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Depressive SymptomsJCJoyAgeNCT03593889

Collaborative Stepped Care and Peer Support Programme for Older People At-Risk of or With Depression

A study testing Collaborative stepped care and peer support programme and Treatment as usual in people with Depressive Symptoms, run by The University of Hong Kong at 8 sites in Hong Kong.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

To develop a viable and sustainable best practice model to promote elderly mental wellness and prevent elderly depression for Hong Kong, the Hong Kong Jockey Club Charities Trust has initiated a pilot holistic support project entitled "JC JoyAge: Holistic Support Project for Elderly Mental Wellness". Read more about this study

Who is it for?
Ages 60 years and olderHealthy volunteers can take part
Conditions the study is for
Depressive Symptoms
What is being tested?
Collaborative stepped care and peer support programme and Treatment as usual
Could I receive a placebo?
No, everyone receives an active treatment
How many people
3,702 participants
Where
8 sitesHong Kong
Study dates
1 Oct 2017to 30 Apr 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 60 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • residing in Kwun Tong, Kwai Chung, Tseung Kwan O, or Sham Shui Po; and
  • have one or more known risk factor(s) for developing depression; and/or
  • have depressive symptoms of mild level or above; and
  • able to give informed consent to participate

Who cannot join

  • known history of autism, intellectual disability, schizophrenia-spectrum disorder, bipolar disorder, Parkinson's disease, or dementia; and
  • imminent suicidal risk; and
  • difficulty in communication

Trial locations and contacts

8 sites in 1 country.

8 sites in 1 country

Hong Kong8 sites

  • Hong Kong Sheng Kung Hui Lady MacLehose Centre

    Kwai Chung

  • New Life Psychiatric Rehabilitation Association

    Kwai Chung

  • Christian Family Service Centre

    Kwun Tong

  • The Mental Health Association of Hong Kong

    Kwun Tong

  • Caritas Hong Kong

    Sham Shui Po

  • New Life Psychiatric Rehabilitation Association

    Sham Shui Po

  • Christian Family Service Centre

    Tseung Kwan O

  • Haven of Hope Christian Service

    Tseung Kwan O

Other trials in Hong Kong

About this study

Official title: Jockey Club JoyAge: Holistic Support Project for Elderly Mental Wellness

To develop a viable and sustainable best practice model to promote elderly mental wellness and prevent elderly depression for Hong Kong, the Hong Kong Jockey Club Charities Trust has initiated a pilot holistic support project entitled "JC JoyAge: Holistic Support Project for Elderly Mental Wellness". Commenced in October 2016, this 3-year project will deliver six programmes: (1) social services staff training; (2) peer supporters certificate training; (3) outreach and engagement activities for at-risk older adults; (4) standardized prevention and early intervention service; (5) community education programmes; and (6) public awareness and public education activities in four pilot districts in Hong Kong, namely Kwun Tong, Sham Shui Po, Kwai Chung, and Tseung Kwan O. The project aims specifically to:

  1. Evaluate the effectiveness of a collaborative stepped care and peer support programme in engaging older people at-risk of or with depression;
  2. Evaluate the efficacy of the programme in reducing symptoms/risks and promoting wellbeing in older people at-risk of or with depression;
  3. Investigate the impact of the programme on care resources utilization in these older adults.
Read the detailed description

Elderly depression is a neglected problem affecting our entire society with grave consequences and high societal costs. Early intervention and prevention can be effective in addressing the problem. The challenges in implementing early intervention and prevention within the existing service platforms, however, are threefold: (1) fragmented services; (2) reactive services; and (3) stigma and low awareness. These challenges resulted in the current service overload and mismatch, which will be compounded by rapid population ageing and mental health workforce shrinkage. The study can address these challenges by (1) realigning existing mental health and elderly services; (2) productive ageing for outreach and engagement; and (3) building up capacity of a preventive network in the neighbourhood. This pilot project therefore combines models of collaborative stepped care and productive ageing, with systematic education programmes, to empower the neighbourhood in providing effective early intervention and prevention for elderly depression. In the four representative pilot districts of Kwun Tong, Sham Shui Po, Kwai Chung, and Tseung Kwan O, community mental health and elderly services will collaborate to deliver a stepped care service protocol for preventing and detecting elderly depression. In 3 years, this project will deliver six programmes: (1) social services staff training; (2) peer supporters certificate training; (3) outreach and engagement activities for at-risk older adults; (4) standardized prevention and early intervention service; (5) community education programmes; and (6) public awareness and public education activities. This will produce a mature service model tested in one-fifth of the districts in Hong Kong with different demographic and service characteristics; create a strong team of Peer Supporters and Social Workers in Elderly Mental Health with clinical competence in preventing elderly depression and promoting elderly mental wellness; significantly raise public and neighbourhood awareness and care for elderly mental wellness; reach out and serve 2,880 at-risk older adults and 960 depressed older adults; and provide evidence on the social impact of the model for further service rollout.

Being tested
Collaborative stepped care and peer support programme, Treatment as usual
Keywords
Collaborative stepped care, Peer support, Early identification, Selective prevention, Indicated prevention
Medical subject headings
Depression

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Collaborative stepped care and peer support programmeBehavioural

    For "at-risk" group, 4 weeks of "selective prevention" group sessions will be provided at the elderly service level by trained peer supporters with registered social worker supervision, on wellness topics tailored to the person's concern as entry point, packaged with mental health information, followed by a review.

    For mild group, 6-8 weeks of indicated prevention with psychoeducation or low-intensity psychotherapy would be provided. For moderate group, 6-8 weeks high-intensity cognitive behavioral therapy (CBT) would be provided. All intervention for depressed elderly would be conducted by registered social workers. The trained peer supporters will be matched to individual older adults to walk them through the process with regular follow-up for 1 year.

  • Treatment as usualOther

    The control group will receive treatment as usual, which will be determined by the responsible workers from NGO units.

Study groups in NCT03593889
Study groupRoleWhat they receive
Intervention groupExperimentalThe intervention group will receive a collaborative stepped care programme provided by registered social workers and trained peer supporters from elderly or mental health service units (NGOs) according to level of risks, symptom severity, and intervention response. Home visits or other format of contact will be delivered by trained peer supporters employed by NGOs to detect and engage hidden cases.
Receives: Behavioral: Collaborative stepped care and peer support programme
Control groupOtherThe control group will receive treatment as usual, which will be determined by the responsible worker from NGO units.
Receives: Other: Treatment as usual

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from baseline depression at 12 months

    Depression will be measured by the Patient Health Questionnaire (PHQ-9). The total score will be used, ranging from 0 to 27. Higher scores indicate higher levels of depressive symptoms.

    Measured: Baseline and 12-month follow-up

Secondary outcomes (8)

  1. Change from baseline loneliness at 12 months

    Loneliness will be measured by the UCLA loneliness scale (UCLA-3). The total score will be used, ranging from 0 to 9. Higher scores indicate greater loneliness.

    Measured: Baseline and 12-month follow-up

  2. Change from baseline life engagement at 12 months

    Life engagement will be assessed using the typical day interview - a semi-structured interview asking clients about their typical day activities

    Measured: Baseline and 12-month follow-up

  3. Change from baseline self-harm risk at 12 months

    Self-harm risk will be measured by the self-harm risk assessment checklist.

    Measured: Baseline and 12-month follow-up

  4. Change from baseline anxiety at 12 months

    Anxiety will be measured by the Generalized Anxiety Disorder scale (GAD-7). The total score will be used, ranging from 0 to 21. Higher scores indicate higher levels of anxiety symptoms.

    Measured: Baseline and 12-month follow-up

  5. Change from baseline cognitive function at 12 months

    Cognitive function will be measured by the Hong Kong Montreal Cognitive Assessment 5-Minute Protocol (HK-MoCA 5-Min). The total score will be used, ranging from 0 to 30. Higher scores indicate higher levels of cognitive function.

    Measured: Baseline and 12-month follow-up

  6. Change from baseline social capital at 12 months

    Participants will be asked to list out names of people who they would turn to when they feel down, and when they need help for trivial things.

    Measured: Baseline and 12-month follow-up

  7. Change from baseline health-related quality of life at 12 months

    Health-related quality of life will be measured by the EuroQoL 5 Dimensions 5 Levels (EQ-5D-5L).

    Measured: Baseline and 12-month follow-up

  8. Change from baseline service utilization at 12 months

    Service utilization will be measured by the Client Service Receipt Inventory (CSRI).

    Measured: Baseline and 12-month follow-up

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Jul 2018
  2. Study start1 Oct 2017
  3. Primary completion31 Dec 2020
  4. Study completion30 Apr 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Non-randomised
Intervention model
Parallel groups
Model description
The intervention group will receive a collaborative stepped care programme provided by registered social workers and trained peer supporters from elderly or mental health service units (NGOs) according to level of risks, symptom severity, and intervention response. Home visits or other format of contact will be delivered by trained peer supporters employed by NGOs to detect and engage hidden cases. The control group will receive treatment as usual, which will be determined by the responsible worker from NGO units.
Masking
None (open label)
Enrolment
3,702 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03593889
Sponsor's protocol ID
EA1709021
Acronym
JCJoyAge
Status last verified
Jul 2024
First submitted
29 May 2018
Last updated
29 Jul 2024
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Wong SMY, Leung DKY, Liu T, Ng ZLY, Wong GHY, Chan WC, Lum TYS. Comorbid anxiety, loneliness, and chronic pain as predictors of intervention outcomes for subclinical depressive symptoms in older adults: evidence from a large community-based study in Hong Kong. BMC Psychiatry. 2024 Nov 21;24(1):839. doi: 10.1186/s12888-024-06281-2.

    PubMed 39574082

  • Liu T, Peng MM, Wong FHC, Leung DKY, Zhang W, Wong GHY, Lum TYS. Differential Associations Between Depressive Symptom-Domains With Anxiety, Loneliness, and Cognition in a Sample of Community Older Chinese Adults: A Multiple Indicators Multiple Causes Approach. Innov Aging. 2023 Jul 19;7(7):igad075. doi: 10.1093/geroni/igad075. eCollection 2023.

    PubMed 37727600

  • Liu T, Leung DKY, Lu S, Kwok WW, Sze LCY, Tse SSK, Ng SM, Wong PWC, Lou VWQ, Tang JYM, Wong DFK, Chan WC, Kwok RYK, Lum TYS, Wong GHY. Collaborative community mental health and aged care services with peer support to prevent late-life depression: study protocol for a non-randomised controlled trial. Trials. 2022 Apr 11;23(1):280. doi: 10.1186/s13063-022-06122-1.

    PubMed 35410292

  • Liu T, Lu S, Leung DKY, Sze LCY, Kwok WW, Tang JYM, Luo H, Lum TYS, Wong GHY. Adapting the UCLA 3-item loneliness scale for community-based depressive symptoms screening interview among older Chinese: a cross-sectional study. BMJ Open. 2020 Dec 10;10(12):e041921. doi: 10.1136/bmjopen-2020-041921.

    PubMed 33303463

Questions about this trial

What is this clinical trial studying?

A study testing Collaborative stepped care and peer support programme and Treatment as usual in people with Depressive Symptoms, run by The University of Hong Kong at 8 sites in Hong Kong.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 29 Jul 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 8 sites in Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from baseline depression at 12 months (time frame: Baseline and 12-month follow-up). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03593889, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jul 2024.

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