A pilot study of assessment of depressive symptomatology and preferred treatments.

Older adults who live in urban low-income neighborhoods and/or are home-bound are more vulnerable than their better-off and less frail peers to depression due to their poor health, social isolation, and financial and other stressors. However, depression among the majority of these low-income older adults often goes undetected, undiagnosed, and untreated because of the lack of awareness and denial of the problem among older adults themselves, their social support systems, and primary care physicians, perceived sense of stigma, and other personal, social, and system barriers to accessing mental healthcare. The specific aims of this pilot study are to:

  • Provide depression screening for 150 older adults who reside in low-income neighborhoods of Austin to assess their depressive symptomatology;
  • Examine risk and protective factors for the older adults’ depression;
  • Examine the older adults’ help-seeking behaviors related to their mental health needs; and
  • Examine the older adults’ acceptance of and preferences for cognitive/psychological, pharmacological, and exercise interventions for depression, with special focus on racial/ethnic differences.

To achieve these aims, we plan to use a cross-sectional survey research design, relying primarily on the administration structured face-to-face individual interviews with the sample. The subjects’ self-reported depressive symptoms (measured by the 20-item Center for Epidemiological Studies Depression Scale [CES-D], Radloff, 1977) will be analyzed in relation to risk and protective factors and their help-seeking behaviors. To examine older adults’ preferences for the types of depression interventions, case vignettes for mild-to-moderate and severe symptoms of depression and descriptions of four treatments will be presented, and the subjects will be asked to evaluate the acceptability/desirability of these treatment modalities using a modified 11-item Treatment Evaluation Inventory (TEI; Landreville & Guerette, 1998).

Center for Health Promotion Research, School of Nursing, University of Texas at Austin