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Calmer Life: treating worry among older adults in underserved, low-income, minority communities
Investigator (PI): Stanley, Melinda
Performing Organization (PO): (Current): Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences / (713) 798-4876
Supporting Agency (SA): Patient-Centered Outcomes Research Institute (PCORI)
Initial Year: 2014
Final Year: 2018
Record Source/Award ID: PCORI/AD-1310-06824
Funding: Total Award Amount: $2,095,408
Award Type: Contract
Award Information: PCORI: More information and project results (when completed)
Abstract: Background: Recurrent, excessive, uncontrollable worry about multiple topics is common in older adults, but it is not well studied. This significant worry can negatively impact thinking, and it is associated with poor sleep, more depression, and worse general health. Despite its prevalence, researchers have not studied significant worry enough, particularly in low-income racial and ethnic minority populations. We know these groups are unlikely to have adequate mental health care. We also know that older adults and minorities prefer treatments for worry that do not require medication, and these kinds of treatments can be effective. Additional tests of treatments that do not involve drugs are needed in low-income racial and ethnic minority populations. Such person-centered research could expand access to appropriate care. Objectives: We want to compare two approaches, one called Calmer Life (CL) and another called Enhanced Community Care (ECC). CL helps individuals by providing worry-reduction skills and resource counseling for basic needs in a flexible, culturally supportive manner. ECC relies on standard information and resource counseling. The study will answer three questions. First, does CL relieve significant worry better than ECC? Second, which one is better at reducing anxiety and depression and improving sleep, ability to do daily activities, and use of medical services? Third, are improvements still present three months after treatment is over? Methods: In agreement with our community partners and governed by a council of community leaders, consumers, and providers from low-income minority communities, we will conduct the study. This community-academic partnership, created four years ago, introduced CL to the community. Case managers and community health workers from partner organizations were trained to implement CL. They taught worry-reduction skills and helped participants increase their use of community resources. Content was flexible so that participants could choose what skills to learn and whether or not to include religion or spirituality. They also could learn skills at home, by telephone, or in the community. In a new, larger comparison study, we will enroll 120 women and 30 men who are 50 years of age or older with significant worry. Most (80%) will be African American, and 70% will have income below poverty. Participants will be assigned by chance to CL or ECC and treated for 6 months. Brief assessments at enrollment and at 6 and 9 months will rely on participants' reports. Differences will be measured statistically. Outcomes: Endorsed by our partners and important to community members, the main outcome of interest is the effect of CL and ECC on significant worry. Other outcomes of interest are anxiety, depression, sleep, daily activities, and use of medical services. Participants, providers, and community leaders also will be interviewed. Their input will help to shape community care strategies to reduce significant worry.
MeSH Terms:
  • Activities of Daily Living
  • African Americans
  • Aged
  • * Aging
  • Anxiety /epidemiology
  • /*prevention & control /*therapy
  • Community-Institutional Relations
  • Counseling /methods
  • Depression /complications
  • /epidemiology
  • Female
  • Humans
  • Male
  • Medically Underserved Area
  • Middle Aged
  • Minority Groups
  • Poverty
  • Sleep
  • Universities
Country: United States
State: Texas
Zip Code: 77030
UI: 20152027
Project Status: Completed
Record History: ('2017: Project extended to 2018.',)