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Journal article
Mediators of the Impact of a Home-Based Intervention (Beat the Blues) on Depressive Symptoms Among Older African Americans
Psychology and aging, v 29(3), pp 601-611
01 Sep 2014
PMID: 25244479
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Older African Americans (N = 208) with depressive symptoms were randomly assigned to a home-based nonpharmacologic intervention (Beat the Blues, or BTB) or wait-list control group. BTB was delivered by licensed social workers and involved up to 10 home visits focused on care management, referral and linkage, depression knowledge and efficacy in symptom recognition, instruction in stress reduction techniques, and behavioral activation through identification of personal goals and action plans for achieving them. Structured interviews by assessors masked to study assignment were used to assess changes in depressive symptoms (main trial endpoint), behavioral activation, depression knowledge, formal care service utilization, and anxiety (mediators) at baseline and 4 months. At 4 months, the intervention had a positive effect on depressive symptoms and all mediators except formal care service utilization. Structural equation models indicated that increased activation, enhanced depression knowledge, and decreased anxiety each independently mediated a significant proportion of the intervention's impact on depressive symptoms as assessed with 2 different measures (PHQ-9 and CES-D). These 3 factors also jointly explained over 60% of the intervention's total effect on both indicators of depressive symptoms. Our findings suggest that most of the impact of BTB on depressive symptoms is driven by enhancing activation or becoming active, reducing anxiety, and improving depression knowledge/efficacy. The intervention components appear to work in concert and may be mutually necessary for maximal benefits from treatment to occur. Implications for designing tailored interventions to address depressive symptoms among older African Americans are discussed.
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Details
- Title
- Mediators of the Impact of a Home-Based Intervention (Beat the Blues) on Depressive Symptoms Among Older African Americans
- Creators
- Laura N. Gitlin - Johns Hopkins UniversityDavid L. Roth - Johns Hopkins UniversityJin Huang - Johns Hopkins University
- Publication Details
- Psychology and aging, v 29(3), pp 601-611
- Publisher
- Amer Psychological Assoc
- Number of pages
- 11
- Grant note
- R01MH079814 / NATIONAL INSTITUTE OF MENTAL HEALTH; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH) #RO1 MH 079814; R01 MH079814 / NIMH NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Mental Health (NIMH)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Nursing and Health Professions; Drexel University
- Web of Science ID
- WOS:000342559900014
- Scopus ID
- 2-s2.0-84918767227
- Other Identifier
- 991020100181104721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Gerontology
- Psychology, Developmental