Jockey Club JoyAge: Holistic Support Project for Elderly Mental Wellness
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- The University of Hong Kong
- Enrollment
- 3,702
- Locations
- 8
- Primary Endpoint
- Change from baseline depression at 12 months
Study Overview
Brief 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". 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:
- Evaluate the effectiveness of a collaborative stepped care and peer support programme in engaging older people at-risk of or with depression;
- Evaluate the efficacy of the programme in reducing symptoms/risks and promoting wellbeing in older people at-risk of or with depression;
- Investigate the impact of the programme on care resources utilization in these older adults.
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.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- None
Eligibility Criteria
- Ages
- 60 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •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
Exclusion Criteria
- •known history of autism, intellectual disability, schizophrenia-spectrum disorder, bipolar disorder, Parkinson's disease, or dementia; and
- •imminent suicidal risk; and
- •difficulty in communication
Arms & Interventions
Intervention group
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.
Intervention: Collaborative stepped care and peer support programme (Behavioral)
Control group
The control group will receive treatment as usual, which will be determined by the responsible worker from NGO units.
Intervention: Treatment as usual (Other)
Outcomes
Primary Outcomes
Change from baseline depression at 12 months
Time Frame: Baseline and 12-month follow-up
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.
Secondary Outcomes
- Change from baseline social capital at 12 months(Baseline and 12-month follow-up)
- Change from baseline loneliness at 12 months(Baseline and 12-month follow-up)
- Change from baseline life engagement at 12 months(Baseline and 12-month follow-up)
- Change from baseline service utilization at 12 months(Baseline and 12-month follow-up)
- Change from baseline anxiety at 12 months(Baseline and 12-month follow-up)
- Change from baseline cognitive function at 12 months(Baseline and 12-month follow-up)
- Change from baseline health-related quality of life at 12 months(Baseline and 12-month follow-up)
- Change from baseline self-harm risk at 12 months(Baseline and 12-month follow-up)
Investigators
Professor Terry Y.S. Lum
Professor
The University of Hong Kong