BRIGHTEN Heart: Design and baseline characteristics of a randomized controlled trial for minority older adults with depression and cardiometabolic syndrome.
African American and Hispanic elderly are at elevated risk of both depression and cardiovascular disease, relative to non-Hispanic whites. Effective interventions are therefore needed to address depressive symptoms and to reduce these disparities. BRIGHTEN Heart was a behavioral randomized controlled trial to test the efficacy of a virtual team intervention in reducing depressive symptoms in minority elderly as measured by the 9-item Patient Health Questionnaire (PHQ9).



250 African American and Hispanic adults, age ≥60 years, with comorbid depression and overweight/obesity were randomized. Participants randomized to the Intervention condition received a social work evaluation, team-based electronic consultation, case management, and psychotherapy over a 12 month period. Control participants were enrolled in a membership program that provided health classes and other services to support chronic disease self-management. Blinded research assistants completed assessments at baseline, and 6 and 12 months postrandomization.



The study population was characterized by low socioeconomic status, with 81.4% having a household income of less than $20,000. Although median depression scores were in the mild range, 25% of participants had scores showing moderate to severe depression at baseline. 75% of participants had four or more chronic conditions. Significant demographic and clinical differences were observed between the African American and Hispanic populations.



BRIGHTEN Heart was designed to rigorously test the efficacy of a multi-level intervention to reduce comorbid depressive symptoms and cardiovascular risk in minority elderly. Investigators successfully recruited a cohort well suited to testing the study hypothesis.
Departments of Preventive Medicine and Family Medicine, Rush Medical College, USA.
S K
SK
Rothschild
Department of Behavioral Sciences, Rush Medical College, USA.
E E
EE
Emery-Tiburcio
Department of Behavioral Sciences, Rush Medical College, USA.
L J
LJ
Mack
Department of Preventive Medicine, Rush Medical College, USA.
Y
Y
Wang
Department of Preventive Medicine, Rush Medical College, USA.
E F
EF
Avery
Rush Alzheimer's Disease Center, Rush University Medical Center, USA.
H
H
Li
Health and Aging Programs, Rush University Medical Center, USA.
R L
RL
Golden
Department of Preventive Medicine, Rush Medical College, USA.
L H
LH
Powell
D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D000071069:Multiple Chronic Conditions; D009765:Obesity / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology; D010346:Patient Care Management; D010348:Patient Care Team; D000073222:Patient Health Questionnaire; D011203:Poverty; D011320:Primary Health Care; D011613:Psychotherapy; D012923:Social Class
Cardiometabolic syndrome; Depression; Multidisciplinary team intervention; Older adults; Primary care