Leveraging Aging Service Providers to Support Internet-Based Cognitive Behavioral Therapy for Depression in Homebound...

Area of Science:

• Gerontology
• Mental Health Technology
• Implementation Science

Background:

• Homebound older adults experience high rates of depression and face significant barriers to mental healthcare access.
• Existing interventions often fail to meet the unique needs of this population.
• Empower@Home, an internet-based cognitive behavioral therapy (iCBT) program, has shown promise in reducing depression but requires real-world validation.

Purpose of the Study:

• To evaluate the real-world effectiveness of the Empower@Home iCBT program integrated into community aging services.
• To assess the feasibility of using nonclinician agency staff as coaches for older adults using Empower@Home.
• To conduct a qualitative process evaluation of the implementation.

Main Methods:

• A type 1 hybrid effectiveness-implementation trial with a 2-arm randomized controlled design.
• 256 homebound older adults recruited from 3 community aging service agencies.
• Participants randomized to immediate Empower@Home or a control group receiving usual care with enhanced support.

Main Results:

• Recruitment initiated October 2024, with completion anticipated by April 2028.
• Analysis of primary (depressive symptoms) and secondary outcomes (social isolation, quality of life, etc.) will occur post-trial.
• Data collection includes baseline, 12-week, 24-week, and 36-week assessments.

Conclusions:

• This study will determine the real-world effectiveness and implementation feasibility of Empower@Home in community aging services.
• Findings could establish a scalable model for technology-assisted mental healthcare delivery to underserved older adults.
• Successful integration could significantly improve access to mental health support for homebound seniors.