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首页> 外文期刊>Psychology and aging >Mediators of the Impact of a Home-Based Intervention (Beat the Blues) on Depressive Symptoms Among Older African Americans
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Mediators of the Impact of a Home-Based Intervention (Beat the Blues) on Depressive Symptoms Among Older African Americans

机译：基于家庭干预（击败蓝调）对年长非洲裔美国人抑郁症状的影响的调解人

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Older African Americans (N = 208) with depressive symptoms were randomly assigned to a home-based nonpharmacologic intervention (Beat the Blues, or BTB) or wait-list control group. BTB was delivered by licensed social workers and involved up to 10 home visits focused on care management, referral and' linkage, depression knowledge and efficacy in symptom recognition, instruction in stress reduction techniques, and behavioral activation through identification of personal goals and action plans for achieving them. Structured interviews by assessors masked to study assignment were used to assess changes in depressive symptoms (main trial endpoint), behavioral activation, depression knowledge, formal care service utilization, and anxiety (mediators) at baseline and 4 months. At 4 months, the intervention had a positive effect on depressive symptoms and all mediators except formal care service utilization. Structural equation models indicated that increased activation, enhanced depression knowledge, and decreased anxiety each independently mediated a significant proportion of the intervention's impact on depressive symptoms as assessed with 2 different measures (PHQ-9 and CES-D). These 3 factors also jointly explained over 60% of the intervention's total effect on both indicators of depressive symptoms. Our findings suggest that most of the impact of BTB on depressive symptoms is driven by enhancing activation or becoming active, reducing anxiety, and improving depression knowledge/ efficacy. The intervention components appear to work in concert and may' be mutually necessary for maximal benefits from treatment to occur. Implications for designing tailored interventions to address depressive symptoms among older African Americans are discussed.
机译：患有抑郁症状的美国黑人（N = 208）被随机分配到家庭非药物干预组（Beat the Blues或BTB）或等待名单对照组。 BTB由有执照的社会工作者提供，涉及多达10次家访，重点在于护理管理，转诊和联系，抑郁症知识和症状识别功效，缓解压力技术的指导以及通过识别个人目标和行动计划来激活行为实现他们。被掩盖在研究任务中的评估者进行的结构化访谈被用来评估基线和四个月时抑郁症状（主要试验终点），行为激活，抑郁知识，正式护理服务利用和焦虑（调解者）的变化。在第4个月时，干预对抑郁症状和除正式护理服务使用外的所有介体均具有积极作用。结构方程模型表明，通过两种不同的方法（PHQ-9和CES-D）评估，增加的激活，增强的抑郁知识和焦虑减轻各自独立地介导了干预措施对抑郁症状的重要影响。这三个因素也共同解释了干预措施对两种抑郁症状指标总作用的60％以上。我们的研究结果表明，BTB对抑郁症状的大多数影响是由增强激活或变得活跃，减少焦虑和改善抑郁知识/功效所驱动的。干预措施似乎可以协同工作，并且可能对于从治疗中获得最大收益是必不可少的。讨论了设计针对性的干预措施以解决老年非洲裔美国人的抑郁症状的意义。

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