Pilot Study of a Statewide Initiative to Enhance Depression Care Among Older Home Care Patients

Delaney, Colleen; Fortinsky, Richard H.; Mills, Dana Scott; Doonan, Lorraine; Grimes, Rita; Rosenberg, Suzanne; Pearson, Terra-Lee; Bruce, Martha L.

doi:10.1177/1084822312465747

Cited by 3 publications

(15 citation statements)

References 25 publications

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“…It was unclear who intervention deliverers were in 12 studies (21.8%) [26, 39, 46, 50, 51, 55, 59–64], but in studies where this information was identifiable, deliverers were most frequently nurses (10 studies, 18.2%) [33, 35–37, 40, 47, 52, 65–67]. With regards to level and mode of delivery, interventions were most frequently delivered at the individual (25 studies, 45.5%) [27–29, 33, 34, 40, 41, 45, 46, 48, 50–52, 54, 56, 60, 63, 65, 66, 68–73] and group level (19 studies, 35.1%) [26, 31, 32, 38, 39, 42, 43, 49, 53, 55, 58, 61, 62, 64, 67, 74–77]. Face to face was the most common (28 studies, 50.9%) mode of delivery [27, 29, 31, 32, 35–38, 41–45, 49, 50, 56, 58, 60–62, 66–68, 74–78].…”

Section: Resultsmentioning

confidence: 99%

“…An assessment of participants’ understanding was included in 20 (60.6%) studies [25, 29, 31, 33–37, 39, 45, 47, 48, 50, 57, 61, 65, 67, 73, 75, 78] and an assessment of participants’ performance of intervention-related skills in 14 (42.4%) studies [33–36, 45, 47, 48, 51, 54, 56, 57, 65, 75, 78]. With regards to strategies to enhance receipt, 4 (12.1%) studies reported using a strategy to enhance participants’ understanding [41, 48, 56, 57], 7 (21.1%) to enhance performance of intervention-related skills [39, 41, 44, 47, 48, 56, 57].…”

Section: Resultsmentioning

confidence: 99%

“…intervention components received or completed, problems areas discussed, advice given) in 9 (16.4%) studies [28, 32, 44, 60, 61, 67–70], satisfaction in 8 (14.5%) studies [27, 41, 49, 52, 55, 59, 65, 66], engagement (level of participation, involvement, enjoyment, or communication) in 8 (14.5%) studies [30, 39, 52, 55, 57, 66, 73, 76], attendance in 8 (14.5%) studies [31, 43, 56, 58, 64, 73, 74, 76], acceptability in 6 (10.9%) studies [26, 42, 48, 49, 63, 75], use of materials (e.g. website use, homework completed) in 4 (7.3%) studies [28, 46, 47, 51], behavioural change and/or maintenance in 4 (7.2%) studies [25, 54, 67, 71], receptivity or responsiveness in 3 (5.5%) studies [38, 62, 77], receipt of intervention materials in 3 (5.5%) studies [39, 59, 84], intention to implement learnings from the intervention in 2 studies [52, 60], telephone contacts during intervention delivery in 2 (3.6%) studies [48, 64], reaction to intervention or feedback on program in 2 (3.6%) studies [32, 39], self-efficacy or confidence in 2 (3.6%) studies [30, 61], exposure (e.g. awareness of intervention) in 2 (3.6%) studies [59, 71], and use of skills learnt in 2 (3.6%) studies [45, 74].…”

Section: Resultsmentioning

confidence: 99%

“…awareness of intervention) in 2 (3.6%) studies [59, 71], and use of skills learnt in 2 (3.6%) studies [45, 74]. Operationalisations of receipt that were only used in 1 study (1.8%) were attitude in relation to intervention topic [61], perceived effects of exposure [36], treatment received with respect [70], feasibility [26], adherence to commitments made [52], adequacy of communication methods used [40], and availability of hardware to use intervention materials [48]. …”

Section: Resultsmentioning

confidence: 99%

“…Fourteen (28.0%) of the 50 studies included a subjective assessment collected on the intervention deliverer [26, 28, 30, 33, 34, 53, 56, 57, 62, 64, 69, 73, 78, 84], 25 (50.0%) studies on the intervention recipient [27, 29, 31, 32, 35–38, 40–42, 45, 47, 51, 54, 59–61, 63, 65, 70–72, 74, 77], and 11 (22.0%) studies on both of these [25, 39, 48–50, 52, 55, 66–68, 75]. …”

Section: Resultsmentioning

confidence: 99%

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Methods used to address fidelity of receipt in health intervention research: a citation analysis and systematic review

Rixon

Baron

McGale

et al. 2016

BMC Health Serv Res

115

104

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BackgroundThe American Behaviour Change Consortium (BCC) framework acknowledges patients as active participants and supports the need to investigate the fidelity with which they receive interventions, i.e. receipt. According to this framework, addressing receipt consists in using strategies to assess or enhance participants’ understanding and/or performance of intervention skills. This systematic review aims to establish the frequency with which receipt is addressed as defined in the BCC framework in health research, and to describe the methods used in papers informed by the BCC framework and in the wider literature.MethodsA forward citation search on papers presenting the BCC framework was performed to determine the frequency with which receipt as defined in this framework was addressed. A second electronic database search, including search terms pertaining to fidelity, receipt, health and process evaluations was performed to identify papers reporting on receipt in the wider literature and irrespective of the framework used. These results were combined with forward citation search results to review methods to assess receipt. Eligibility criteria and data extraction forms were developed and applied to papers. Results are described in a narrative synthesis.Results19.6% of 33 studies identified from the forward citation search to report on fidelity were found to address receipt. In 60.6% of these, receipt was assessed in relation to understanding and in 42.4% in relation to performance of skill. Strategies to enhance these were present in 12.1% and 21.1% of studies, respectively. Fifty-five studies were included in the review of the wider literature. Several frameworks and operationalisations of receipt were reported, but the latter were not always consistent with the guiding framework. Receipt was most frequently operationalised in relation to intervention content (16.4%), satisfaction (14.5%), engagement (14.5%), and attendance (14.5%). The majority of studies (90.0%) included subjective assessments of receipt. These relied on quantitative (76.0%) rather than qualitative (42.0%) methods and studies collected data on intervention recipients (50.0%), intervention deliverers (28.0%), or both (22.0%). Few studies (26.0%) reported on the reliability or validity of methods used.ConclusionsReceipt is infrequently addressed in health research and improvements to methods of assessment and reporting are required.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1904-6) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Methods used to address fidelity of receipt in health intervention research: a citation analysis and systematic review

Rixon

Baron

McGale

et al. 2016

BMC Health Serv Res

115

104

View full text Add to dashboard Cite

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Nonphysician Care Providers Can Help to Increase Detection of Cognitive Impairment and Encourage Diagnostic Evaluation for Dementia in Community and Residential Care Settings

Maslow

Fortinsky

2018

The Gerontologist

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In the United States, at least half of older adults living with dementia do not have a diagnosis. Their cognitive impairment may not have been detected, and some older adults whose physician recommends that they obtain a diagnostic evaluation do not follow through on the recommendation. Initiatives to increase detection of cognitive impairment and diagnosis of dementia have focused primarily on physician practices and public information programs to raise awareness about the importance of detection and diagnosis. Nonphysician care providers who work with older adults in community and residential care settings, such as aging network agencies, public health agencies, senior housing, assisted living, and nursing homes, interact frequently with older adults who have cognitive impairment but have not had a diagnostic evaluation. These care providers may be aware of signs of cognitive impairment and older adults' concerns about their cognition that have not been expressed to their physician. Within their scope of practice and training, nonphysician care providers can help to increase detection of cognitive impairment and encourage older adults with cognitive impairment to obtain a diagnostic evaluation to determine the cause of the condition. This article provides seven practice recommendations intended to increase involvement of nonphysician care providers in detecting cognitive impairment and encouraging older adults to obtain a diagnostic evaluation. The Kickstart-Assess-Evaluate-Refer (KAER) framework for physician practice in detection and diagnosis of dementia is used to identify ways to coordinate physician and nonphysician efforts and thereby increase the proportion of older adults living with dementia who have a diagnosis.

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Testing of a Statewide Initiative to Enhance Depression Care in Older Home Care Patients

Delaney

Barrere

Grimes³

et al. 2016

Home Health Care Management & Practice

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The prevalence of geriatric depression in home care is extremely high with 15% of older patients meeting the diagnostic criteria for major depression. 1 When milder forms of depression are also included, this number doubles to one third of home care patients. 2 Depression in older adults is associated with reduced quality of life, increased risk of suicide and hospitalizations, as well as greater functional impairment. 3-6 Compared with younger adults, older adults are more likely to have milder forms of depression referred to as dysthymia; however, they tend to have longer and more frequent episodes of depression as well as more medical comorbidities potentially influencing course and outcomes. 7 National data indicate that although depression is widespread in late life, it is often under-recognized and undertreated. According to the National Institutes of Mental Health, there are currently about six million Americans 65 and older dealing with depression, whereas less than 10% are being treated. 8 Depression is a major risk factor for hospitalization for home health care patients. 9-11 A study that analyzed 374,123 Medicare beneficiaries receiving home care services found a 20% increase in hospitalization in patients who demonstrated the presence of depressive symptoms on admission to home care, regardless of other factors such as type of diagnosis and level of functional ability. 10 To encourage home care agencies to screen for depression and implement interventions when detected, the Centers for Medicare and Medicaid now requires that home care agencies document depression screening on Item M 1730 on the Outcome and Assessment Information Set (OASIS-C) at start of care and recertification. 12 Home care professionals have identified lack of education as a major barrier to providing evidence-based care. 13 However, a few previous studies have demonstrated that with training and support, home health care professionals can effectively identify, provide education, and refer patients for treatment. 13,14 These findings underscore the need for further education of home care professionals. Depressive symptoms among older home care patients are a public health concern that affects the lives of many families in a variety of ways. Several personal and service barriers exist that result in the under-detection and suboptimal care for this population. Many people experiencing depressive feelings may mistakenly view these changes as normal aging. 15 For others, treatment for depressive symptoms is not sought due to the stigma of mental illness, fear of side effects from antidepressants, which are often the major medical treatments for depression, and fear of loss of independence or being declared incompetent. Service barriers include fragmented mental 642752H HCXXX10.

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Pilot Study of a Statewide Initiative to Enhance Depression Care Among Older Home Care Patients

Cited by 3 publications

References 25 publications

Methods used to address fidelity of receipt in health intervention research: a citation analysis and systematic review

Methods used to address fidelity of receipt in health intervention research: a citation analysis and systematic review

Nonphysician Care Providers Can Help to Increase Detection of Cognitive Impairment and Encourage Diagnostic Evaluation for Dementia in Community and Residential Care Settings

Testing of a Statewide Initiative to Enhance Depression Care in Older Home Care Patients

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