Actively Recruiting
Empower@Home: Hybrid Effectiveness-Implementation Randomized Controlled Trial (RCT)
Led by University of Michigan · Updated on 2025-11-21
256
Participants Needed
1
Research Sites
247 weeks
Total Duration
On this page
Sponsors
U
University of Michigan
Lead Sponsor
N
National Institute of Mental Health (NIMH)
Collaborating Sponsor
AI-Summary
What this Trial Is About
This study is a randomized Type I hybrid effectiveness-implementation trial aimed at evaluating the effectiveness of Empower@Home, an internet-delivered cognitive-behavioral therapy (CBT) program supported by aging service providers, in comparison to enhanced usual care for homebound older adults with depressive symptoms. A total of 256 participants will be randomly assigned to either the treatment group (Empower@Home) or the control group (enhanced usual care) in a 1:1 allocation ratio, with randomization stratified by participating agencies. The primary aim of this study is to determine the clinical effectiveness of the Empower@Home program. It is hypothesized that participants receiving Empower@Home will show greater improvements in depressive symptoms at 12, 24, and 36 weeks after entering the study compared to those receiving enhanced usual care. Additionally, treatment moderators will be explored and a cost-effectiveness analysis will be conducted to assess the economic viability of the intervention. The second aim is to investigate the mechanisms of change facilitated by the intervention using a mixed-methods approach. Causal mediation analysis will examine whether the acquisition of CBT skills, reduction in cognitive distortions, and increased behavioral activation, as well as participant engagement and the therapeutic alliance with the coach, mediate the treatment effects. Qualitative interviews with participants will be conducted to provide deeper insights into these mechanisms and enhance the interpretation of the mediation analysis. The third aim focuses on evaluating the implementation process using the updated Consolidated Framework for Implementation Research (CFIR). This will involve a qualitative process evaluation to identify barriers and facilitators to the implementation of Empower@Home, drawing on perspectives from multiple stakeholders.
CONDITIONS
Official Title
Empower@Home: Hybrid Effectiveness-Implementation Randomized Controlled Trial (RCT)
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Be receiving or eligible to receive services at the recruitment sites
- Read and speak English
- Be at least 50 years old
- Have at least moderate depressive symptoms at screening (8 or higher on the Patient Health Questionnaire-9 [PHQ-9])
- Agree not to start outside therapy during the study if not currently receiving it, or not to increase therapy frequency if currently receiving it
You will not qualify if you...
- Probable dementia based on the Blessed Orientation and Memory Scale
- Moderate or high risk of suicide based on the 6-item Columbia-Suicide Severity Rating Scale
- Terminal illness with less than six months to live or unstable physical health conditions based on self-report
- Diagnosis of a psychotic disorder such as schizophrenia or bipolar disorder based on self-report and medical chart review
- Severe vision impairment (legally blind) based on self-report
- Current substance use disorders or receiving substance use treatment
- Currently receiving outside therapy more frequently than once a month or started new therapy treatment less than 3 months ago
AI-Screening
AI-Powered Screening
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Trial Site Locations
Total: 1 location
1
University of Michigan
Ann Arbor, Michigan, United States, 48109
Actively Recruiting
Research Team
X
Xiaoling Xiang, PhD
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
SINGLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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