Home-based telebehavioral health for U.S. military personnel and veterans with depression: A randomized controlled trial.
OBJECTIVE
Evidence of feasibility, safety, and effectiveness of home-based telebehavioral health (HBTBH) needs to be established before adoption of HBTBH in the military health system can occur. The purpose of this randomized controlled noninferiority trial was to compare the safety, feasibility, and effectiveness of HBTBH to care provided in the traditional in-office setting among military personnel and veterans.


METHODS
One hundred and twenty-one U.S. military service members and veterans were recruited at a military treatment facility and a Veterans Health Administration hospital. Participants were randomized to receive 8 sessions of behavioral activation treatment for depression (BATD) either in the home via videoconferencing (VC) or in a traditional in-office (same room) setting. Participants were assessed at baseline, midtreatment (4 weeks), posttreatment (8 weeks), and 3 months posttreatment.


RESULTS
Mixed-effects modeling results with Beck Hopelessness Scale and Beck Depression Inventory II scores suggested relatively strong and similar reductions in hopelessness and depressive symptoms for both groups; however, noninferiority analyses failed to reject the null hypothesis that in-home care was no worse than in-office treatment based on these measures. There were not any differences found between treatment groups in regards to treatment satisfaction. Safety procedures were successfully implemented, supporting the feasibility of home-based care.


CONCLUSIONS
BATD can be feasibly delivered to the homes of active duty service members and veterans via VC. Small-group differences suggest a slight benefit of in-person care over in-home telehealth on some clinical outcomes. Reasons for this are discussed. (PsycINFO Database Record
National Center for Telehealth and Technology.
David D
DD
Luxton
National Center for Telehealth and Technology.
Larry D
LD
Pruitt
Veterans Affairs Portland Health Care System.
Amy
A
Wagner
National Center for Telehealth and Technology.
Derek J
DJ
Smolenski
National Center for Telehealth and Technology.
Michael A
MA
Jenkins-Guarnieri
National Center for Telehealth and Technology.
Gregory
G
Gahm
D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D003863:Depression / Q000628:therapy*; D003865:Major Depressive Disorder / Q000628:therapy*; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D017216:Telemedicine / Q000379:methods*; D014728:Veterans / Q000523:psychology*; D055815:Young Adult