Integrated Tele-Behavioral Activation and Fall Prevention for Low-income Homebound Older Adults With Depression

What this Trial Is About

Researchers are evaluating the clinical and cost effectiveness of an integrated tele-delivered behavioral activation (Tele-BA) and fall prevention (FP) program for low-income, racially diverse homebound older adults with depression and fall risk. The study aims to improve access to depression treatment and fall prevention services for this underserved population, addressing the shortage of licensed clinicians by using bachelor's-level lay counselors/coaches. This pragmatic clinical trial includes 320 seniors served by home-delivered meal and aging-service programs in Central Texas. Participants are randomly assigned to one of four groups: integrated Tele-BA and FP, Tele-BA alone, FP alone, or an attention control group receiving telephone support calls. The integrated group receives five weekly one-hour Tele-BA sessions followed by four weekly in-home FP sessions. The Tele-BA alone or FP alone groups receive their respective interventions plus booster telephone calls. The attention control group receives weekly telephone check-in calls providing social support without specific therapeutic content. Participants will undergo follow-up assessments at 12, 24, and 36 weeks after baseline to measure changes in depressive symptoms, fall counts and injuries, quality of life, disability, social engagement, and satisfaction with social roles. Additional measures include fear of falling and exercise frequency. The study also tracks healthcare and social service use. These evaluations help researchers understand the impact of the interventions on depression and fall prevention in this vulnerable group.

Integrated Tele-Behavioral Activation and Fall Prevention for Low-income Homebound Seniors With Depression