title: Delivery Characteristics, Acceptability, and Depression Outcomes of a Home-based Depression Intervention for Older African Americans: The Get Busy Get Better Program.
abstract: To facilitate replication, we examined delivery characteristics, acceptability, and depression outcomes of a home-based intervention, Get Busy Get Better, Helping Older Adults Beat the Blues (GBGB). GBGB, previously tested in a randomized trial, reduced depressive symptoms and enhanced quality of life in African Americans.
  
  
  
  A total of 208 African Americans aged above 55 years with Patient Health Questionnaire (PHQ-9) scores ≥5 on two subsequent screenings were randomized to receive GBGB immediately or 4 months later. GBGB involves up to 10 home sessions consisting of care management, referral/linkage, depression education/symptom recognition, stress reduction, and behavioral activation. Interventionists recorded delivery characteristics (dose, intensity) and perceived acceptability of sessions. Baseline and post-tests were used to characterize participants and examine associations between dose/intensity and depression scores. Participant satisfaction and perceived benefits were examined at 8 months.
  
  
  
  Of 208 participants, 181 (87%, mean age = 69.6) had treatment data. Of these, 165 (91.2%) had ≥3 treatment sessions (minimal dose). Participants had on average 8.1 sessions (SD = 2.6) for an average of 65.4min (SD = 18.3) each. Behavioral activation and care management were provided the most (average of six sessions for average duration = 17.9 and 22.2min per session respectively), although all participants received each treatment component. GBGB was perceived as highly acceptable and beneficial by interventionists and participants. More sessions and time in program were associated with greater symptom reduction.
  
  
  
  GBGB treatment components were highly acceptable to participants. Future implementation and sustainability challenges include staffing, training requirements, reimbursement limitations, competing agency programmatic priorities, and generalizability to other groups.
authors.affiliation: Johns Hopkins University School of Nursing Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, Maryland. lgitlin1@jhu.edu.
authors.forename: Laura N
authors.initials: LN
authors.lastname: Gitlin
authors.affiliation: Center in the Park, Philadelphia, Pennsylvania.
authors.forename: Lynn Fields
authors.initials: LF
authors.lastname: Harris
authors.affiliation: Center in the Park, Philadelphia, Pennsylvania.
authors.forename: Megan C
authors.initials: MC
authors.lastname: McCoy
authors.affiliation: University of Colorado, Denver, Aurora, Colorado.
authors.forename: Edward
authors.initials: E
authors.lastname: Hess
authors.affiliation: Sycamore Consulting LLC, New Hope, Pennsylvania.
authors.forename: Walter W
authors.initials: WW
authors.lastname: Hauck
mesh_terms: D001741:Black or African American; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003695:Delivery of Health Care; D003863:Depression / Q000628:therapy*; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012720:Severity of Illness Index; D000068217:Social Workers
chemical_list: D000928:Antidepressive Agents
keywords: Behavioral activation; Depression care; Home care; Treatment implementation