A Low-intensity Behavioral Intervention for Depression in Older Adults Delivered by Lay Coaches: Proof-of-Concept Trial

Abstract

A broader workforce is necessary to expand U.S. geriatric mental health services. We examined (1) feasibility of training undergraduate students to deliver Do More, Feel Better (DMFB), an evidence-informed program for depression; and (2) feasibility, acceptability, and outcomes in a single-arm proof-of-concept trial. In Study 1, we taught DMFB to 18 upper-level undergraduate students and assessed fidelity using role plays. In Study 2, four students delivered six weekly DMFB sessions to 12 community-dwelling older adults (M = 66.83 years old, SD = 10.39) with depression (PHQ ≥ 10). Patient outcomes were change in pre- to post-treatment depressive symptoms, disability, and the target mechanism of increased activity. Fidelity was high in the course (Study 1; 82.4% of role plays rated as ‘passing’) and the trial (Study 2; 100% of 24 sessions rated as ‘passing’). The majority (83.3%) of patients were retained and evidenced statistically and clinically significant improvement in depressive symptoms (Hamilton Rating Scale for Depression [HAM-D]), disability (World Health Organization’s Disability Assessment Schedule 2.0 [WHODAS 2.0], and activity (Behavioral Activation for Depression Scale [BADS]). It is feasible to train bachelor’s-level students to deliver a brief, structured intervention for depression. Future research should consider implementation strategies and stakeholder feedback.

Citation

Renn, B. N., Sams, N., Areán, P. A., & Raue, P. J. (2022). A low-intensity behavioral intervention for depression in older adults delivered by lay coaches: Proof-of-concept trial. Aging & Mental Health, 1–8. https://doi.org/10.1080/13607863.2022.2084709