Key result
The BRIGHTEN Heart intervention led to a significantly higher rate of >50% reduction in PHQ-9 depression scores compared to the control program (70.7% vs 56.3%; p=0.036).
Why the study?
Does the BRIGHTEN Heart intervention reduce symptoms of depression in urban minority older adults with elevated depressive symptoms and BMI?
RCT (n=250)
Yes
Does the BRIGHTEN Heart intervention reduce symptoms of depression in urban minority older adults with elevated depressive symptoms and BMI?
The BRIGHTEN Heart intervention showed a small benefit in depression trajectory at 12 months and a higher rate of >50% reduction in depressive symptoms compared to an educational program alone in minority older adults.
Supports BRIGHTEN Heart for depression reduction in urban minority older adults; extends integrated behavioral evidence to this underserved population.
OBJECTIVE: Assess the effectiveness of an interdisciplinary geriatric team intervention in decreasing symptoms of depression among urban minority older adults in primary care. Secondary outcomes included cardiometabolic syndrome and trauma. METHOD: 250 African American and Hispanic older adults with PHQ-9 scores ≥ 8 and BMI ≥ 25 were recruited from 6 underserved urban primary care clinics. Intervention arm participants received the BRIGHTEN Heart team intervention plus membership in Generations, an older adult educational activity program; comparison participants received only Generations. RESULTS: Both arms demonstrated clinically significant improvements in PHQ-9 scores at 6 months (-5 points, intervention and comparison) and 12 months (-7 points intervention, -6.5 points comparison); there was no significant difference in change scores between groups on depression or cardiometabolic syndrome at 6 months; there was a small difference in depression trajectory at 12 months (p < .001). More participants in the treatment group (70.7%) had greater than 50% reduction in PHQ-9 scores than the comparison group (56.3%; p = .036). For those with higher PTSD symptoms (PCL-C6), improvement in depression was significantly better in the intervention arm than the comparison arm, regardless of baseline PHQ-9 (p = .001). In mixed models, those with higher PTSD symptoms (β = -0.012, p = < 0.001) in the intervention arm showed greater depression improvement than those with lower PTSD symptoms (β = -0.004, p = .001). CONCLUSIONS: The BRIGHTEN Heart intervention may be effective in reducing depression for urban minority older adults. Further research on team care interventions and screening for PTSD symptoms in primary care is warranted. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Emery‐Tiburcio et al. (2018) conducted an RCT in Depression (n=250). BRIGHTEN Heart team intervention vs. Generations educational activity program only was evaluated on >50% reduction in PHQ-9 scores (p=0.036). The BRIGHTEN Heart intervention led to a significantly higher rate of >50% reduction in PHQ-9 depression scores compared to the control program (70.7% vs 56.3%; p=0.036).
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