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CompletedNCT01407926Updated Jun 7, 2019Results posted

Nurse-Led Interprofessional Mental Health Promotion Intervention for Older Home Care Clients

An observational study in Depressive Symptoms, sponsored by McMaster University. Completed at 1 site in Canada. Open to participants aged 70 Years and older. Per ClinicalTrials.gov, last updated 2019-06-07.

Sponsored by McMaster University · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
142
Ages
70 Years and older
Sex
All
01

Study summary

Objective: The objective of this study is to evaluate the feasibility, acceptability and effectiveness of a 6-month nurse-led, interprofessional mental health promotion intervention aimed at older home care clients with depressive symptoms using personal support services.

Methods/Design: This one-group pre-test post-test study aims to recruit a total of 250 long-stay (> 60 days) home care clients, 70 years or older, with depressive symptoms who are receiving personal support services through a home care program in Ontario, Canada. The nurse-led intervention is a multi-faceted 6-month program led by a Registered Nurse that involves regular home visits, monthly case conferences, and evidence-based assessment and management of depression using an interprofessional approach. The primary outcome is the change in severity of depressive symptoms from baseline to 6 months using the Centre for Epidemiological Studies in Depression Scale. Secondary outcomes include changes in the prevalence of depressive symptoms and anxiety, health-related quality of life, cognitive function, and the rate and appropriateness of depression treatment from baseline to 12 months. Changes in the costs of use of health services will be assessed from a societal perspective.

02

Conditions studied

  • Depressive Symptoms

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Keywords

  • Depression
  • Aging
  • Clinical Effectiveness
  • Home Care
  • Nurse-Led
03

In context

Depression

8,057 studies on the registry are indexed under Depression; 1,641 are open to participants now.

This study's enrollment of 142 is below the median of 160 across 1,084 observational studies indexed under Depression.

Browse Depression studies →

Lead sponsor

McMaster University is the lead sponsor of 720 studies on the registry; 124 are open to participants now.

Of its 6 completed or terminated interventional studies of FDA-regulated products, 2 (33%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
70 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

Older home care clients receiving personal support services through a home care program in Southern Ontario

Inclusion criteria

  • long-stay (> 60 days) home care clients
  • 70 years or older
  • newly referred to and receiving PSS through the CCAC
  • living in the community (not in a long-term care home)
  • mentally competent to give informed consent (or with a substitute decision-maker available)
  • competent in English (or with an interpreter available)
  • screens positive for depressive symptoms

Exclusion criteria

Exclusion Criteria:

  • receiving palliative care services
  • not competent in English and no interpreter available
  • not mentally competent to give informed consent and no substitute decision-maker available
05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
142 participants (actual)

Groups and cohorts

  • Nurse-Led Mental Health Promotion Group

    Interprofessional nurse-led strategy involving regular home visits over 6 months by an RN and PSW. The RN will conduct a comprehensive health assessment and screen clients for risk factors for depression and other chronic conditions, implement health promotion strategies to address this risk factors and enhance health, review their medications, conduct in-home exercise , refer clients to other health services

    Other: Nurse-Led Mental Health Promotion Intervention

Interventions

  • OtherNurse-Led Mental Health Promotion Intervention

    The nurse-led intervention is a multi-faceted 6-month program led by a Registered Nurse that involves regular home visits, monthly case conferences, and evidence-based assessment and management of depression using an interprofessional approach.

06

What researchers measure

Primary outcomes

  1. Centre for Epidemiological Studies in Depression Scale

    The CES-D consists of 20 items, which range from 0-60, with higher scores indicating greater severity of depressive symptoms. It has been used in prior randomized controlled trials by three of the study investigators that involved older home care clients with mood disorders and has a high degree of reliability, content, construct and criterion related validity, distinguishes between depressed and non-depressed people, and is a sensitive tool for measuring changes in depressive symptoms over time in psychiatric populations.

    Time frame: Baseline to 12 months

Secondary outcomes

  1. Generalized Anxiety Disorder Screener

    The Generalised Anxiety Disorder Assessment (GAD-7) is a seven item instrument that is used to measure or assess the severity of generalised anxiety disorder (GAD). Each item asks the individual to rate the severity of his or her symptoms over the past two weeks. Response options include "not at all", "several days", "more than half the days" and "nearly every day". The GAD-7 score is calculated by assigning scores of 0, 1, 2, and 3, to the response categories of "not at all," "several days," "more than half the days," and "nearly every day," respectively, and then adding together the scores for the seven questions. GAD-7 total score for the seven items ranges from 0 to 21. Scores represent: * 0-5 = Mild anxiety * 6-10 = Moderate anxiety * 11-15 = Moderately severe anxiety * 15-21 = Severe anxiety When used as a screening tool, further evaluation is recommended when the score is 10 or greater

    Time frame: Baseline and 12 months

  2. SF-12 Physical Composite Index

    The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means a better outcome

    Time frame: 12 months minus Baseline value

  3. SF-12 Physical Functioning Index

    The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

    Time frame: Baseline and 12 months

  4. SF-12 Role Limitation Physical Index

    The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

    Time frame: Baseline and 12 months

  5. SF-12 Pain Index Score

    The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

    Time frame: Baseline and 12 months

  6. SF-12 General Health Index

    The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

    Time frame: Baseline and 12 months

  7. SF-12 Mental Health Composite Index

    The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

    Time frame: Baseline and 12 months

  8. SF-12 Vitality Index Score

    The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

    Time frame: Baseline and 12 months

  9. SF-12 Social Functioning Index

    The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

    Time frame: Baseline and 12 months

  10. SF-12 Role Limitation Emotional Index

    The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

    Time frame: Baseline and 12 months

  11. SF-12 Mental Health Index

    The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

    Time frame: Baseline and 12 months

07

Results

Posted Jun 7, 2019

Participant flow

Participant flow — Overall Study
MilestoneNurse-Led Mental Health Promotion Group
Started142
Completed87
Not completed55
Withdrew: Lost to follow-up55

Outcome measures

PrimaryCentre for Epidemiological Studies in Depression Scale

The CES-D consists of 20 items, which range from 0-60, with higher scores indicating greater severity of depressive symptoms. It has been used in prior randomized controlled trials by three of the study investigators that involved older home care clients with mood disorders and has a high degree of reliability, content, construct and criterion related validity, distinguishes between depressed and non-depressed people, and is a sensitive tool for measuring changes in depressive symptoms over time in psychiatric populations.

Time frame:
Baseline to 12 months
Reported as:
Mean · units on a scale
Centre for Epidemiological Studies in Depression Scale
units on a scaleNurse-Led Mental Health Promotion Group
Centre for Epidemiological Studies in Depression Scale-3.52 (-5.77 to -1.27)
SecondaryGeneralized Anxiety Disorder Screener

The Generalised Anxiety Disorder Assessment (GAD-7) is a seven item instrument that is used to measure or assess the severity of generalised anxiety disorder (GAD). Each item asks the individual to rate the severity of his or her symptoms over the past two weeks. Response options include "not at all", "several days", "more than half the days" and "nearly every day". The GAD-7 score is calculated by assigning scores of 0, 1, 2, and 3, to the response categories of "not at all," "several days," "more than half the days," and "nearly every day," respectively, and then adding together the scores for the seven questions. GAD-7 total score for the seven items ranges from 0 to 21. Scores represent: * 0-5 = Mild anxiety * 6-10 = Moderate anxiety * 11-15 = Moderately severe anxiety * 15-21 = Severe anxiety When used as a screening tool, further evaluation is recommended when the score is 10 or greater

Time frame:
Baseline and 12 months
Reported as:
Mean · units on a scale
Generalized Anxiety Disorder Screener
units on a scaleNurse-Led Mental Health Promotion Group
Generalized Anxiety Disorder Screener-1.83 (-3.03 to -0.62)
SecondarySF-12 Physical Composite Index

The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means a better outcome

Time frame:
12 months minus Baseline value
Reported as:
Mean · units on a scale
SF-12 Physical Composite Index
units on a scaleNurse-Led Mental Health Promotion Group
SF-12 Physical Composite Index8.70 (3.65 to 13.75)
SecondarySF-12 Physical Functioning Index

The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

Time frame:
Baseline and 12 months
Reported as:
Mean · units on a scale
SF-12 Physical Functioning Index
units on a scaleNurse-Led Mental Health Promotion Group
SF-12 Physical Functioning Index6.88 (-0.37 to 14.12)
SecondarySF-12 Role Limitation Physical Index

The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

Time frame:
Baseline and 12 months
Reported as:
Mean · units on a scale
SF-12 Role Limitation Physical Index
units on a scaleNurse-Led Mental Health Promotion Group
SF-12 Role Limitation Physical Index15.47 (6.87 to 24.07)
SecondarySF-12 Pain Index Score

The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

Time frame:
Baseline and 12 months
Reported as:
Mean · units on a scale
SF-12 Pain Index Score
units on a scaleNurse-Led Mental Health Promotion Group
SF-12 Pain Index Score5.94 (-3.10 to 14.98)
SecondarySF-12 General Health Index

The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

Time frame:
Baseline and 12 months
Reported as:
Mean · units on a scale
SF-12 General Health Index
units on a scaleNurse-Led Mental Health Promotion Group
SF-12 General Health Index-0.25 (-6.31 to 5.81)
SecondarySF-12 Mental Health Composite Index

The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

Time frame:
Baseline and 12 months
Reported as:
Mean · units on a scale
SF-12 Mental Health Composite Index
units on a scaleNurse-Led Mental Health Promotion Group
SF-12 Mental Health Composite Index8.96 (3.69 to 14.23)
SecondarySF-12 Vitality Index Score

The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

Time frame:
Baseline and 12 months
Reported as:
Mean · units on a scale
SF-12 Vitality Index Score
units on a scaleNurse-Led Mental Health Promotion Group
SF-12 Vitality Index Score8.75 (0.39 to 17.11)
SecondarySF-12 Social Functioning Index

The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

Time frame:
Baseline and 12 months
Reported as:
Mean · units on a scale
SF-12 Social Functioning Index
units on a scaleNurse-Led Mental Health Promotion Group
SF-12 Social Functioning Index4.38 (-8.57 to 17.32)
SecondarySF-12 Role Limitation Emotional Index

The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

Time frame:
Baseline and 12 months
Reported as:
Mean · units on a scale
SF-12 Role Limitation Emotional Index
units on a scaleNurse-Led Mental Health Promotion Group
SF-12 Role Limitation Emotional Index10.31 (1.09 to 19.53)
SecondarySF-12 Mental Health Index

The SF-12 is a multipurpose short form to measure health status. There are 10 domains: Physical Composite Index (score range from 0-100); Physical Functioning Index (score range from 0-100); Role Limitation Physical Index (score range 0-100); Pain Index Score (score range from 0-100); General Health Index (score range from 0-100); Mental Health Composite Index (score range from 1-100); Vitality Index (score range from 0-100); Social Functioning Index (score rang 0-100); Role Limitation Emotional Index (score range 0-100); and SF-12 Mental Health Index (score range from 0-100), the higher the score means the better the outcome.

Time frame:
Baseline and 12 months
Reported as:
Mean · units on a scale
SF-12 Mental Health Index
units on a scaleNurse-Led Mental Health Promotion Group
SF-12 Mental Health Index10.00 (3.53 to 16.47)

Adverse events

Collected over 1 year. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Nurse-Led Mental Health Promotion Group0/142 (0%)0/142 (0%)0/142 (0%)

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Nurse-Led Mental Health Promotion Group
<=18 years0
Between 18 and 65 years0
>=65 years142
Age, Continuous
Age, Continuous(years)Nurse-Led Mental Health Promotion Group
Mean82 ± 5.7
Sex: Female, Male
Sex: Female, Male(Participants)Nurse-Led Mental Health Promotion Group
Female92
Male50
Region of Enrollment
Region of Enrollment(participants)Nurse-Led Mental Health Promotion Group
Canada142
08

Study locations

1 site
  • McMaster University, School of Nursing
    Hamilton, Ontario L8N 3Z5, Canada
09

References and documents

Publications

  • Markle-Reid M, McAiney C, Forbes D, Thabane L, Gibson M, Browne G, Hoch JS, Peirce T, Busing B. An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms. BMC Geriatr. 2014 May 10;14:62. doi: 10.1186/1471-2318-14-62. PubMed 24886344 ↗
  • Markle-Reid MF, McAiney C, Forbes D, Thabane L, Gibson M, Hoch JS, Browne G, Peirce T, Busing B. Reducing depression in older home care clients: design of a prospective study of a nurse-led interprofessional mental health promotion intervention. BMC Geriatr. 2011 Aug 25;11:50. doi: 10.1186/1471-2318-11-50. PubMed 21867539 ↗
10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 7, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT01407926
Lead sponsor
McMaster University
Collaborators
Canadian Institutes of Health Research (CIHR), Ontario Ministry of Health and Long Term Care
Responsible party
Sponsor
First posted
Aug 2, 2011
Start date
May 2010
Primary completion
Jun 2013
Completion
Jun 2013
Results posted
Jun 7, 2019
Last update
Jun 7, 2019

Study contacts

Maureen F Markle-Reid, RN, PhD
principal investigator · McMaster University, School of Nursing

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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