Depressive Symptoms Clinical Trial
Official title:
Resilience Against Depression Disparities (Also Known as Resilience Education to Reduce Depression Disparities)
Depressive symptoms and disorders are among the most common adult health conditions with a
lifetime prevalence of 15-20% and are a leading cause of disability /morbidity worldwide.
Although evidence-based approaches such as cognitive behavioral therapy (CBT), antidepressant
medications, and depression collaborative care and quality improvement (QI) programs
integrating depression care into primary health care can improve depression outcomes and
disparities, racial / ethnic disparities continue to persist. Concurrently, according to a
2011 Institute of Medicine (IOM) report, little information exists on how to address the high
rates of depression among sexual and gender minorities.
Our study randomizes depressed, LGBTQ (lesbian, gay, bisexual, transgendered, queer), racial
/ ethnic minority adults to an evidence-based agency-level, depression quality improvement
(QI) training [Resources for Services (RS)] and technical support alone or to a resiliency
class (RC+), a 7-session resiliency, cognitive behavioral therapy class to enhance mood +
automated mobile text reminders about basic reminders and care follow-up impact on improving
adult patients' depressive symptoms. Depression QI (RS) training will be offered to three
clusters of four to five LGBTQ-focused programs: two clusters in LA (Hollywood and South LA)
and one cluster in NO. Clusters are comprised of one primary care, one mental health, and two
to three community agencies (e.g., faith-based, social services/support, advocacy). All
programs will receive depression QI training. Enrolled adult depressed patients (n=320) will
be randomized individually to RC+ or RS (depression QI) alone to assess effects on primary
outcomes: depressive symptoms [8-item patient health questionnaire (PHQ-8) score and
secondary outcomes: mental health quality of life [12-item mental composite score (MCS-12) ≤
40], Resilience (Brief Resilience Scale), mental wellness, and physical health quality of
life [12-item physical composite (PCS-12)score] at 6- and 12-month follow-up.
Depressive symptoms and disorders are among the most common adult health conditions and are a
leading cause of disability /morbidity worldwide. Although evidence-based approaches such as
cognitive behavioral therapy (CBT), antidepressant medications, and depression collaborative
care and quality improvement (QI) programs integrating depression care into primary health
care can improve depression outcomes and disparities, racial / ethnic disparities continue to
persist. Concurrently, according to a 2011 Institute of Medicine (IOM) report notes little
information exists on how to address the high rates of depression among sexual and gender
minorities, largely composed of lesbian, gay, and bisexual (LGBTQ) individuals. Limited
comparative effectiveness data exists to know what treatments and services options improve
health disparities due to patient characteristics such as race / ethnicity, and sexual
orientation.
"Resilience Against Depression Disparities (RADD)" randomizes enrolled depressed, LGBTQ,
racial / ethnic minority adults (n=320) to an agency-level, evidence-based depression quality
improvement (QI) intervention [Resources for Services (RS)] training and technical support
and then randomizes individuals to Resources for Services alone or to Resiliency Class+, a
7-session resiliency, depression cognitive behavioral therapy class + automated mobile text
reminders about basic reminders and care follow-up impact on improving adult patients'
depressive symptoms over 6- and 12-months. RS training will be offered to three clusters of
four to five LGBTQ-focused programs: two clusters in LA (Hollywood and South LA) and one
cluster in NO. Clusters are comprised of one primary care, one mental health, and two to
three community agencies (e.g., faith-based, social services/support, advocacy). All programs
will receive RS (depression QI training). All enrolled adult depressed patients will be
within programs participating in RS (depression QI) trainings. Half of enrolled participants
will be randomized to the Resilience Class +.
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