Resilience Against Depression Disparities (Also Known as Resilience Education to Reduce Depression Disparities)

Summary

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.

Conditions

• Depressive Symptoms

Interventions

BEHAVIORAL

Resiliency Class

See Arm Description

OTHER

Resource for Services (RS)

See Resource for Services (RS) Description

Sponsors & Collaborators

• Louisiana State University Health Sciences Center in New Orleans

  collaborator OTHER

• Tulane University

  collaborator OTHER

• Healthy African American Families II

  collaborator UNKNOWN

• University of California, San Francisco

  collaborator OTHER

• Arming Minorities Against Addiction & Disease

  collaborator UNKNOWN

• Louisiana Community Health Outreach Network

  collaborator UNKNOWN

• Bowen Chung, MD, MSHS

  lead OTHER

Principal Investigators

• Bowen Chung, MD, MSHS · University of California, Los Angeles

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2017-05-04

Primary Completion

2019-08-01

Completion

2019-11-01

Countries

• United States

Study Locations