title: Calmer Life: A Culturally Tailored Intervention for Anxiety in Underserved Older Adults.
abstract: To evaluate the feasibility of the Calmer Life and Enhanced Community Care interventions delivered by community and expert providers and test their preliminary effectiveness on worry, generalized anxiety disorder (GAD) severity, anxiety, depression, sleep, health-related quality of life, and satisfaction.
  
  
  
  Small randomized trial, with measurements at baseline and 3 months.
  
  
  
  Underserved, low-income, mostly minority communities in Houston, TX.
  
  
  
  Forty underserved adults 50 years and older, with significant worry and principal or coprincipal GAD or anxiety disorder not otherwise specified.
  
  
  
  Combination of person-centered, flexible skills training to reduce worry; resource counseling to target unmet basic needs; and facilitation of communication with primary care providers developed through a community-academic partnership with social service and faith-based organizations. Religion/spirituality may be incorporated.
  
  
  
  
  
  
  
  worry (Penn State Worry Questionnaire-Abbreviated), GAD severity (GAD-7), anxiety (Geriatric Anxiety Inventory-Short Form).
  
  
  
  depression (Patient Health Questionnaire-8 and Geriatric Depression Scale-Short Form), sleep (Insomnia Severity Index), health-related quality of life (12-item Medical Outcomes Study Short Form), satisfaction (Client Satisfaction Questionnaire and exit interviews).
  
  
  
  Provider training was valid; mean ratings for community providers were well above average, with none less than adequate. Reach was excellent. Participants receiving the Calmer Life intervention had greater improvement in GAD severity and depression than those receiving Enhanced Community Care. Satisfaction with both treatments was equivalent.
  
  
  
  A larger comparative-effectiveness trial needs to examine outcomes following the Calmer Life intervention relative to standard community-based care and to evaluate more fully issues of implementation potential.
authors.affiliation: Houston VA HSR&D Center for Quality, Effectiveness, and Safety, Houston, TX, USA; Baylor College of Medicine, Houston, TX, USA; South Central Mental Illness Research, Education, and Clinical Center, USA. Electronic address: mstanley@bcm.edu.
authors.forename: Melinda A
authors.initials: MA
authors.lastname: Stanley
authors.affiliation: Houston VA HSR&D Center for Quality, Effectiveness, and Safety, Houston, TX, USA; Baylor College of Medicine, Houston, TX, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Wilson
authors.affiliation: Baylor College of Medicine, Houston, TX, USA; University of St. Thomas (SS), Houston, TX, USA.
authors.forename: Srijana
authors.initials: S
authors.lastname: Shrestha
authors.affiliation: Houston VA HSR&D Center for Quality, Effectiveness, and Safety, Houston, TX, USA; Baylor College of Medicine, Houston, TX, USA.
authors.forename: Amber B
authors.initials: AB
authors.lastname: Amspoker
authors.affiliation: Baylor College of Medicine, Houston, TX, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Armento
authors.affiliation: Southeastern University, Lakeland, FL, USA.
authors.forename: Jeremy P
authors.initials: JP
authors.lastname: Cummings
authors.affiliation: Houston VA HSR&D Center for Quality, Effectiveness, and Safety, Houston, TX, USA; Baylor College of Medicine, Houston, TX, USA.
authors.forename: Gina
authors.initials: G
authors.lastname: Evans-Hudnall
authors.affiliation: Houston VA HSR&D Center for Quality, Effectiveness, and Safety, Houston, TX, USA; Baylor College of Medicine, Houston, TX, USA.
authors.forename: Paula
authors.initials: P
authors.lastname: Wagener
authors.affiliation: Houston VA HSR&D Center for Quality, Effectiveness, and Safety, Houston, TX, USA; Baylor College of Medicine, Houston, TX, USA; South Central Mental Illness Research, Education, and Clinical Center, USA.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Kunik
mesh_terms: D000368:Aged; D001008:Anxiety Disorders / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003156:Community Mental Health Services / Q000592:standards; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D057566:Self Report; D012720:Severity of Illness Index; D013689:Telephone; D013781:Texas; D016896:Treatment Outcome; D035862:Vulnerable Populations
keywords: anxiety; behavior therapies; cognitive; older adults