Collaborative Stepped-Care and Productive Ageing Program for Older People With Depressive Symptoms

NCT ID: NCT04863300

Last Updated: 2025-03-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

5239 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-01

Study Completion Date

2024-06-30

Brief Summary

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The Jockey Club Holistic Support Project for Elderly Mental Wellness (JC JoyAge) has developed and implemented a collaborative stepped care model for older persons at-risk of or with depression in four districts in Hong Kong since 2015 (Clinical Trials Identifier: NCT03593889). Results from JC JoyAge show that the collaborative stepped-care model is effective in improving older persons' mental wellness, and the specialised training and engagement of Peer Supporters are effective in building capacity in the community. The proposed impact extension programme lasts for four years (from 2020 to 2023), and the overall goal is to expand the JC JoyAge model to all 18 districts in Hong Kong, to provide integrated and evidence-based mental health services to older adults with subclinical depressive symptoms, with the hope of model adoption in regular service upon project completion.

Detailed Description

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This four-year extension project includes three main elements: 1) Trainings, including different programmes for social services staff, Mental Wellness Ambassadors, and Peer Supporters; 2) Implementation of JoyAge service model: standardized collaborative stepped-care and Peer Support programmes for prevention and early intervention of depression in older adults; and 3) Public awareness campaign: coordinated programmes to increase mental health literacy and raise public awareness.

Specific goals of the programmes through the above three elements include:

1. To implement JC JoyAge clinical protocol and guidelines to coordinate care among community mental health and aged care services centres for elderly mental wellness in 18 districts;
2. To engage vulnerable and at-risk older adults in the community through productive ageing activities and mental wellbeing self-management training;
3. To enhance the capacity of social service staff in handling elderly depression through specialized and infusion training and knowledge exchange;
4. To raise public awareness and elderly mental health literacy among family members, neighbours, community stakeholders, and the general public to encourage early detection/help-seeking on depressive risk of older adults; and
5. To establish evidence of the effectiveness and cost-effectiveness of JC JoyAge Phase II model.

Conditions

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Depressive Symptoms

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

The intervention group will receive a collaborative stepped care programme provided by registered social workers and trained peer supporters from two types of NGOs (aged care or mental health service units) according to level of risks, symptom severity, and intervention response of the clients. Home visits or other format of contact will be delivered by trained peer supporters employed by NGOs to detect and engage hidden cases.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Intervention group

Participants in the intervention group will receive a collaborative stepped care programme provided by registered social workers and trained Peer Supporters from aged care service units - the Districts Elderly Community Centres (DECC), and mental health service units - the Integrated Community Centre on Mental Wellness (ICCMW), all are local NGOs. In the collaborative stepped care model (see attachment Table 1), older persons are matched to the intervention module that most suits their current needs. The person does not have to start at the lowest level of intervention to progress to the next level of intervention. Rather, they enter the service with the intervention level aligned to their needs, e.g., level of risks, symptom severity (measured by the Patient Health Questionnaire, PHQ-9), and intervention response. Home visits or other format of contact will be delivered by trained Peer Supporters employed by the NGOs to detect and engage hidden cases.

Group Type EXPERIMENTAL

Collaborative stepped care and peer support

Intervention Type BEHAVIORAL

Case identification will be done through open referral and outreach activities such as street booth, talks, and home visits.

For older adults with mild depressive symptoms (PHQ-9 score 5-9), 6-8 weeks of indicated prevention with psychoeducation or low-intensity psychotherapy would be provided by the project social workers in DECC. For participants with moderate depressive symptoms (PHQ-9 score 10-14), 6-8 weeks high-intensity clinical intervention, mainly group cognitive behavioral therapy (CBT), would be provided by project social workers from DECC and ICCMW. For those with moderately severe depressive symptoms (PHQ-9 score 15-19), 8-10 weeks individual CBT or group CBT at higher frequency would be provided by the project social workers from ICCMW.

In the progress review when a client is assessed to meet the discharge criteria, a 2-month exit plan involving a Peer Supporter follow-up is invoked.

Interventions

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Collaborative stepped care and peer support

Case identification will be done through open referral and outreach activities such as street booth, talks, and home visits.

For older adults with mild depressive symptoms (PHQ-9 score 5-9), 6-8 weeks of indicated prevention with psychoeducation or low-intensity psychotherapy would be provided by the project social workers in DECC. For participants with moderate depressive symptoms (PHQ-9 score 10-14), 6-8 weeks high-intensity clinical intervention, mainly group cognitive behavioral therapy (CBT), would be provided by project social workers from DECC and ICCMW. For those with moderately severe depressive symptoms (PHQ-9 score 15-19), 8-10 weeks individual CBT or group CBT at higher frequency would be provided by the project social workers from ICCMW.

In the progress review when a client is assessed to meet the discharge criteria, a 2-month exit plan involving a Peer Supporter follow-up is invoked.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* age 60 years or above; and
* have depressive symptoms of mild level or above; and
* able to give informed consent to participate

Exclusion Criteria

* known history of autism, intellectual disability, schizophrenia-spectrum disorder, bipolar disorder, Parkinson's disease, or dementia; and
* difficulty in communication
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Aberdeen Kai-fong Welfare Association

OTHER

Sponsor Role collaborator

Caritas Medical Centre, Hong Kong

OTHER

Sponsor Role collaborator

Christian Family Service Centre

OTHER

Sponsor Role collaborator

Haven of Hope Hospital

OTHER

Sponsor Role collaborator

Hong Kong Christian Service

OTHER

Sponsor Role collaborator

Hong Kong Sheng Kung Hui Lady MacLehose Centre

UNKNOWN

Sponsor Role collaborator

Hong Kong Sheng Kung Hui Welfare Council Limited

OTHER

Sponsor Role collaborator

Hong Kong Young Women's Christian Association

OTHER

Sponsor Role collaborator

New Life Psychiatric Rehabilitation Association

OTHER

Sponsor Role collaborator

St. James' Settlement

OTHER

Sponsor Role collaborator

The Hong Kong Society for the Aged

UNKNOWN

Sponsor Role collaborator

The Mental Health Association of Hong Kong

OTHER

Sponsor Role collaborator

Neighbourhood Advice-Action Council

OTHER

Sponsor Role collaborator

Tung Wah Group of Hospitals

OTHER

Sponsor Role collaborator

The University of Hong Kong

OTHER

Sponsor Role lead

Responsible Party

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Professor Terry Y.S. Lum

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Terry Lum, PhD

Role: PRINCIPAL_INVESTIGATOR

The University of Hong Kong

Locations

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Aberdeen Kaifong Welfare Association Services Centre

Hong Kong, , Hong Kong

Site Status

Baptist Oi Kwan Social Service Integrated Community Centre for Mental Wellness (Kwai Tsing)

Hong Kong, , Hong Kong

Site Status

Baptist Oi Kwan Social Service

Hong Kong, , Hong Kong

Site Status

Caritas Cheng Shing Fung District Elderly Centre (Sham Shui Po)

Hong Kong, , Hong Kong

Site Status

Caritas District Elderly Centre - Yuen Long(Tin Chak Centre)

Hong Kong, , Hong Kong

Site Status

Caritas Wellness Link - North District

Hong Kong, , Hong Kong

Site Status

Caritas Wellness Link Tsuen Wan

Hong Kong, , Hong Kong

Site Status

Chan Tseng Hsi Kwai Chung District Elderly Community Centre

Hong Kong, , Hong Kong

Site Status

Christian Family Service Centre (Kwun Tong)

Hong Kong, , Hong Kong

Site Status

Christian Family Service Centre Wellness Zone - Integrated Community Centre for Mental Wellness

Hong Kong, , Hong Kong

Site Status

Chuk Yuen Canon Martin District Elderly Community Centre_Wai Yuen House

Hong Kong, , Hong Kong

Site Status

Ellen Li District Elderly Community Centre - Yung Shing Shopping Centre

Hong Kong, , Hong Kong

Site Status

Fong Shu Chuen District Elderly Community Centre

Hong Kong, , Hong Kong

Site Status

H.K.S.K.H. Lady MacLehose Centre Dr. Lam Chik Suen District Elderly Community Centre

Hong Kong, , Hong Kong

Site Status

H.K.S.K.H. Lok Man Alice Kwok Integrated Service Centre

Hong Kong, , Hong Kong

Site Status

H.K.S.K.H. Western District Elderly Community Centre - Integrated Home Care Services Team

Hong Kong, , Hong Kong

Site Status

Haven of Hope Christian Service

Hong Kong, , Hong Kong

Site Status

Hong Kong Christian Service Bliss District Elderly Community Centre

Hong Kong, , Hong Kong

Site Status

Jockey Club Wong Chi Keung District Elderly Community Centre - Aberdeen

Hong Kong, , Hong Kong

Site Status

Neighbourhood Advice-action Council (Shan King) Community Nursing Services (CNS) Centre

Hong Kong, , Hong Kong

Site Status

New Life Psychiatric Rehabilitation Association (Sha Tin)

Hong Kong, , Hong Kong

Site Status

New Life Psychiatric Rehabilitation Association (Tuen Mun)

Hong Kong, , Hong Kong

Site Status

New Life Psychiatric Rehabilitation Association (Yau Tsim Mong)

Hong Kong, , Hong Kong

Site Status

New Life Psychiatric Rehabilitation Association Islands District

Hong Kong, , Hong Kong

Site Status

New Life Psychiatric Rehabilitation Association The Wellness Centre (Tin Shui Wai)

Hong Kong, , Hong Kong

Site Status

S.K.H. Holy Carpenter Church District Elderly Community Centre (Kowloon)

Hong Kong, , Hong Kong

Site Status

Sage Eastern District Elderly Community Centre

Hong Kong, , Hong Kong

Site Status

Sage Tsuen Wan District Elderly Community Centre

Hong Kong, , Hong Kong

Site Status

Shun On District Elderly Community Centre

Hong Kong, , Hong Kong

Site Status

St. James' Settlement Central & Western District Elderly Community Centre

Hong Kong, , Hong Kong

Site Status

St. James' Settlement Wan Chai District Elderly Community Centre

Hong Kong, , Hong Kong

Site Status

The Mental Health Association of Hong Kong Amity Place

Hong Kong, , Hong Kong

Site Status

The Mental Health Association of Hong Kong Tai Po District

Hong Kong, , Hong Kong

Site Status

The Neighbourhood Advice-Action Council

Hong Kong, , Hong Kong

Site Status

The Neighbourhood Advice-Action Counil Tung Chung Intergrated Service Centre

Hong Kong, , Hong Kong

Site Status

The Salvation Army Tai Po Multi-service Centre for Senior Citizens

Hong Kong, , Hong Kong

Site Status

The Society of Rehabilitation and Crime Prevention, Hong Kong

Hong Kong, , Hong Kong

Site Status

The Wellness Centre, New Life Psychiatric Rehabilitation Association (Kwai Chung)

Hong Kong, , Hong Kong

Site Status

Tseung Kwan O Aged Care Complex, Jockey Club District Elderly Community Centre cum Day Care Unit

Hong Kong, , Hong Kong

Site Status

Tung Wah Group of Hospitals Wilson T.S. Wang District Elderly Community Centre

Hong Kong, , Hong Kong

Site Status

TWGHs Lok Hong Integrated Community Centre for Mental Wellness

Hong Kong, , Hong Kong

Site Status

Wong Cho Tong District Elderly Community Centre

Hong Kong, , Hong Kong

Site Status

YWCA Ming Yue District Elderly Community Centre

Hong Kong, , Hong Kong

Site Status

Countries

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Hong Kong

References

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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.

Reference Type DERIVED
PMID: 39574082 (View on PubMed)

Provided Documents

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Document Type: Study Protocol, Statistical Analysis Plan, and Informed Consent Form

View Document

Other Identifiers

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EA2003001

Identifier Type: -

Identifier Source: org_study_id

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