Collaborative Stepped-care Intervention for Adults With Subthreshold Depressive Symptoms in the Primary Care Setting

Summary

To ensure accessibility and availability of mental health services in the community and to reduce the burden associated with depression and related conditions, the study aim to evaluate the effectiveness of a collaborative stepped-care intervention (cognitive behavioural therapy-based) for adults with subthreshold depressive symptoms at the district-based primary healthcare setting.

Conditions

• Depression

Interventions

BEHAVIORAL

Cognitive behavioural therapy (CBT)-based intervention with stepped-care

After initial clinical assessment, participants will be offered interventions based on their depressive symptom severity (Patient Health Questionnaire-9-item \[PHQ-9\]). Mild symptoms (PHQ-9=5-9) without major risks (\*see above): 4 weekly CBT-informed intervention sessions led by trained Emotional Support Assistants (Peer Supporters with 80hrs mental health training + 15hrs intensive clinical training). Mild symptoms (PHQ-9=5-9) with major risk factors or moderate-to-moderately severe symptoms (PHQ-9=10-19): 6 weekly CBT-based intervention sessions led by trained clinical social workers, with 2 booster sessions as necessary. Individual CBT-based intervention will be provided to those unsuitable for group interventions. In cases of non-remission (PHQ-9≥5): a second intervention trial will be provided. Those needing additional support will be referred to a partnered General Practitioner (if PHQ-9=10-19) or referred to more intensive psychological or psychiatric services as needed.

OTHER

Care-as-usual

Following an initial interview session with research assessments, participants continue with their usual care at their primary care setting.

Sponsors & Collaborators

• The Hong Kong Jockey Club Charities Trust

  collaborator OTHER

• Baptist Oi Kwan Social Service

  collaborator OTHER

• Caritas Hong Kong, Hong Kong

  collaborator UNKNOWN

• Christian Family Service Centre

  collaborator OTHER

• Fu Hong Society

  collaborator UNKNOWN

• Haven of Hope Hospital

  collaborator OTHER

• Hong Kong Christian Service

  collaborator OTHER

• Hong Kong Sheng Kung Hui Welfare Council Limited

  collaborator OTHER

• Hong Kong Young Women's Christian Association

  collaborator OTHER

• The Mental Health Association of Hong Kong

  collaborator OTHER

• Neighbourhood Advice-Action Council

  collaborator OTHER

• New Life Psychiatric Rehabilitation Association

  collaborator OTHER

• Richmond Fellowship of Hong Kong

  collaborator UNKNOWN

• Hong Kong Sheng Kung Hui Lady MacLehose Centre

  collaborator UNKNOWN

• SideBySide

  collaborator UNKNOWN

• St. James' Settlement

  collaborator OTHER

• The Hong Kong Society for the Aged

  collaborator UNKNOWN

• The Salvation Army, Hong Kong and Macau Command

  collaborator OTHER

• Tung Wah Group of Hospitals

  collaborator OTHER

• The University of Hong Kong

  lead OTHER

Principal Investigators

• Terry YS Lum, Ph.D. · The University of Hong Kong

• Gloria HY Wong, Ph.D. · University of Reading; The University of Hong Kong

• Wai Chi Chan, MBChB · The University of Hong Kong

Study Design

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

45 Years

Max Age

59 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2024-12-23

Primary Completion

2027-06-30

Completion

2027-06-30

Countries

• Hong Kong

Study Locations