Improving quality of life in diverse rural older adults: A randomized trial of a psychological treatment.

Abstract

The efficacy of home-delivered cognitive-behavioral therapy (CBT) in improving quality of life and reducing psychological symptoms in older adults was examined in this study. One hundred thirty-four participants, predominately African American and characterized as primarily rural, low resource, and physically frail, were randomly assigned to either CBT or a minimal support control condition. Results indicate that CBT participants evidenced significantly greater improvements in quality of life and reductions in psychological symptoms. Mediation of treatment through cognitive and behavioral variables was not found despite the acceptable delivery of CBT by research therapists. These data suggest that treatment can be effective with a disadvantaged sample of older adults and extend efficacy findings to quality of life domains. Creating access to evidence-based treatments through nontraditional delivery is an important continuing goal for geriatric health care.

Effects of Home-Delivered Cognitive Behavioral Therapy (CBT) for Depression on Anxiety Symptoms among Rural, Ethnically Diverse Older Adults

“…Exclusion criteria were: (a) having self-reported history of schizophrenia, bipolar disorder, or current substance abuse; (b) receiving psychotherapy currently; or (c) demonstrating significant cognitive impairment as indicated by a score of 23 or less (16 or less for those with less than a ninth-grade education) on the Mini-Mental Status Examination (Folstein, Folstein,& McHugh, 1975). For a more nuanced description of the project and necessary ad hoc modifications of the inclusion criteria, please see Scogin et al (2007).…”

“…For a complete description of the procedures, see the larger study from which these secondary analyses were derived (Scogin et al, 2007). Trained research assistants completed assessments in the participants’ homes.…”

“…Project to Enhance Aged Rural Living (PEARL; Scogin, PI; AG16311)was a randomized control trial aimed at assessing the efficacy of home-delivered CBT for depressionto improve quality of life and reduce negative psychological symptoms among ethnically diverse, rural-dwelling, older adultsthrough an immediateversus a minimal support control (MSC) group study design (LaRocca & Scogin, 2015; Scogin, Morthland, Kaufman, Burgio, Chaplin,& Kong, 2007; Scogin, Moss, Harris, & Presnell, 2014). Results found that participants receiving home-delivered CBT demonstrated significantly greater improvements in quality of life and reductions in psychological symptoms than MSC participants.…”

Mediators of the impact of a home-based intervention (beat the blues) on depressive symptoms among older African Americans.

“…Scogin and colleagues (2007) found that while their intervention improved quality of life, cognitive and behavioral variables were not impacted and hence they did not mediate the positive benefits of the intervention.…”

Discrimination experience and quality of life among rural-to-urban migrants in China: the mediation effect of expectation–reality discrepancy

“…This concept emphasized the essentially subjective nature of QOL [25]. Previous empirical studies found that perceived QOL was a significant predictor of subsequent physical illness and psychological disorders [26,27]. Therefore, studying QOL among a population is an essential step to understand and improve health status, wellbeing, and mental health among various vulnerable populations, such as rural-to-urban migrants who moved from rural areas to urban areas seeking jobs or a better life.…”