Abstract

Objectives

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.

Method

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.

Results

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]).

Conclusion

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.

中文翻译：

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由非专业教练对老年人抑郁症进行低强度行为干预：概念验证试验

 抽象的

 目标

扩大美国老年心理健康服务需要更广泛的劳动力。我们研究了（1）培训本科生开展“做得更多，感觉更好”（DMFB）的可行性，这是一个针对抑郁症的循证项目； (2) 单臂概念验证试验的可行性、可接受性和结果。

 方法

在研究 1 中，我们向 18 名高年级本科生教授 DMFB，并通过角色扮演评估忠诚度。在研究 2 中，四名学生为 12 名社区居住的患有抑郁症 (PHQ ≥ 10) 的老年人（ M = 66.83 岁， SD = 10.39）提供了六次每周一次的 DMFB 课程。患者结果是治疗前后抑郁症状、残疾和增加活动的目标机制的变化。

 结果

课程（研究 1；82.4% 的角色扮演被评为“通过”）和试验（研究 2；24 场课程中 100% 被评为“通过”）的保真度很高。大多数 (83.3%) 患者得到保留，并在抑郁症状（汉密尔顿抑郁评定量表 [HAM-D]）、残疾（世界卫生组织残疾评估表 2.0 [WHODAS 2.0]）和活动（抑郁行为激活量表 [BADS]）。

 结论

培训本科生对抑郁症进行简短、结构化的干预是可行的。未来的研究应考虑实施策略和利益相关者的反馈。