A team of researchers at UTHealth Houston has been awarded a $6.48 million grant from the National Institute of Mental Health to test a new intervention aimed at preventing depression in older, low-income stroke survivors. The study seeks to engage these individuals in meaningful activities through video chats that promote mood-enhancing behaviors.
Principal investigator Jennifer E.S. Beauchamp, PhD, RN, who also serves as the director of the Mental Health Program at the UTHealth Houston Institute for Stroke and Cerebrovascular Diseases, highlighted the crucial need for such an intervention. Approximately one-third of stroke survivors develop depression, while up to 60% experience some level of depressive symptoms.
If left untreated, subthreshold depression may escalate into post-stroke depression (PSD), leading to a series of complications, including increased risks of subsequent strokes, diminished functioning, poor quality of life, and even premature death.
“Low-income, older stroke survivors face unique challenges, including financial strains and typical age-related stressors such as disabilities and loss of independence,” said Beauchamp, who is also the Nancy B. Willerson Distinguished Professor in Nursing.
The intervention employs a technique known as behavioral activation, which focuses on identifying and encouraging behaviors that can promote positive mood changes. Though commonly associated with cognitive behavioral therapy, this approach can be delivered by trained lay counselors rather than licensed therapists.
In this study, community health workers will conduct video sessions with participants within three months post-stroke. Approximately 300 low-income stroke survivors aged 55 and older will be recruited from the Stroke Transitions Education and Prevention Program associated with the Department of Neurology at McGovern Medical School at UTHealth Houston.
Participants will be randomized into two groups, with half receiving the behavioral activation intervention and the other half receiving usual care. The intervention consists of five weekly videoconferences and homework assignments, supplemented by follow-up calls and assessments over a nine-month period.
The primary objectives of the study include evaluating the effectiveness of the tele-intervention in reducing depressive symptoms, anxiety levels, emotional distress, the prevalence of PSD, and the frequency of healthcare visits among the participants.
“Our ultimate goal is to enhance the overall quality of life for stroke survivors through this intervention,” Beauchamp said. “If we can demonstrate its effectiveness, it could significantly influence the prevention of post-stroke depression.”
The study, titled BehavioraL ActIvation for the PreVention of Post-strokE Depression in LoW-incomE OLder Stroke Survivors (LIVE-WEL), includes a collaborative effort from an interprofessional team of co-investigators at UTHealth Houston. This team comprises Sean I. Savitz, professor of neurology and director of the stroke institute; Anjail Z. Sharrief, MD, PhD, a professor and director of Stroke Prevention; Ron Acierno, PhD, professor and executive director of the UTHealth Houston Trauma and Resilience Center; Robert Suchting, PhD, and Belinda Reininger, DrPH, both prominent figures in their respective fields.
Furthermore, Namkee G. Choi, PhD, from The University of Texas at Austin’s Steve Hicks School of Social Work, is contributing to the research effort.
Overall, this ambitious study aims not only to address pressing mental health issues among stroke survivors but also to provide a framework for future interventions that target high-risk populations in the community.
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