IDEAS home Printed from https://ideas.repec.org/p/spa/wpaper/2019wpecon22.html
   My bibliography  Save this paper

Feasibility of a cluster randomized controlled trial of a psychosocial intervention to improve late life depression in socioeconomically deprived areas of São Paulo, Brazil (PROACTIVE)

Author

Listed:
  • Marcia Scazufca
  • Paula Pereda

Abstract

Background: Depression is a common and recurrent condition among older adults and is associated with poor quality of life and increased health care utilization and costs. The purpose of this study was to assess the feasibility of delivering a psychosocial intervention targeting depression, and to develop the procedures to conduct a cluster randomized controlled trial (RCT) among older adults registered with primary care clinics in poor neighbourhoods of São Paulo, Brazil. Methods: We conducted a pilot study of a two-arm cluster RCT using a protocol developed previously (see accompanying paper). Two primary care clinics adhering to the Family Health Strategy were allocated to either the intervention or the control arm. In the control arm, patients received enhanced usual care consisting of staff training for improved recognition and management of depression. In the intervention arm, alongside the enhanced usual care, patients received a 17-week psychosocial intervention delivered by health workers assisted with an application installed in a tablet. Results: We randomly selected 579 of 2020 older adults registered in the intervention clinic to participate in the study. Among these individuals, 353 were assessed for depression and 40 (11.0%) scored at least 10 on the PHQ-9 and were therefore invited to participate. The consent rate was 33/40 (82%) with a resulting yield of 33/579 (5.7%). In the control arm, we randomly selected 320 older adults among 1482 registered in the clinic, 223 were assessed for depression and 28 (12.6%) scored 10 or above on the PHQ-9. The consent rate was 25/28 (89%), with a resulting yield of 25/320 (7.8%). Of the 33 who consented in the intervention arm, 19 (59.4%) completed all sessions. The mean PHQ-9 at follow-up (approximately 30 weeks after inclusion) was 12.3 (SD=3.7) and 3.8 (SD=3.9) in the control and intervention arms respectively. Follow-up rates were 92% and 94% in control and intervention arms, respectively. Conclusions: Identification and engagement of clinics, random selection and recruitment of individuals, baseline and follow-up assessment all proved to be feasible in primary care clinics in São Paulo, Brazil. Results support the development of a definitive cluster RCT.

Suggested Citation

  • Marcia Scazufca & Paula Pereda, 2019. "Feasibility of a cluster randomized controlled trial of a psychosocial intervention to improve late life depression in socioeconomically deprived areas of São Paulo, Brazil (PROACTIVE)," Working Papers, Department of Economics 2019_22, University of São Paulo (FEA-USP).
    • Handle: RePEc:spa:wpaper:2019wpecon22
    as

    Download full text from publisher

    File URL: http://www.repec.eae.fea.usp.br/documentos/Scazufca_Pereda_22WP.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Beatriz Eugenia Alvarado & Maria Victoria Zunzunegui & François Béland & Maryline Sicotte & Lourdes Tellechea, 2007. "Social and Gender Inequalities in Depressive Symptoms Among Urban Older Adults of Latin America and the Caribbean," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 62(4), pages 226-236.
    2. Grewal, Ini & Lewis, Jane & Flynn, Terry & Brown, Jackie & Bond, John & Coast, Joanna, 2006. "Developing attributes for a generic quality of life measure for older people: Preferences or capabilities?," Social Science & Medicine, Elsevier, vol. 62(8), pages 1891-1901, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Kinghorn, Philip, 2019. "Using deliberative methods to establish a sufficient state of capability well-being for use in decision-making in the contexts of public health and social care," Social Science & Medicine, Elsevier, vol. 240(C).
    2. Joanna Coast & Hareth Al‐Janabi & Eileen J. Sutton & Susan A. Horrocks & A. Jane Vosper & Dawn R. Swancutt & Terry N. Flynn, 2012. "Using qualitative methods for attribute development for discrete choice experiments: issues and recommendations," Health Economics, John Wiley & Sons, Ltd., vol. 21(6), pages 730-741, June.
    3. Hareth Al-Janabi & Terry N. Flynn & Joanna Coast, 2011. "Estimation of a Preference-Based Carer Experience Scale," Medical Decision Making, , vol. 31(3), pages 458-468, May.
    4. Kathryn Hale & Truls Østbye & Bilesha Perera & Robert Bradley & Joanna Maselko, 2019. "A Novel Adaptation of the HOME Inventory for Elders: The Importance of the Home Environment Across the Life Course," IJERPH, MDPI, vol. 16(16), pages 1-21, August.
    5. Coast, Joanna, 2018. "A history that goes hand in hand: Reflections on the development of health economics and the role played by Social Science & Medicine, 1967–2017," Social Science & Medicine, Elsevier, vol. 196(C), pages 227-232.
    6. Terry N. Flynn & Elisabeth Huynh & Tim J. Peters & Hareth Al‐Janabi & Sam Clemens & Alison Moody & Joanna Coast, 2015. "Scoring the Icecap‐a Capability Instrument. Estimation of a UK General Population Tariff," Health Economics, John Wiley & Sons, Ltd., vol. 24(3), pages 258-269, March.
    7. Nadezhda Golovchanova & Katja Boersma & Henrik Andershed & Karin Hellfeldt, 2021. "Affective Fear of Crime and Its Association with Depressive Feelings and Life Satisfaction in Advanced Age: Cognitive Emotion Regulation as a Moderator?," IJERPH, MDPI, vol. 18(9), pages 1-15, April.
    8. Sachie Mizohata & Raynald Jadoul, 2013. "Towards International and Interdisciplinary Research Collaboration for the Measurements of Quality of Life," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 111(3), pages 683-708, May.
    9. Hareth Al‐Janabi, 2018. "Do capability and functioning differ? A study of U.K. survey responses," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 465-479, March.
    10. Juliana Lustosa Torres & Maria Fernanda Lima-Costa & Michael Marmot & Cesar de Oliveira, 2016. "Wealth and Disability in Later Life: The English Longitudinal Study of Ageing (ELSA)," PLOS ONE, Public Library of Science, vol. 11(11), pages 1-12, November.
    11. Engel, Lidia & Bryan, Stirling & Noonan, Vanessa K. & Whitehurst, David G.T., 2018. "Using path analysis to investigate the relationships between standardized instruments that measure health-related quality of life, capability wellbeing and subjective wellbeing: An application in the ," Social Science & Medicine, Elsevier, vol. 213(C), pages 154-164.
    12. Van de Velde, Sarah & Bracke, Piet & Levecque, Katia, 2010. "Gender differences in depression in 23 European countries. Cross-national variation in the gender gap in depression," Social Science & Medicine, Elsevier, vol. 71(2), pages 305-313, July.
    13. Mitchell, Paul Mark & Roberts, Tracy E. & Barton, Pelham M. & Coast, Joanna, 2015. "Assessing sufficient capability: A new approach to economic evaluation," Social Science & Medicine, Elsevier, vol. 139(C), pages 71-79.
    14. Joanna Coast, 2019. "Assessing capability in economic evaluation: a life course approach?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 779-784, August.
    15. Flynn, Terry Nicholas & Louviere, Jordan J. & Peters, Tim J. & Coast, Joanna, 2010. "Using discrete choice experiments to understand preferences for quality of life. Variance-scale heterogeneity matters," Social Science & Medicine, Elsevier, vol. 70(12), pages 1957-1965, June.
    16. Cassandra Mah & Vanessa K. Noonan & Stirling Bryan & David G. T. Whitehurst, 2021. "Empirical Validity of a Generic, Preference-Based Capability Wellbeing Instrument (ICECAP-A) in the Context of Spinal Cord Injury," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 14(2), pages 223-240, March.
    17. Erin M Graybill & Peter McMeekin & John Wildman, 2014. "Can Aging in Place Be Cost Effective? A Systematic Review," PLOS ONE, Public Library of Science, vol. 9(7), pages 1-6, July.
    18. Jan R. Oyebode & Simon Pini & Emma Ingleson & Molly Megson & Mike Horton & Linda Clare & Hareth Al-Janabi & Carol Brayne & Penny Wright, 2019. "Development of an Item Pool for a Needs-Based Measure of Quality of Life of Carers of a Family Member with Dementia," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 12(1), pages 125-136, February.
    19. Engel, L. & Chudyk, A.M. & Ashe, M.C. & McKay, H.A. & Whitehurst, D.G.T. & Bryan, S., 2016. "Older adults' quality of life – Exploring the role of the built environment and social cohesion in community-dwelling seniors on low income," Social Science & Medicine, Elsevier, vol. 164(C), pages 1-11.
    20. Ruhi Saith, 2011. "A Public Health Perspective on the Capability Approach," Journal of Human Development and Capabilities, Taylor & Francis Journals, vol. 12(4), pages 587-594, November.

    More about this item

    Keywords

    older adults; depression; pilot controlled trial; primary care; collaborative care intervention.;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I10 - Health, Education, and Welfare - - Health - - - General
    • C93 - Mathematical and Quantitative Methods - - Design of Experiments - - - Field Experiments
    • C90 - Mathematical and Quantitative Methods - - Design of Experiments - - - General

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spa:wpaper:2019wpecon22. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Pedro Garcia Duarte (email available below). General contact details of provider: https://edirc.repec.org/data/deuspbr.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.