods*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D012074:Remission Induction; D016896:Treatment Outcome
keywords: Clinical trial.; Depression; Intervention; Nursing homes