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DepressionREPICALNCT05526235

A Scalable Psychological Intervention to Reduce Psychological Distress Among Workers of Assisted Living Facilities

A study testing Doing What Matters (DWM), Problem Management Plus (PM+) and Psychological First Aid (PFA) in people with Depression and Anxiety, run by Fundació Sant Joan de Déu at 1 site in Spain.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The current study is a randomized controlled trial (RCT) that aims to evaluate the effectiveness of a stepped-care program (Doing What Matters [DWM] and Problem Management Plus [PM+]) in reducing anxiety and depression symptoms amongst long-term care workers (LTCWs), following changes in care due to the COVID-19… Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Depression, Anxiety, Psychological Distress
What is being tested?
Doing What Matters (DWM), Problem Management Plus (PM+) and Psychological First Aid (PFA)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
150 participants
Where
1 siteSpain
Study dates
27 Sep 2022to Sep 2024
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 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 18 years or older;
  • Having elevated levels of psychological distress (Kessler Psychological Distress Scale (K10) >15.9).
  • Written/digital informed consent before entering the study.
  • Being a worker in a long-term care facility or a home care worker in the community of Catalonia.

Who cannot join

  • Having acute medical conditions (requiring hospitalization)
  • Imminent suicide risk, or expressed acute needs, or protection risks that require immediate follow-up
  • Having a severe mental disorder (e.g., psychotic disorders, substance-dependence)
  • Having severe cognitive impairment (e.g., severe intellectual disability or dementia)
  • Currently specialized psychological treatment (e.g., Eye movement desensitization and reprocessing, Cognitive behavioral therapy)
  • In case of current psychotropic medication use, being on an unstable dose for at least 2 months.

Trial locations and contacts

1 site in 1 country.

Mireia Felez-Nobrega, PhD contact

936406350 ext. 12540

mireia.felez@sjd.es

Leticia González Spinoglio, MSc contact

936406350 ext. 2543

leticia.gonzalez@sjd.es

Spain1 site, 1 recruiting
  • Parc Sanitari Sant Joan de Déu

    Sant Boi de Llobregat, Barcelona, 08930

    Josep Maria Haro, MD, PHD

    Recruiting

Other trials in Spain

About this study

Official title: Reducing the Psychosocial Impact of the Covid-19 Pandemic on Workers of Assisted Living Facilities

The current study is a randomized controlled trial (RCT) that aims to evaluate the effectiveness of a stepped-care program (Doing What Matters [DWM] and Problem Management Plus [PM+]) in reducing anxiety and depression symptoms amongst long-term care workers (LTCWs), following changes in care due to the COVID-19 pandemic.

Read the detailed description

Background: The COVID-19 pandemic has impacted the mental health of long-term care workers (LTCWs). This study combines two low-intensity psychological interventions developed by the World Health Organization (Doing What Matters [DWM] and Problem Management Plus [PM+]) into a stepped-care program for LTCWs.

Objective: To evaluate the implementation of a stepped-care program (DWM; PM+) amongst LTCWs following changes in care due to the COVID-19 pandemic in terms of mental distress, resilience and wellbeing.

Study design: A randomized controlled implementation trial with a single-blinded, parallel-group design.

Study population: Long-term care workers (including workers of assisted living facilities and home care) with self-reported elevated psychological distress.

Intervention-study: All participants (in both the treatment and the comparison group) will receive Psychological First Aid (PFA) and care as usual (CAU). In addition to PFA and CAU, the treatment group will receive the stepped-care intervention (DWM with or without PM+). The stepped-care intervention consists of DWM (step 1) and conditionally PM+ (step 2) if participants still meet criteria for psychological distress (Kessler Psychological Distress scale (K10) >15.9) 1 month after having received DWM.

Main study parameters/endpoints: Screening for inclusion and exclusion criteria will be interviewer-administered through phone calls. All assessments will be online and will take place at baseline, 2 weeks after having received DWM, 1 week after having received PM+ and 2 months after PM+. The main study parameter will be the decrease of anxiety and depressive symptoms from baseline to two-month follow-up, measured through the sum score of the Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder-7 (GAD-7), i.e. the PHQ-Anxiety and Depression Score (PHQ-ADS).

Being tested
Doing What Matters (DWM), Problem Management Plus (PM+), Psychological First Aid (PFA)
Medical subject headings
Depression, Anxiety Disorders

What participants receive

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

  • Doing What Matters (DWM)Behavioural

    Also called Doing What Matters in Times of Stress, Self Help Plus, DWM, SH+

    The original DWM program consists of a self-help guide called 'Doing What Matters in Times of Stress', that is complemented with pre-recorded audio exercises. The audio material imparts key information about stress management and guides participants through individual exercises. Additionally, participants are guided by a briefly trained helper. In this study, DWM will be delivered as an online intervention. The DWM intervention, i.e. both the audio recordings and the self-help guide, has been adapted for use on a smartphone or other device with internet access. The format of DWM is innovative in that it seeks to ensure that key intervention components are delivered as intended through the use of pre-recorded audio, without the burden of extensive training and supervision. In the online application tool a new module is released every week so participants will be asked to go through the entire DWM intervention within 5 weeks with weekly guidance from a helper.

  • Problem Management Plus (PM+)Behavioural

    Also called PM+

    PM+ is a new, brief, psychological intervention program based on cognitive behavioral therapy (CBT) techniques. The manual involves the following empirically supported elements: problem solving plus stress management, behavioral activation, facing fears, and accessing social support. Across the five 90-minute sessions participants may talk to trained non-professional. PM+ has four core features, and it is brief. In this study, the delivery mode of the PM+ intervention will be flexible, with remote delivery in phases of the pandemic when physical distancing rules apply. This is a future-oriented attempt towards a more holistic mental health care system that can flexibly switch between modes of delivery (e.g. remotely (e.g. Zoom) or face-to), depending on the needs and the specific containment measures that apply, and the specific preferences and needs of the participant.

  • Psychological First Aid (PFA)Behavioural

    Also called PFA

    PFA is a brief intervention consisting of a 15-min call that assess the immediate concerns and needs of an individual in order to connect individuals to help and resources.

Study groups in NCT05526235
Study groupRoleWhat they receive
Stepped-care program (Step 1: DWM; Step 2: PM+)ExperimentalThe treatment group will first receive Psychological First Aid (PFA). PFA consists of a 15-min call that assess the immediate concerns and needs of an individual in order to connect individuals to help and resources. Afterwards participants will receive the stepped-care program consisting of Doing What Matters (DWM) (step 1) and Problem Management Plus (PM+) (step 2). Step 2 will only be provided if the participant still has elevated levels of psychological distress (i.e. during the second quantitative assessment at 2 weeks after DWM). Participants will also be allowed to continue with their mental health interventions (CAU), as long as they meet eligibility criteria. Interventions: Behavioral: Doing What Matters (DWM) Behavioral: Problem Management Plus (PM+) Behavioral: Psychological First Aid (PFA)
Receives: Behavioral: Doing What Matters (DWM); Behavioral: Problem Management Plus (PM+); Behavioral: Psychological First Aid (PFA)
Psychological First Aid (PFA)Active comparatorParticipants allocated to the control arm will also receive PFA. Participants will also be allowed to continue with their mental health interventions (CAU), as long as they meet eligibility criteria. Intervention: Behavioral: Psychological First Aid (PFA)
Receives: Behavioral: Psychological First Aid (PFA)

What is being measured

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

  1. Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS)

    The PHQ-ADS is a 16-item self-reported instrument that combines the nine-item Patient Health Questionnaire depression scale and seven-item Generalized Anxiety Disorder scale-as a composite measure of depression and anxiety. Respondents are asked how much each symptom has bothered them over the past 2 weeks, with response options of "not at all", "several days", "more than half the days", and "nearly every day", scored as 0, 1, 2, and 3. The scale can range from 0 to 48, with higher scores indicating higher levels of depression and anxiety symptomatology.

    Measured: Change from baseline to 20 weeks

Secondary outcomes (6)
  1. Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS)

    The PHQ-ADS is a 16-item self-reported instrument that combines the nine-item Patient Health Questionnaire depression scale and seven-item Generalized Anxiety Disorder scale-as a composite measure of depression and anxiety. Respondents are asked how much each symptom has bothered them over the past 2 weeks, with response options of "not at all", "several days", "more than half the days", and "nearly every day", scored as 0, 1, 2, and 3. The scale can range from 0 to 48, with higher scores indicating higher levels of depression and anxiety symptomatology.

    Measured: Change: Baseline, 6 weeks, and 12 weeks

  2. Patient Health Questionnaire (PHQ-9)

    The PHQ-9 is a 9-item self-reported instrument that measures depression symptoms. Respondents are asked how much each symptom has bothered them over the past 2 weeks, with response options of "not at all", "several days", "more than half the days", and "nearly every day", scored as 0, 1, 2, and 3. The scale can range from 0 to 27, with higher scores indicating higher levels of depression.

    Measured: Baseline, 6 weeks, 12 weeks, and 20 weeks

  3. Generalized Anxiety Disorder (GAD-7) scale

    The GAD-7 is a 7-item self-reported instrument that measures anxiety symptoms. Respondents are asked how much each symptom has bothered them over the past 2 weeks, with response options of "not at all", "several days", "more than half the days", and "nearly every day", scored as 0, 1, 2, and 3. The scale can range from 0 to 21, with higher scores indicating higher levels of anxiety.

    Measured: Change: Baseline, 6 weeks, 12 weeks, and 20 weeks

  4. Posttraumatic Stress Disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (PCL-5) - 8-item version

    The PCL-5 is a self-reported instrument that measures PTSD symptoms. Respondents are asked how much each symptom has bothered them over the past 4 weeks, with response options of "not at all", "a little bit", "moderately", "quite a bit", and "extremely". Items are rated on a 0-4 scale. The scale can range from 0 to 32 for the 8-item version, with higher scores indicating higher levels of PTSD symptoms.

    Measured: Change: Baseline, 6 weeks, 12 weeks, and 20 weeks

  5. EuroQol 5-dimensional descriptive system - 5-level version (EQ-5D-5L)

    The EQ-5D-5L measures quality of life and consists of two parts, the EQ-5D and the EQ VAS. Part 1, the EQ-5D, rates the level of impairment across five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. The labels for the 5L followed the format "no problems," "slight problems," "moderate problems," "severe problems," and "unable to"/"extreme problems" for all dimensions. For mobility, the description of "confined to bed" has been changed to "unable to walk about.". Part 2, the EQ-VAS, is a visual analogue scale. The endpoints of the scale are called 'The best health you can imagine' and 'The worst health you can imagine' and the current health status of that day needs to be indicated, after which the number checked on the scale also needs to be written down. Higher scores indicate worst qualitive of life.

    Measured: Baseline, 6 weeks, 12 weeks, and 20 weeks

  6. Client Service Receipt Inventory (CSRI) - adaptation

    The CSRI was developed for the collection of data on service utilization (e.g. use of health system, other services, time out of employment and other usual activities, need for informal care) and related characteristics of people with mental disorders, as the basis for calculating the costs of care for mental health cost-effectiveness research. The RESPOND-adapted version consists of a 13-item self-reported instrument that asks about the number and duration of contacts with healthcare professionals (physicians, mental health specialists, and nurses) in the past two months.

    Measured: Change: Baseline, 6 weeks, 12 weeks, and 20 weeks

Timeline

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

  1. First posted2 Sep 2022
  2. Study start27 Sep 2022
  3. Primary completionMay 2024 (estimated)
  4. Study completionSep 2024 (estimated)

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
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
150 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05526235
Sponsor's protocol ID
202114
Acronym
REPICAL
Status last verified
Apr 2024
First submitted
21 Jul 2022
Last updated
26 Apr 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Gonzalez-Spinoglio L, Esplugues-Tormo M, Gine-Vazquez I, Rodeiro-Boliart J, Aguilar-Ortiz S, Ayuso-Mateos JL, McGreevy KR, Mediavilla R, Roos R, Sijbrandij M, Witteveen AB, Haro JM, Felez-Nobrega M. A Randomized Controlled Trial of a Digital Stepped-Care Program to Reduce Anxiety and Depressive Symptoms Among Long-Term Care Workers With Psychological Distress: The REPICAL Study. Depress Anxiety. 2026 Oct 2;2026:5875889. doi: 10.1155/da/5875889. eCollection 2026.

    PubMed 42829513

Questions about this trial

What is this clinical trial studying?

A study testing Doing What Matters (DWM), Problem Management Plus (PM+) and Psychological First Aid (PFA) in people with Depression and Anxiety, run by Fundació Sant Joan de Déu at 1 site in Spain.

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 6 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: status not confirmed, as of the sponsor's last update on 26 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Spain. 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?

Results are not available in the source record.

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

Contact Mireia Felez-Nobrega, PhD (936406350 ext. 12540, mireia.felez@sjd.es), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) (time frame: Change from baseline to 20 weeks). 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 NCT05526235, which also lists 1 linked publication.

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 26 Apr 2024.

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