Chinese Older Adults-Collaboration in Health (COACH)Study (COACH)
Depression, Hypertension
About this trial
This is an interventional treatment trial for Depression focused on measuring Depression, Hypertension, Older Adults
Eligibility Criteria
Inclusion Criteria:
- Community-dwelling residents registered to the selected village, and thus also registered patients of the village's PCP.
- Age ≥ 60 years, the typical retirement age in rural China.
- Clinically significant depression defined as baseline PHQ-9 score ≥ 10.
- Diagnosis of hypertension
- Intact cognitive functioning (6-Item Screener score <3) to assure ability to participate with the treatment team in management of their conditions.
- Capable of independent communication
- Capacity to give informed consent.
Exclusion Criteria:
- Incapable (no capacity) of giving verbal consent to this study.
- Acute high suicide risk at baseline assessment. Patients assessed to be dangerously suicidal at later assessments will be discontinued from the study, their providers notified, and their safety guaranteed.
- Psychosis, alcoholism. We exclude patients with psychosis or active alcoholism in the past 6 months.
Sites / Locations
- Tulane University
- Regents of the University of Michigan
- University of Rochester Medical Center
- University of Pennsylvania
- Zhejiang University
- Zhejiang Provincial Committee on Aging
- Zhejiang Provincial Center for Disease Control and Prevention
Arms of the Study
Arm 1
Arm 2
No Intervention
Experimental
Care as usual
Collaborations in Health (COACH)
COACH integrates the care provided by the older person's primary care provider (PCP) with that delivered by an Aging Worker (AW; a lay member of the village's Aging Association), supervised by a psychiatrist consultant. Based on chronic disease management principles, the PCP is trained to use evidence based practice guidelines for treatment of both HTN and depression, and provided with access to mental health consultation regarding optimal management of the patient's depression. The AW is trained to conduct a systematic assessment of the older person's social context to identify and reduce social and environmental barriers to treatment adherence and response. AWs participate with the PCP in developing multi-disciplinary care plans for their shared patients, reinforce treatment adherence and adoption of healthy behaviors, and emphasize activation and engagement of the older person in activities designed to improve their connectedness to others and to the community.