Improving Adult Protective Services Client Outcomes: A Stepped-Care Social and Mental Health Engagement Program

The purpose of this study is to ascertain the feasibility and effectiveness of an 8-week social engagement program aimed at reducing depression and increasing social engagement among seniors who are transitioning out of Adult Protective Services (APS) for either elder abuse or self-neglect.

Study Overview

• Status: Recruiting
• Conditions: Depression in Old Age
• Intervention / Treatment: Behavioral: Stepped-care social and mental health engagement; Behavioral: APS Usual care

• Study Type: Interventional
• Enrollment (Estimated): 300
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Jason Burnett, PhD; Phone Number: (713) 873-4685; Email: Jason.Burnett@uth.tmc.edu
• Study Contact Backup: Name: Sophia Wasik; Phone Number: (713) 873-4685; Email: Sophia.Wasik@uth.tmc.edu

Study Locations

• United States
  • Texas
    • Houston, Texas, United States, 77030
      • Recruiting
      • The University of Texas Health Science Center at Houston
      • Contact: Sophia Wasik; Phone Number: (713) 873-4685; Email: Sophia.Wasik@uth.tmc.edu
      • Contact: Jason Burnett, PhD; Phone Number: 713-873-4685; Email: Jason.Burnett@uth.tmc.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

Older Adults

• an APS validated EM/SN case
• able to provide informed consent
• able to speaks English or Spanish,
• community-dwelling,
• able to hear sufficiently using the telephone
• transitioning out of APS intervention (i.e. in the case closure phase of the APS service).

Student

• college or university student
• enrolled at one of the UTHealth graduate programs in Houston, University of Houston, Texas Southern University, Sam Houston State University, or Rice University
• commit to making 8-weekly consecutive calls
• complete the required 1-hour training and assessment.

Exclusion Criteria:

Older Adults

• Individuals needing a proxy to consent
• suspected or confirmed decision-making capacity impairments or uncontrolled psychiatric illnesses such as schizophrenia, paranoia, delusion, or delirium
• Older adults transitioning to a nursing home, assisted-living, or residential care facility

Student

-only engaging in the program to fulfill some educational requirement

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Treatment	Behavioral: Stepped-care social and mental health engagement; Each student will be matched to an older adult and the students will make one call o the older adult which lasts upto 1 hour each week for 8 weeks. Ending each call, the student will assess symptoms of depression anxiety through questionnaires. If the participant responds yes on two consecutive calls to any of these questions, they will be asked if they would like to receive a call from the University of Texas Health Science Center Trauma and Resilience Center to discuss free counseling services.; Behavioral: APS Usual care; Participants will receive a phone call for data collection. Then they will be offered to receive an abbreviated version of the stepped-care social and mental health engagement intervention, lasting only 6-weeks with the option to continue calls if agreeable between the student and older adult.
Active Comparator: Usual Care	Behavioral: APS Usual care; Participants will receive a phone call for data collection. Then they will be offered to receive an abbreviated version of the stepped-care social and mental health engagement intervention, lasting only 6-weeks with the option to continue calls if agreeable between the student and older adult.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in social isolation assessed by the Duke Social Support Index (DSSI-6)	This is a 6-item questionnaire and each is measured from 1(hardly ever) to 3(most of the time) for a maximum score of 18, higher score indicating greater social support	baseline, 4-week and 8-week follow-up
Change in loneliness as assessed by the University of California Los Angeles (UCLA )loneliness scale	This is a 20-item questionnaire , each item is rated as either O ("I often feel this way"), S ("I sometimes feel this way"), R ("I rarely feel this way"), N ("I never feel this way") for a score range of 0-3,for a maximum score of 60, higher score indicating worse outcome	baseline, 4-week and 8-week follow-up
Change in depression as assessed by the PATIENT HEALTH QUESTIONNAIRE (PHQ-9)	This is a 9 item questionnaire and each is scored from 0(not at all) to 3(nearly every day) , for a maximum score of 27 , higher score indicating more depression	baseline, 4-week and 8-week follow-up
Recurrence of Elder mistreatment (EM)	This is a yes or no questionnaire that will be answered by adult protective services (APS)	From participant's first call to 1 month post final call
Recurrence of self neglect (SN)	This is a yes or no questionnaire that will be answered by adult protective services (APS)	From participant's first call to 1 month post final call

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in anxiety as assessed by the Generalized Anxiety Disorder scale (GAD-7)	This is a 7-item questionnaire , each is scored from 0(not at all) to 3(nearly every day), for a score range of 0-21 higher score indicating more anxiety	baseline, 4-week and 8-week follow-up
Change in resilience as assessed by the Brief Resilience Scale	This is a 6-item questionnaire, questions 1, and 5 are scored from 1(strongly disagree) to 5(strongly agree) and questions 2, 4 and 6 are reverse scored , for a score range of 6-30. The total score is then divided by the number of questions answered to get the final score. higher score indicating more resilience.	baseline, 4-week and 8-week follow-up

Collaborators and Investigators

• Sponsor: The University of Texas Health Science Center, Houston
• Collaborators: US Department of Health and Human Services, Administration on Community Living
• Investigators: Principal Investigator: Jason Burnett, PhD, The University of Texas Health Science Center, Houston

Study record dates

Study Major Dates

• Study Start (Actual): August 9, 2023
• Primary Completion (Estimated): February 1, 2025
• Study Completion (Estimated): June 1, 2025

Study Registration Dates

• First Submitted: February 5, 2024
• First Submitted That Met QC Criteria: February 5, 2024
• First Posted (Actual): February 13, 2024

Study Record Updates

• Last Update Posted (Actual): February 13, 2024
• Last Update Submitted That Met QC Criteria: February 5, 2024
• Last Verified: February 1, 2024

More Information

Terms related to this study

• Keywords: social engagement; Adult Protective Services (APS); elder abuse; self neglect
• Additional Relevant MeSH Terms: Behavioral Symptoms; Depression
• Other Study ID Numbers: HSC-MS-23-0344

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No