Generalized Anxiety Disorder Clinical Trial
Official title:
Calmer Life: A Randomized Controlled Trial of a Participant-Centered Treatment for Anxiety in Low-Income, Older Adults
The overall goals of the proposed research study are to: (1) examine quantitative outcomes in a well-conducted randomized clinical trial of Calmer Life, relative to Enhanced Community Care, an information and referral intervention that represents care in a real-world community-service environment, and (2) evaluate implementation feasibility, which includes training community providers; examining program reach, engagement, acceptability, and barriers-facilitators; and preparing practical tools for replicating the program.
Cognitive behavioral treatment (CBT) produces positive outcomes for late-life worry/GAD in
academic and primary care settings, but minorities are significantly underrepresented in
clinical trials, and standard CBT poorly addresses the needs of low-income minority older
adults in underserved communities. More attention needs to be given to service delivery of
anxiety treatments for underserved older adults. Calmer Life (CL) is a culturally tailored,
participant-centered research study that offers a skills-based intervention for late-life
anxiety and includes other elements of care to meet the needs of underserved, minority older
adults, including the option to integrate religion/spirituality (R/S), flexible delivery
modes, and modular treatment format.
Participants will be randomly assigned to CL or Enhanced Community Care(ECC). CL and ECC
will be provided by behavioral health clinicians recruited from partner organizations,
psychology trainees, and other research staff over 3 months. Assessments will occur at
baseline and 3 months.
Participants in the CL condition can choose up to 12 individual skill sessions, and will be
recommended to complete a minimum of 6 sessions. If participants desire to incorporate R/S,
an R/S assessment occurs during session 2 to help the provider understand the participant's
beliefs and practices. R/S can be integrated into any of the skills learned during the
intervention (e.g., deep breathing, self-statements, sleep management) or omitted entirely.
Participants in the ECC condition will receive brief biweekly check in calls to provide
information about community resources (including mental health), offer emotional support,
and assess symptom severity and need for crisis intervention. Emergency procedures will be
followed in crisis situations. After 3 months of ECC is completed, participants in the ECC
group will be offered the CL intervention.
Outcome measures will be administered for participants in both groups at baseline, 1 month,
and 3 months. Participants in ECC will complete measures at 6 months after completion of CL.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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