Peer to Peer Delivery of Behavioral Activation


The goal of this study is to test the feasibility, acceptability and preliminary impact of peer-delivered Behavioral Activation (BA) for depressed older adults (60+) who are Naturally Occurring Retirement Communities (NORC) residents or senior center participants.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Single (Outcomes Assessor)
  • Study Primary Completion Date: October 7, 2015

Detailed Description

This project focuses on helping to solve a growing problem in health care today. Through increased screening in the older adult population, detection of depression has increased which has established a growing need for mental health resources. Unfortunately, there are limited resources to keep up with the steady increase of individuals in need. Training peers to work with older depressed adults in techniques such as behavioral activation provides an alternative model to help moderate the increased need and provide a unique intervention of care. Developing an innovative peer facilitated program has the potential to enhance the delivery of quality health care.

The specific aims of the study are 1) to train peer coaches and implement Peer to Peer in the community 2) to examine depression ratings over time.


  • Behavioral: Peer to Peer
    • 12 weekly sessions of peer-delivered behavioral activation
  • Other: Standard Mental Health Referral
    • Standard mental health referral to a community agency

Arms, Groups and Cohorts

  • Experimental: Peer to Peer
    • These individuals will receive a standard mental health referral to a community agency and in addition meet with a trained peer coach for 12 weekly meetings.
  • Active Comparator: Referral
    • These individuals will receive a standard mental health referral to a community agency.

Clinical Trial Outcome Measures

Primary Measures

  • Proportion of Peer to Peer Coaches Who Undergo Behavioral Activation Training and Achieve Certification
    • Time Frame: 4 weeks prior to Baseline
    • Proportion of Peer to Peer coaches who undergo Behavioral Activation training and achieve certification
  • Number of Peer to Peer Clients Who Attend > 80% of Behavioral Activation Sessions
    • Time Frame: 12 weeks
    • Number of Peer to Peer clients who attend > 80% of Behavioral Activation sessions

Secondary Measures

  • Changes in Hamilton Depression Rating Scale Scores
    • Time Frame: Baseline and 12 weeks
    • Hamilton Depression Rating Scale mean change scores from baseline to 12 weeks. This scale measures severity of depressive symptoms (range=0-76), with higher scores indicating more sever depressive symptomatology.

Participating in This Clinical Trial

Inclusion Criteria

  • Age 60 and older
  • Member of Lenox Hill Senior Center, St. Peter's Senior Center, or Beth Abe
  • Score of 10+ on Patient Health Questionnaire (PHQ-9)

Exclusion Criteria

  • Presence of alcohol abuse, substance abuse, psychotic disorder, or bipolar disorder as observed on the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID)
  • Inability to speak English
  • Dementia: Mini Mental State Examination (MMSE) score below 24
  • High suicide risk, i.e. intent or plan to attempt suicide

Gender Eligibility: All

Minimum Age: 60 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Weill Medical College of Cornell University
  • Collaborator
    • National Institute of Mental Health (NIMH)
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Patrick Raue, PhD, Principal Investigator, Weill Medical College of Cornell University

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