AzTrials
AzTrials

AnxietyNCT02391363

Calmer Life: Treating Worry Among Older Adults In Underserved, Low-income, Minority Communities

A study testing Cognitive behavior treatment and Information and referral in people with Anxiety, run by Baylor College of Medicine at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this research study is to see how helpful two different interventions offered through the Calmer Life program are in reducing worry and improving mood. The investigators also want to understand how a program like Calmer Life can be offered in underserved communities. Read more about this study

Who is it for?
Ages 50 years and older
Conditions the study is for
Anxiety
What is being tested?
Cognitive behavior treatment and Information and referral
Could I receive a placebo?
No, everyone receives an active treatment
How many people
247 participants
Where
1 siteUnited States
Study dates
Nov 2014to Feb 2018
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 50 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • PSWQ greater than 22

Who cannot join

  • PHQ score less than 20
  • Active suicidal intent
  • Active psychosis or bipolar disorder
  • Substance abuse
  • Cognitive impairment

Trial locations and contacts

1 site in 1 country.

United States1 site
  • VA HSR&D Center for Innovations in Quality, Effectiveness & Safety (IQuESt)

    Houston, Texas, 77030

Other trials in United States

About this study

The purpose of this research study is to see how helpful two different interventions offered through the Calmer Life program are in reducing worry and improving mood. The investigators also want to understand how a program like Calmer Life can be offered in underserved communities.

Read the detailed description

Background: Recurrent, excessive, uncontrollable worry about multiple topics is common in older adults, but it is not well studied. This significant worry can negatively affect thinking, and it is associated with poorer sleep, more depression, and worse general health. Despite its prevalence, researchers have not studied significant worry enough, particularly in low-income racial and ethnic minority populations. We know these groups are unlikely to have adequate mental health care. We also know that older adults and minorities prefer treatments for worry that do not require medication, and that these kinds of treatments can be effective. Additional tests of treatments that do not involve drugs are needed in low-income racial and ethnic minority populations. Such person-centered research could expand access to appropriate care.

Objectives: The study team plans to compare two approaches, one called Calmer Life (CL) and another called Enhanced Community Care (ECC). CL helps individuals by providing worry-reduction skills and resource counseling for basic needs in a flexible, culturally supportive manner. ECC relies on standard information and resource counseling. The study will answer three questions. First, compared to ECC, is CL more effective at relieving significant worry? Second, which one is more effective at reducing anxiety and depression and improving sleep, ability to do daily activities, and use of medical services? Third, are improvements still present three months after treatment concludes?

Methods: In agreement with our community partners and governed by a council of community leaders, consumers, and providers from low-income minority communities, we will conduct the study. This community-academic partnership, created four years ago, introduced CL to the community. Case managers and community health workers from partner organizations were trained to implement CL. They taught worry-reduction skills and helped participants increase their use of community resources. Content was flexible so that participants could choose which skills to learn and whether or not to include religion or spirituality. They also could learn skills at home, by telephone, or in the community. In a new, larger comparison study, we will enroll 120 women and 30 men who are 50 years of age or older with significant worry. Most (80 percent) will be African American, and 70 percent will have income below poverty. Participants will be assigned by chance to CL or ECC and treated for six months. Brief assessments at enrollment and at six and nine months will rely on participants' reports. Differences will be measured statistically.

Conditions
Anxiety
Being tested
Cognitive behavior treatment, Information and referral
Keywords
anxiety, worry
Medical subject headings
Anxiety Disorders

What participants receive

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

  • Cognitive behavior treatmentBehavioural

    Anxiety management skills with the option to included religious/spiritual beliefs and practices

  • Information and referralBehavioural

    Resource counseling and follow-up for mental health and basic needs

Study groups in NCT02391363
Study groupRoleWhat they receive
Calmer LifeExperimentalCognitive behavior treatment for anxiety
Receives: Behavioral: Cognitive behavior treatment
Enhanced Community CareActive comparatorEnhanced information and referral services for mental health and basic needs
Receives: Behavioral: Information and referral

What is being measured

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

  1. Penn State Worry Questionnaire - A (PSWQ-A) at 6 Months

    Brief measure of worry with 8 items measured on a 1-5 scale (1 = not at all typical, 3 = somewhat typical, 5 = very typical). Scores range from 8 to 40. Higher scores indicate greater anxiety.

    Measured: Baseline, 6 months

  2. Penn State Worry Questionnaire - A (PSWQ-A) at 9 Months

    Brief measure of worry with 8 items measured on a 1-5 scale (1 = not at all typical, 3 = somewhat typical, 5 = very typical). Scores range from 8 to 40. Higher scores indicate greater anxiety.

    Measured: Baseline, 9 months

  3. Generalized Anxiety Disorder-7 (GAD-7) at 6 Months

    Measure of Generalized Anxiety Disorder symptoms. 7 items rated from 0 (not at all) to 3 (nearly every day). Scores range from 0 to 21. Higher scores indicate greater GAD symptoms.

    Measured: Baseline, 6 months

  4. Generalized Anxiety Disorder-7 (GAD-7) at 9 Months

    Measure of Generalized Anxiety Disorder symptoms. 7 items rated from 0 (not at all) to 3 (nearly every day). Scores range from 0 to 21. Higher scores indicate greater GAD symptoms.

    Measured: Baseline, 9 months

Secondary outcomes (26)
  1. Geriatric Anxiety Inventory - SF (GAI-SF) at 6 Months

    Five item scale with response options of yes = 1 and no = 0 to each item. Scores range from 0 to 5. Greater scores indicate greater anxiety.

    Measured: Baseline, 6 months

  2. Geriatric Anxiety Inventory - SF (GAI-SF) at 9 Months

    Five item scale with response options of yes = 1 and no = 0 to each item. Scores range from 0 to 5. Greater scores indicate greater anxiety.

    Measured: Baseline, 9 months

  3. Patient Health Questionnaire Depression Scale (PHQ 8) at 6 Months

    Brief measure of depression symptoms consisting of 8 items rated from 0-3 (0 = not at all, 1 = several days, 2 = more than half the days, 3 = nearly every day). Scores range from 0 to 24. Higher scores indicate greater depression severity.

    Measured: Baseline, 6 months

  4. Patient Health Questionnaire Depression Scale (PHQ 8) at 9 Months

    Brief measure of depression symptoms consisting of 8 items rated from 0-3 (0 = not at all, 1 = several days, 2 = more than half the days, 3 = nearly every day). Scores range from 0 to 24. Higher scores indicate greater depression severity.

    Measured: Baseline, 9 months

  5. Geriatric Depression Scale Short Form (GDS) at 6 Months

    Brief measure of depression designed for use with older adults consisting of 15 items rated yes (1) or no (0). Scores range from 0 to 15. Higher scores indicate greater depression.

    Measured: Baseline, 6 months

  6. Geriatric Depression Scale Short Form (GDS) at 9 Months

    Brief measure of depression designed for use with older adults consisting of 15 items rated yes (1) or no (0). Scores range from 0 to 15. Higher scores indicate greater depression.

    Measured: Baseline, 9 months

  7. Insomnia Severity Index (ISI) at 6 Months

    Measure of sleep difficulties consisting of 7 items rated on a 0-4 scale. Scores range from 0 to 28. Higher scores indicate greater sleep difficulties.

    Measured: Baseline, 6 months

  8. Insomnia Severity Index (ISI) at 9 Months

    Measure of sleep difficulties consisting of 7 items rated on a 0-4 scale. Scores range from 0 to 28. Higher scores indicate greater sleep difficulties.

    Measured: Baseline, 9 months

  9. Late-Life Function and Disability Instrument (LL-FDI) Disability Subscale - Frequency at 6 Months

    Measure that assesses disability frequency across 16 life tasks and social roles. Frequencies for the 16 items are rated on a scale from 1 (never) to 5 (very often). Summary scores are transformed to scaled summary scores ranging from 0 to 100. Higher scores represent higher participation in tasks/higher functioning.

    Measured: Baseline, 6 months

  10. Late-Life Function and Disability Instrument (LL-FDI) Disability Subscale - Frequency at 9 Months

    Measure that assesses disability frequency across 16 life tasks and social roles. Frequencies for the 16 items are rated on a scale from 1 (never) to 5 (very often). Summary scores are transformed to scaled summary scores ranging from 0 to 100. Higher scores represent higher participation in tasks/higher functioning.

    Measured: Baseline, 9 months

  11. Late-Life Function and Disability Instrument (LL-FDI) Disability Subscale - Limitation at 6 Months

    Measure that assesses disability limitations across 16 life tasks and social roles. Limitations for the 16 items are rated on a scale from 1 (completely limited) to 5 (not at all limited). Raw scores are transformed to scaled summary scores ranging from 0 to 100. Higher scores represent higher levels of capability of participating in tasks/higher functioning.

    Measured: Baseline, 6 months

  12. Late-Life Function and Disability Instrument (LL-FDI) Disability Subscale - Limitation

    Measure that assesses disability limitations across 16 life tasks and social roles. Limitations for the 16 items are rated on a scale from 1 (completely limited) to 5 (not at all limited). Raw scores are transformed to scaled summary scores ranging from 0 to 100. Higher scores represent higher levels of capability of participating in tasks/higher functioning.

    Measured: Baseline, 9 months

  13. Medical Outcomes Study 12-Item Short-Form Health Survey Physical Component Summary (SF-12 PCS) at 6 Months

    Physical component summary score of the 12-item Medical Outcomes Study Short Form (SF-12), a measure of health-related quality of life. Summary raw scores are transformed to scale scores ranging from 0 to 100. Higher scores indicate higher levels of physical functioning.

    Measured: Baseline, 6 months

  14. Medical Outcomes Study 12-Item Short-Form Health Survey Physical Component Summary (SF-12 PCS)

    Physical component summary score of the 12-item Medical Outcomes Study Short Form (SF-12), a measure of health-related quality of life. Summary raw scores are transformed to scale scores ranging from 0 to 100. Higher scores indicate higher levels of physical functioning.

    Measured: Baseline, 9 months

  15. Medical Outcomes Study 12-Item Short-Form Survey Mental Component Summary (SF-12 MCS) at 6 Months

    Mental component summary score of the 12-item Medical Outcomes Study Short Form (SF-12), a measure of health-related quality of life. Summary raw scores are transformed to scale scores ranging from 0 to 100.Higher scores indicate higher levels of mental health functioning.

    Measured: Baseline, 6 months

  16. Medical Outcomes Study 12-Item Short-Form Survey Mental Component Summary (SF-12 MCS) at 9 Months

    Mental component summary score of the 12-item Medical Outcomes Study Short Form (SF-12), a measure of health-related quality of life. Summary raw scores are transformed to scale scores ranging from 0 to 100.Higher scores indicate higher levels of mental health functioning.

    Measured: Baseline, 9 months

  17. PTSD Checklist-5 (PCL-5) Total at 6 Months

    Measure of PTSD symptoms. 20 items rated from 0 (not at all) to 4 (extremely). Scores range from 0 to 80. Higher scores = higher symptom severity.

    Measured: Baseline, 6 months

  18. PTSD Checklist-5 (PCL-5) Total at 9 Months

    Measure of PTSD symptoms. 20 items rated from 0 (not at all) to 4 (extremely). Scores range from 0 to 80. Higher scores = higher symptom severity.

    Measured: Baseline, 9 months

  19. Health Service Use at 6 Months

    Number of participants who had visited a health care provider (e.g., physician, nurse, physician's assistant) over the past 3 months.

    Measured: Baseline, 6 months

  20. Health Service Use at 9 Months

    Number of participants who had visited a health care provider (e.g., physician, nurse, physician's assistant) over the past 3 months.

    Measured: Baseline, 9 months

  21. Hospital Admissions at 6 Months

    Number of participants who were admitted to a hospital in the past 3 months.

    Measured: Baseline, 6 months

  22. Hospital Admissions at 9 Months

    Number of participants who were admitted to a hospital in the past 3 months.

    Measured: Baseline, 9 months

  23. Social Service or Resource Use at 6 Months

    Number of participants who received social services or resources over the past 3 months

    Measured: Baseline, 6 months

  24. Social Service or Resource Use at 9 Months

    Number of participants who received social services or resources over the past 3 months

    Measured: Baseline, 9 months

  25. Psychological Service Use at 6 Months

    Number of participants who discussed personal or emotional problems with a medical provider, clergy, mental health provider, or support group over the past 3 months

    Measured: Baseline, 6 months

  26. Psychological Service Use at 9 Months

    Number of participants who discussed personal or emotional problems with a medical provider, clergy, mental health provider, or support group over the past 3 months

    Measured: Baseline, 9 months

Timeline

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

  1. First posted18 Mar 2015 (estimated)
  2. Study startNov 2014
  3. Primary completionSep 2017
  4. Study completionFeb 2018

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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
247 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02391363
Sponsor's protocol ID
AD-1310-06824
Status last verified
Feb 2019
First submitted
26 Feb 2015
Last updated
31 May 2019
Data monitoring committee
Yes

Publications

  • Stanley MA, Wilson NL, Shrestha S, Amspoker AB, Wagener P, Bavineau J, Turner M, Fletcher TL, Freshour J, Kraus-Schuman C, Kunik ME. Community-Based Outreach and Treatment for Underserved Older Adults With Clinically Significant Worry: A Randomized Controlled Trial. Am J Geriatr Psychiatry. 2018 Nov;26(11):1147-1162. doi: 10.1016/j.jagp.2018.07.011. Epub 2018 Aug 7.

    PubMed 30224269
  • Steiner AJ, Boulos N, Wright SM, Mirocha J, Smith K, Lopez E, Gohar SH, Ishak WW. Major Depressive Disorder in Patients With Doctoral Degrees: Patient-reported Depressive Symptom Severity, Functioning, and Quality of Life Before and After Initial Treatment in the STAR*D Study. J Psychiatr Pract. 2017 Sep;23(5):328-341. doi: 10.1097/PRA.0000000000000251.

    PubMed 28961662
  • Shrestha S, Wilson N, Kunik ME, Wagener P, Amspoker AB, Barrera T, Freshour J, Kraus-Schuman C, Bavineau J, Turner M, Stanley MA. Calmer Life: A Hybrid Effectiveness-implementation Trial for Late-life Anxiety Conducted in Low-income, Mental Health-Underserved Communities. J Psychiatr Pract. 2017 May;23(3):180-190. doi: 10.1097/PRA.0000000000000234.

    PubMed 28492456

Questions about this trial

What is this clinical trial studying?

A study testing Cognitive behavior treatment and Information and referral in people with Anxiety, run by Baylor College of Medicine at 1 site in United States.

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 1 inclusion and 5 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: finished, as of the sponsor's last update on 31 May 2019. 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 United States. 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?

Yes. Results are posted in the registry (first posted 31 May 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Penn State Worry Questionnaire - A (PSWQ-A) at 6 Months (time frame: Baseline, 6 months). The study lists 4 primary outcomes in all. 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 NCT02391363, which also lists 3 linked publications.

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 31 May 2019.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in