CARAH wins Challenge Grant for Cost Effectiveness Study

Thomas Jefferson University’s Center for Applied Research on Aging and Health (CARAH) won a NIH Challenge Grant in Health and Science Research for "Cost Effectiveness of a Home Support Program for Depression in Black Elders." The project adds a cost and outcome component to CARAH's current NIMH funded randomized controlled trial "Treating Depression in Older African Americans," known as Beat the Blues. CARAH will receive $1 million over two years to perform this cost effectiveness analysis in partnership with health economics faculty at the Jefferson School of Population Health (JSPH). This is one of about 200 grants funded through this highly competitive mechanism in which over 21,000 grant applications were submitted nationally.

Beat the Blues (BTB) is a 10-session home-based intervention to treat depression in older community-dwelling African Americans. The program is embedded in a senior center, Center in the Park (CIP), involving their agency staff as depression screeners and interventionists. Social workers trained in the protocol meet with participants to identify care management concerns, make referrals and linkages, provide depression education, develop tailored action plans to accomplish identified behavioral goals and enhance engagement in pleasurable activities, and teach stress reduction techniques (e.g., deep breathing) for managing daily stressors.

"As the prevalence of late-life depression among older African Americans with comorbidities is high, an economic evaluation of BTB has great potential for enabling translation of the program into practice settings, such as senior centers, and thus, improving the lives of vulnerable populations," explains Laura N. Gitlin, PhD, Director of CARAH. Co-investigator and JSPH Program Director of Health Economics and Outcomes Research, Laura Pizzi, PharmD, MPH adds, "This study is significant because it indicates that NIH values economic analysis as a tool to inform allocation of limited healthcare resources. We believe that our work will represent an important contribution to the literature about the cost effectiveness of home support programs."

The specific goals of the challenge grant are to calculate the cost of delivering BTB by senior center staff trained in the program and to calculate the program's cost effectiveness. The latter goal will be assessed from a societal perspective using two outcome measures: cost per quality adjusted life year and cost per reduction in depression symptoms.

The findings from this study will enable its translation for delivery by a senior center. Lynn Fields Harris, MPA, executive director of the collaborating senior setting, Center in the Park, states, "It will have immediate benefits for community-based agencies and their capacity to deliver evidence-based programs, as well as for the older adults served by them." The project also has implications for health policy. By linking coverage decisions to adequate scientific evidence of treatment and cost effectiveness, the study seeks to impact policies to support evidence-based services to an underserved group for whom mental health disparities persist.

The grant will fund a collaboration between CARAH, CIP and JSPH. Key team members in addition to Dr. Gitlin, Dr. Pizzi and Ms. Harris include Eric Jutkowitz, health economics fellow at JSPH; Kathy Foley, PhD, project director in health economics and outcomes research at JSHP, Nancy Chernett, MA, MPH, CARAH project director; and Megan McCoy, MSS, MLSP, LSW, the CIP project director for BTB.

Contact:
Jane Clinton
jane.clinton@jefferson.edu
(215) 503-9865

Published: 10-27-09

Back