Research indicates that engaging in enjoyable or meaningful activities can help prevent depression after a stroke. An interprofessional team at UTHealth Houston has secured a federal grant to test an intervention using video chats to promote mood-enhancing behaviors among older, low-income stroke survivors.
Jennifer E.S. Beauchamp, PhD, RN, an associate professor at Cizik School of Nursing at UTHealth Houston, is the principal investigator on the five-year, $6.48 million grant from the National Institute of Mental Health (R01MH140091), part of the National Institutes of Health. Beauchamp also serves as director of the Mental Health Program at the UTHealth Houston Institute for Stroke and Cerebrovascular Diseases.
Beauchamp noted that approximately one-third of stroke survivors develop depression, with up to 60% experiencing some level of depressive symptoms. If untreated, subthreshold depression often progresses to post-stroke depression (PSD). Patients with PSD face increased risks for subsequent strokes, neurological deficits, diminished functioning, poor quality of life, and premature death from all causes including suicide.
“Low-income, older stroke survivors face financial strains on top of typical age-related life stressors such as disabilities, bereavement, managing multiple medications, and loss of independence,” said Beauchamp.
The study focuses on behavioral activation which involves identifying behaviors that positively affect mood. Patients are encouraged to engage in activities that improve their mood. This technique is a core component of cognitive behavioral therapy but can be delivered independently by lay counselors who are not licensed therapists.
Community health workers trained as lay counselors will deliver a behavioral activation intervention via remote video-enabled sessions within three months following a patient's first stroke. About 300 low-income patients aged 55 and older will be recruited from the Stroke Transitions Education and Prevention Program in the Department of Neurology at McGovern Medical School at UTHealth Houston. Participants will undergo a randomized controlled trial with half receiving behavioral activation and half receiving usual care. The intervention includes five weekly videoconferences and homework assignments followed by additional follow-up calls and assessments over nine months.
The study aims to evaluate the tele-intervention's effectiveness in reducing depressive symptoms, anxiety, emotional distress, PSD development among stroke survivors, and healthcare visits among participants.
“Our goal is that this intervention will improve overall quality of life for stroke survivors,” Beauchamp stated. “If intervention effectiveness is demonstrated it could have a profound effect on prevention of post-stroke depression.”
The study is titled BehavioraL ActIvation for the PreVention of Post-strokE Depression in LoW-incomE OLder Stroke Survivors (LIVE-WEL).
Other co-investigators include Sean I. Savitz; Anjail Z. Sharrief; Ron Acierno; Robert Suchting; Belinda Reininger from UTHealth Houston; and Namkee G. Choi from The University of Texas at Austin.
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