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Brief Video-Delivered Intervention to Reduce Anxiety and Improve Functioning in Older Veterans: Pilot Randomized
Christine E Gould1,2, Chalise Carlson1, Julie L Wetherell3,4
1Geriatric Research, Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, United States.
JMIR Aging
|December 9, 2024
Summary
Guided self-management interventions for older veterans with anxiety are feasible. The Healthy Living program showed greater promise than BREATHE for reducing anxiety symptoms and improving functioning.
Area of Science:
- Gerontology
- Psychiatry
- Mental Health
Background:
- Older veterans face significant barriers to mental health services.
- Guided self-management offers a potential solution for accessibility and provider shortages.
Purpose of the Study:
- To assess the feasibility and acceptability of a randomized controlled trial for guided self-management interventions.
- To compare the effectiveness of two interventions (relaxation and health psychoeducation) on anxiety and functioning in older veterans.
- To explore factors influencing home practice and engagement.
Main Methods:
- 56 older veterans with anxiety disorders were randomized to either BREATHE (Breathing, Relaxation, and Education for Anxiety Treatment in the Home Environment) or Healthy Living (psychoeducation).
- Interventions were video-delivered with weekly telephone coaching.
- Anxiety, depression, and functioning were measured at multiple time points, with qualitative interviews at study end.
Main Results:
- Both interventions were feasible and acceptable, with no difference in retention.
- The Healthy Living group completed more lessons than the BREATHE group.
- Neither intervention significantly reduced overall anxiety or improved functioning, though Healthy Living showed a greater decline in somatic anxiety.
Conclusions:
- Guided self-management interventions for late-life anxiety in veterans are feasible for larger trials.
- The BREATHE intervention was not effective in reducing anxiety compared to Healthy Living.
- Adherence to home practice was challenging, particularly for those with higher anxiety or medical comorbidity.
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