Low-income individuals have limited access to evidence-based interventions for mental health. Peer recovery specialists, individuals in recovery from mental health and/or substance use problems, have the potential to increase access to evidence-based interventions for individuals from low-resource communities, particularly when trained and supervised in models that are acceptable and feasible in these communities. This study will examine the effectiveness and implementation potential of a peer-delivered evidence-based intervention (Behavioral Activation) among individuals receiving services from a community-based treatment setting providing integrated physical and behavioral healthcare.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
250
Peer Activate is an adapted behavioral activation (BA) intervention, developed for delivery by peer recovery specialists to reduce rates of depressive symptoms and substance use. BA focuses on increasing positive reinforcement through engaging in adaptive, valued behaviors. BA has been found to be effective in improving substance use outcomes and decreasing depressive symptoms among low-income individuals with SUD. Peer Activate includes 6 weekly sessions with up to 6 additional booster sessions.
Peers will deliver non-specific peer services, including linkage to care, general support, and facilitated referrals to external providers as needed.
Detroit Recovery Project
Detroit, Michigan, United States
Change in Hamilton Depression Rating Scale
The Hamilton Depression Rating Scale (HAM-D) is a structured interview regarding patients' symptoms of depression and functional impairment. The HAM-D will be administered by research assistants under the supervision of the MPI (Felton) at baseline, post-intervention, 6- and 12-month follow-up. The measure is widely used in depression and substance use treatment studies and has excellent psychometric properties. Nine items are scored 0-4 and 8 items are scored 0-2, with higher scores reflecting greater levels of depressive symptoms. A total score will be calculated by summing each other items. Summed total scores can range from 0-52, with higher values reflecting greater depression.
Time frame: Baseline, post-intervention (approximately 3 months after baseline), 6- and 12-month follow-up
Change in Patient Health Questionnaire-9
The Patient Health Questionnaire-9 (PHQ-9) is a self-report measure of depressive symptoms. Participants will complete the PHQ-9 at baseline, post-intervention, 6- and 12-month follow-up. The measure is valid and reliable in low-resource community settings. The measure includes nine items which are scored from 0-3, with 3 reflecting more severe levels of each depressive symptom. A total score is created by summing items with a possible range from 0-27 (with higher scores reflecting greater depressive symptoms).
Time frame: Baseline, post-intervention (approximately 3 months after baseline), 6- and 12-month follow-up
Change in Short Inventory of Problems
The Short Inventory of Problems is a self-report measure of problems related to substance use. Participants will complete the SIP at baseline, post-intervention, 6- and 12-month follow-up. The measure is valid and reliable and has been used by the investigator team in numerous studies among low-income populations. The measure includes 17 items, each ranked from 0-3 with higher scores reflecting greater problems related to alcohol and substance use. A total score is created by summing each item and can range from 0-51 with higher values reflecting more substance-related problems.
Time frame: Baseline, post-intervention (approximately 3 months after baseline), 6- and 12-month follow-up
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