Journal Article

Preventing Depression in Later Life: Translation From Concept to Experimental Design and Implementation

Brown, Charlotte, Thomas, Stephen B., Miller, Mark D., Morse, Jennifer Q., Ford, Angela F., Stack, Jacqueline A., Reynolds, Charles F., Sriwattanakomen, Roy, Kasckow, John

2008

Overview

The authors detail the public health need for depression prevention research and the decisions made in designing an experiment testing problem solving therapy as “indicated” preventive intervention for high-risk older adults with subsyndromal depression. Special attention is given to the recruitment of African Americans because of well-documented inequalities in mental health services and depression treatment outcomes between races. A total of 306 subjects (half white, half African American) with scores of 16 or higher on the Center for Epidemiological Studies of Depression Scale, but with no history of major depressive disorder in the past 12 months, are being recruited and randomly assigned to either problem solving therapy-primary care or to a dietary education control condition. Time to, and rate of, incident episodes of major depressive disorder are to be modeled using survival analysis. Level of depressive symptoms will be analyzed via a mixed models approach. Twenty-two subjects have been recruited into the study, and to date eight have completed the randomly assigned intervention and postintervention assessment. Four of 22 have exited after developing major depressive episodes. None have complained about study procedures or demands. Implementation in a variety of community settings is going well. The data collected to date support the feasibility of translating from epidemiology to RCT design and implementation of empirical depression prevention research in later life.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Adults / African American / African Americans / Aged / Behavior Therapy / Black or African American / Black People - psychology / Clinical outcomes / Decision making / Depression prevention / Depressive Disorder - diagnosis / Depressive Disorder - ethnology / Depressive Disorder - prevention & control / Depressive Disorder - psychology / Depressive personality disorders / elderly / Epidemiology / Feasibility / Feasibility Studies / Female / Health disparities / Health Education / Health Plan Implementation / High risk / Humans / Implementation / indicated preventive intervention / Inequality / Internal Medicine / Intervention / Male / Medical treatment / Mental depression / Mental health services / Older people / Personality Inventory / Prevention / Primary care / Primary Health Care / Problem solving / Psychotherapy, Brief / Public health / Recruitment / Research design / Therapy / Translation / Treatment outcomes / White People - psychology