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Feasibility of a family-centered intervention for depressed older men in primary care.

Authors
  • Hinton, Ladson1
  • La Frano, Erika2
  • Harvey, Danielle3
  • Alfaro, Eduardo Delgadillo1
  • Kravitz, Richard4
  • Smith, Andrew5
  • Apesoa-Varano, Ester Carolina6
  • Jafri, Asma5
  • Unutzer, Jurgen7
  • 1 Department of Psychiatry and Behavioral Sciences, University of California at Davis, Sacramento, California, USA.
  • 2 Community Health Centers Del Valle, Santa Maria, California, USA.
  • 3 Department of Public Health Sciences, University of California at Davis, Sacramento, California, USA.
  • 4 Department of Internal Medicine, University of California at Davis, Sacramento, California, USA.
  • 5 San Joaquin General Hospital, French Camp, California, USA.
  • 6 Betty Irene Moore School of Nursing, University of California at Davis, Sacramento, California, USA.
  • 7 Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA.
Type
Published Article
Journal
International journal of geriatric psychiatry
Publication Date
Dec 01, 2019
Volume
34
Issue
12
Pages
1808–1814
Identifiers
DOI: 10.1002/gps.5196
PMID: 31414506
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Families provide considerable support to many older adults with depression, yet few intervention studies have sought to include them. Family participation in depression treatment aligns with the preferences of older men, a group at high risk for depression under treatment. This study examined the feasibility of a family-centered depression intervention for older men in a primary care setting. A clinical trial was conducted in a Federally Qualified Health Center (FQHC) in California's Central Valley. Depressed older men (age 50 and older) were allocated to usual care enhanced by depression psychoeducation or a family-centered depression intervention delivered by a licensed clinical social worker. Intervention feasibility was assessed in terms of recruitment, retention, and extent of family engagement. The PHQ-9 was administered at baseline, 1, 3, and 6 months. For more than 6 months, 45 men were referred to the study; 31 met the inclusion criteria, 23 were successfully enrolled, and 20 (88%) participated in more than or equal to one treatment sessions. Overall, 85% (11 of 13) of men allocated to the intervention engaged a family member in more than or equal to one session and 54% (7 of 13) engaged the family member in more than or equal to three sessions. While men in both groups showed evidence of a significant decline in PHQ-9 scores early on, which attenuated over time, there were no significant between group differences. Our family-centered depression intervention showed acceptable feasibility on the basis of a variety of parameters. Future research on family-based approaches may benefit from longer duration and more intensive treatment as well as additional strategies to overcome recruitment barriers. © 2019 John Wiley & Sons, Ltd.

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