Reducing Depressive Symptoms Among Rural African Americans



Status:Recruiting
Conditions:Depression
Therapuetic Areas:Psychiatry / Psychology
Healthy:No
Age Range:18 - Any
Updated:1/26/2019
Start Date:May 2016
End Date:April 2021
Contact:Ellen M Hutchins, MPH
Email:emhutchins@uams.edu
Phone:501-526-6676

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Rural African Americans are disproportionately impacted by social stressors that place them
at risk for experiencing elevated depressive symptoms. This project will test the
effectiveness of a culturally adapted behavioral activation intervention (REJOICE) for use
within rural African American churches. Further, this project will gather data on strategies
necessary to promote the successful implementation of this intervention within rural African
American churches.

Rural African Americans are disproportionately exposed to numerous stressors such as poverty,
racism, and discrimination that place them at risk for experiencing elevated levels of
depressive symptoms. Elevated levels of depressive symptoms can lead to a host of negative
outcomes including both the development of and poor management of chronic illnesses (i.e.
hypertension, diabetes, etc.), poor social functioning, poor occupational functioning, and
development of clinical depression. Though effective treatments for decreasing depressive
symptoms exist, rural African Americans often fail to receive adequate and timely care.

African American churches have been identified as potential venues for providing depression
education and treatment for rural African Americans. Within the African American rural
community, churches represent a key portal through which a large proportion (as much as 85%)
of the African American community can be reached. Churches have been used to address physical
health outcomes in those communities but few have focused primarily on addressing mental
health outcomes.

Through the NIMHD funded project entitled, "Faith Academic Initiatives to Transform Health
(FAITH) in the Delta", our partnership, consisting of faith community leaders and UAMS
researchers, culturally adapted an evidence-based behavioral activation intervention for use
with rural African American churches. This 8-session behavioral activation therapy was
adapted to include faith-based themes, Scripture, and other aspects of the rural African
American faith culture (e.g. bible studies, use of lay leaders to deliver the intervention).
In addition to assessing the effectiveness of our intervention, ascertaining ways to
implement this intervention with proper fidelity to maintain clinical outcomes is also
critically important to increase the efficiency of translating research into practice. Work
towards disseminating evidence-based depression interventions to "real world" settings is
particularly salient in addressing depression disparities, whereby rural African Americans
bear a disproportionate burden. Thus, this application proposes a Hybrid-2
pragmatic-effectiveness implementation trial that seeks to test the effectiveness of the
culturally adapted evidence-based intervention and gather preliminary data on the strategies
necessary to support successful implementation of this intervention in rural African American
churches.

Specifically, this study aims to: 1) Refine a culturally appropriate, evidence-based
depression intervention (REJOICE) based on results from our NIMHD-funded pilot study, 2)
Determine whether REJOICE is superior to a usual-care control group at post treatment and a
3-month follow-up, 3) Collect pilot data regarding "real world" implementation strategies
(i.e. face to face training and coaching calls) on the uptake and maintenance of REJOICE in
rural African American churches.

Inclusion Criteria:

- African American

- Aged 18 and older

- Mild to moderate levels of depressive symptoms (scores of 11-20 on the Beck Depression
Inventory-II (BDI-II)

- Associated with a participating church through membership or participation in a church
activity

- Free of medical problems that might contraindicate participation in a BA intervention
(i.e. active intoxication (scores of 3 or more on the AUDIT-C), cognitive decline
(score of 4 or more on the Brief Cognitive Screener51).

Exclusion Criteria:

- Individuals who are experiencing severe levels of depressive symptoms (scores of 21 or
higher on BDI-II)
We found this trial at
18
sites
6501 South Hazel Street
Pine Bluff, Arkansas 71603
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Pine Bluff, AR
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Brinkley, Arkansas 72021
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Brinkley, AR
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2305 Springhill Road
Bryant, Arkansas 72202
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Bryant, AR
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37947 Arkansas 44
Crumrod, Arkansas 72328
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Crumrod, AR
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Dumas, Arkansas 71639
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Dumas, AR
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110 East Banks Street
Dumas, Arkansas 71639
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Dumas, AR
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1401 New Castle Road
Forrest City, Arkansas 72335
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Forrest City, AR
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427 Cherry Street
Helena, Arkansas 72342
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Helena, AR
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408 North Division Street
Humphrey, Arkansas 72073
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Humphrey, AR
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1200 Lewis St
Little Rock, Arkansas 72204
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Little Rock, AR
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5121 Baseline Road
Little Rock, Arkansas 72209
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Little Rock, AR
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55 South Poplar Street
Marianna, Arkansas 72360
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Marianna, AR
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296 Moton Street
Marianna, Arkansas 72360
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Marianna, AR
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McGehee, Arkansas 71654
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McGehee, AR
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5301 West 5th Avenue
Pine Bluff, Arkansas 71603
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Pine Bluff, AR
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1200 University Drive
Pine Bluff, Arkansas 71603
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Pine Bluff, AR
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1430 Springdale Road
West Helena, Arkansas 72390
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West Helena, AR
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125 North Coanza
West Helena, Arkansas 72390
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West Helena, AR
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