Integrated Tele-Behavioral Activation and Fall Prevention for Low-income Homebound Seniors With Depression

Summary

This study will test clinical and cost effectiveness of an integrated tele- and bachelor's-level counselor/coach delivered behavioral activation (BA) and fall prevention (FP) for low-income homebound older adults. The long-term objective of the proposed study is to improve access to depression treatment and fall prevention for growing numbers of low-income homebound seniors. We plan to recruit 320 low-income, racially diverse homebound seniors who are served by a home-delivered meal (HDM) program and other aging-service agencies in Central Texas. In a 4-arm, pragmatic clinical trial with randomization prior to consent, the participants in the integrated Tele-BA and FP (TBF hereafter) arm will receive 5 Tele-BA sessions and 4 in-home FP sessions. Those in the Tele-BA or FP alone arms will receive the respective intervention and 4 bimonthly telephone check-in (booster) calls, and those in the Attention Control (AC) arm will receive 5 weekly telephone check-in calls followed by 4 bimonthly follow-up calls. Follow-up assessments will be at 12, 24, and 36 weeks after baseline.

Eligibility

Inclusion Criteria:

* Age 50+
* English or Spanish proficiency
* 24-item Hamilton Rating Scale for Depression score \> 15
* 12-item Fall Risk Questionnaire score \>4

Exclusion Criteria:

* Recently (\< 4 weeks) initiated or modified antidepressant pharmacotherapy
* High suicide risk
* Probable dementia
* Bipolar disorder
* Substance use/misuse
* Current participation in any psychotherapy or FP program
* Bedbound status

Conditions3

Locations1 site

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