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Title: Pilot study of a two-arm non-randomized controlled cluster trial of a psychosocial intervention to improve late life depression in socioeconomically deprived areas of Sao Paulo, Brazil (PROACTIVE): feasibility study of a psychosocial intervention for late life depression in Sao Paulo
Authors: SCAZUFCA, MarciaCOUTO, Maria Clara P. de PaulaHENRIQUE, Maiara GarciaMENDES, Ana VilelaMATIJASEVICH, AliciaPEREDA, Paula CarvalhoFRANZIN, Renato M.SEABRA, Antonio CarlosVEN, Pepijn van deHOLLINGWORTH, WilliamPETERS, Tim J.ARAYA, Ricardo
Citation: BMC PUBLIC HEALTH, v.19, n.1, article ID 1152, 14p, 2019
Abstract: Background Depression is a common and recurrent condition among older adults and is associated with poor quality of life and increased health care utilization and costs. The purpose of this pilot study was to assess the feasibility of delivering a psychosocial intervention targeting depression, and to develop the procedures to conduct a cluster randomized controlled trial among older adults registered with primary care clinics in poor neighbourhoods of Sao Paulo, Brazil. Methods We conducted a pilot study of a two-arm cluster, non-randomized controlled trial. Two primary care clinics adhering to the Family Health Strategy were allocated to either the intervention or the control arm. In the control arm, patients received enhanced usual care consisting of staff training for improved recognition and management of depression. In the intervention arm, alongside the enhanced usual care, patients received a 17-week psychosocial intervention delivered by health workers assisted with an application installed in a tablet. Results We randomly selected 579 of 2020 older adults registered in the intervention clinic to participate in the study. Among these individuals, 353 were assessed for depression and 40 (11.0%) scored at least 10 on the PHQ-9 and were therefore invited to participate. The consent rate was 33/40 (82%) with a resulting yield of 33/579 (5.7%). In the control arm, we randomly selected 320 older adults among 1482 registered in the clinic, 223 were assessed for depression and 28 (12.6%) scored 10 or above on the PHQ-9. The consent rate was 25/28 (89%), with a resulting yield of 25/320 (7.8%). Of the 33 who consented in the intervention arm, 19 (59.4%) completed all sessions. The mean PHQ-9 at follow-up (approximately 30 weeks after inclusion) were 12.3 (SD = 3.7) and 3.8 (SD = 3.9) in the control and intervention arms, respectively. Follow-up rates were 92 and 94% in control and intervention arms, respectively. Conclusions Identification and engagement of clinics, randomization, recruitment of individuals, measures, and baseline and follow-up assessments all proved to be feasible in primary care clinics in Sao Paulo, Brazil. Results support the development of a definitive cluster randomized controlled trial.
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Artigos e Materiais de Revistas Científicas - FM/MPR
Departamento de Medicina Preventiva - FM/MPR

Artigos e Materiais de Revistas Científicas - LIM/23
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica

Artigos e Materiais de Revistas Científicas - LIM/39
LIM/39 - Laboratório de Processamento de Dados Biomédicos

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