Emotional Awareness and SElf-regulation for Depression in Patients With Hypertension (EASE) Study
The purpose of this study is to adapt and then evaluate the feasibility, acceptability, and efficacy of a telephone-based intervention (UPLIFT: Using Practice and Learning to Increase Favorable Thoughts) for individuals with elevated depressive symptoms and hypertension. UPLIFT is a group-based intervention that is delivered over 8 weekly sessions for 1 hour/week by phone.
Aim 1 of this study is to adapt UPLIFT using qualitative focus groups and individual interviews and to test the adapted UPLIFT program in a single-arm design. Aim 2 of this study is a randomized controlled trial (RCT) that will compare the effects of the adapted UPLIFT program to usual care (UC) and to test mediators and moderators of the effects of UPLIFT.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Once 16 participants are enrolled (to form 2 groups of 8 patients each), an independent study staff member will determine participants' group assignments. The randomization sequence will be created a priori by Dr. Keith Goldfeld (biostatistician) by using a computer-generated list of random numbers with stratification by antidepressant medication use and baseline levels of depressive symptoms (PHQ scores <10 and ≥10).
UPLIFT: Eligible participants will complete 8 weekly group sessions by phone. The intervention builds cognitive-behavioral and mindfulness skills to help reduce depressive symptoms. Each hour-long weekly session consists of: check-in, instruction, skill building, discussion, and a home-based practice assignment.
Usual care: Subjects randomized to UC will be advised to seek help from their primary care physician (PCP) or other sources as they normally would if they encountered symptomatic deterioration or other difficulties over the course of the study. All treatments received over the course of the study for the UC group and outside of the study (for the intervention group) will be assessed at each time point.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
New York
-
New York, New York, United States, 10016
- New York University Medical Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Diagnosis of hypertension based on the criteria in the ICD-9/-10
- Mild to moderate depressive symptoms (PHQ-9 ≥ 5)
- English-speaking
- If taking depression medications, medications must stable for the past 6 weeks (no change to type or dose)
- Willing to provide informed consent, be audio-recorded, and comply with all other aspects of protocol
Exclusion Criteria:
- Moderate to severe depressive symptoms (PHQ-9 ≥ 15)
- Current substance abuse
- Current eating disorder
- Self-harm within the past 3 months
- Current obsessive-compulsive disorder
- Current anxiety disorder (e.g., PTSD, panic disorder)
- Active suicidal ideation
- History of or current diagnosis of psychosis
- Significant cognitive impairment (mini mental state examination score ≤ 20)
- History of previous training in mindfulness
- History of more than 8 sessions of cognitive behavioral therapy
- Counseling more frequently than once per month
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: UPLIFT
Eligible participants will complete 8 weekly group sessions by phone.
The intervention builds cognitive-behavioral and mindfulness skills to help reduce depressive symptoms.
Each hour-long weekly session consists of: check-in, instruction, skill building, discussion, and a home-based practice assignment.
|
Session 1: Introduction to UPLIFT/Noticing Thoughts Session 2: Checking and Changing Thoughts Session 3: Coping & Relaxing Session 4: Attention & Mindfulness Session 5: The Present as a Calm Place Session 6: Thoughts as Changeable, Thoughts as Not Fixed Session 7: Focus on Pleasure & the Importance of Reinforcement Session 8: Preventing Lapses and Giving Thanks
|
|
Active Comparator: Usual Care
Subjects randomized to UC will be advised to seek help from their primary care physician (PCP) or other sources as they normally would if they encountered symptomatic deterioration or other difficulties over the course of the study.
All treatments received over the course of the study for the UC group and outside of the study (for the intervention group) will be assessed at each time point.
|
Subjects randomized to UC will be advised to seek help from their primary care physician (PCP) or other sources as they normally would if they encountered symptomatic deterioration or other difficulties over the course of the study
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Feasibility measured by the number of weekly sessions attended
Time Frame: 6 Months
|
Determined by the number of weekly sessions attended and number of days of home-based practice completed each week
|
6 Months
|
|
Acceptability
Time Frame: 6 Months
|
8-item Client Satisfaction Questionnaire (CSQ-8)
|
6 Months
|
|
PHQ-9
Time Frame: 6 Months
|
validated measure of depressive symptoms.
Items rate symptom severity during the prior 2 weeks based on DSM-IV diagnostic criteria for major depression.
Scores range from 0-27; scores of 5, 10, 15, and 20 represent mild, moderate, moderately severe, and severe depression, respectively.
The PHQ-9 will be completed at screening and at all study visits (continuous scores).
|
6 Months
|
|
Quick Inventory of Depressive Symptomatology (QIDS-SR 16)
Time Frame: 6 Months
|
Standardized depression instrument that has treatment sensitivity advantages over the PHQ-9 and will be administered at pre- and post-treatment.
Total scores on the QIDS-SR16 range from 0 to 27 and reflect depression severity across 9 domains of the DSM-IV MDD criteria: depressed mood, loss of interest or pleasure, concentration/decision making, self-outlook, suicidal ideation, energy/fatigability, sleep, weight/appetite change, and psychomotor changes.
|
6 Months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Amanda Shallcross, MD, NYU Langone Health
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 16-01350
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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