Research

BE-ACTIV!  Treating Depression in Nursing Homes

Funding:  NIMH

Project Summary.  The purpose of this project is to test the efficacy of a behavioral intervention for depression in nursing homes.  The program, BE-ACTIV, has been adapted and piloted in nursing homes, and shows promise of reducing depression in residents with major and minor depression.  The intervention is conceptually based on Lewinsohn's behavioral theory of depression and derived from Teri's effective, outpatient intervention for elders with dementia.  It involves collaboration between a mental health therapist and nursing home Activities Department staff, and is tailored to the individual resident.  The goal is to increase opportunities for pleasant events, thus increasing activity and positive affect.  There are 2 specific aims: (1) using a randomized, controlled, two-group design, to compare outcomes for depressed residents receiving the BE-ACTIV program with those receiving treatment as usual in their nursing homes; and (2) to evaluate the treatment mechanisms, including staff attention, increased activity levels, and increased positive affect, related to improvement following participation in BE-ACTIV.  The latter aim employs both within-subject process measures and between-subject comparisons.  Measures include diagnostic evaluation, depression and mood rating scales, general functioning, observed affect and activity participation, behavior problems, resident satisfaction, and staff burden.  Analyses will make use of random effects modeling to analyze within- and between-subject variability in intervention process and treatment response.