Regular Research ArticlesCommunity-Based Outreach and Treatment for Underserved Older Adults With Clinically Significant Worry: A Randomized Controlled Trial
Section snippets
METHODS
Institutional review boards at Baylor College of Medicine and the Michael E. DeBakey Veterans Affairs Medical Center approved the study. Participants provided informed consent and received $25 for each assessment at baseline and at 6 and 9 months.
Participant Flow and Characteristics
Figure 1 shows participant flow and reasons for dropout. Total study attrition was 22.3% (33 of 148 included), with 9.5% (14 of 148) dropping before baseline assessment and 12.8% (19 of 148) dropping after randomization. Demographic variables were comparable for included participants dropping out before baseline and those completing baseline assessment who were randomized (Table 2). Among 134 randomized participants, attrition rates were similar in CL (15.7%, 11 of 70) and ECC-RC (12.5%, 8 of
DISCUSSION
To our knowledge, this is the first clinical trial of late-life worry/anxiety interventions among underserved, low-income, mostly minority older adults. In the context of a solid community-academic partnership, we successfully recruited a sample of mostly African American, low-income older adults with clinically significant worry, almost all of whom had at least one Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, psychiatric disorder. These data highlight the need for
CONCLUSION
CL and ECC-RC produced similar and moderate improvements in worry/anxiety and related symptoms, albeit with remaining symptoms that may require ongoing care. Given the significant attention to resource counseling in both of these interventions, improvements may reflect the central role of case management and community service use for improving depression in older, low-income, underserved populations. Community agencies and faith-based organizations may choose to use either CL or ECC-RC, or a
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