Gitlin Beat the BluesTwo studies by core faculty from the Center for Innovative Care in Aging at the Johns Hopkins University School of Nursing show that a low-cost, home-based program called Beat the Blues can reduce symptoms of depression in two of three older African Americans, even when they have severe financial worries.

In the August 2013 Annals of Internal Medicine, professor Laura N. Gitlin, PhD, and colleagues report that over two-thirds (67 percent) of Beat the Blues participants—primarily unemployed older women, living alone and experiencing financial and multiple health problems—showed meaningful reductions in depressive symptoms at four months, compared with a comparable group placed on a “waiting list.” When those on the waiting list later participated in the program, they too experienced improved mood and quality of life. At eight months, close to 70 percent of all participants sustained program-related benefits, according to the report, “A home-based intervention to reduce depressive symptoms and improve quality of life in older African Americans: A randomized controlled trial.”

In “Beat the Blues decreases depression in financially strained older African American adults,” published in the August 2013 American Journal of Geriatric Psychiatry, associate professor Sarah L. Szanton, PhD, CRNP, Gitlin, and Johns Hopkins Bloomberg School of Public Health colleague Roland J. Thorpe, Jr., PhD, found that Beat the Blues also lowers depressive symptoms among people having trouble paying for their basic needs, what is called “financial strain.” The strong link between depression and economic difficulties is well known. Yet those with financial strain were just as likely as other study participants to experience reduced depressive symptoms thanks to this inexpensive, targeted intervention.  

The content, structure, and even the title of Beat the Blues were tailored specifically to older African Americans. To engage study participants, the research team went where older, urban-living seniors congregate: the local senior center. Collaboration with this trusted community resource facilitated recruitment of over 208 study participants with depressive symptoms who were split into two comparable groups. One immediately participated in Beat the Blues, the other became the waiting list. Up to 10 sessions over four months were conducted by a social worker in participants’ homes. Each session included depression education, care management, and stress reduction, along with specialized health and self-care goal setting, and referral to community-based services and supports, particularly important given participants’ limited incomes.   

Results were assessed at four months, at which time people on the waiting list joined the program. At eight months, a second assessment found that former waiting list participants—including those experiencing financial strain—experienced the same benefits and that the majority of the first test group sustained an improved health status.

“Depression isn’t a normal part of getting older; it isn’t a character flaw or a moral failing. It’s a treatable health problem,” says Gitlin. “And we’ve shown that Beat the Blues reduces depressive symptoms, and not just in the short term. We also demonstrated the key role senior centers play for populations hesitant to seek mental health care.” Szanton adds, “Our paired studies suggests that depression can be ‘decoupled’ from financial strain. We can reduce depressive symptoms that can keep people from undertaking daily activities important to their health.”

The findings suggest the program’s broader promise. Gitlin says, “If Beat the Blues can help lift symptoms of depression among low-income, older African Americans, it also has potential for success in other populations.”

Says Szanton, “Beat the Blues may well help curb the significant human and economic costs of depression."

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