(PS8-75) Internet-Based Cognitive Behavioral Therapy with Layperson Support: A Mixed-Methods Evaluation of Empower@Home

Abstract Text:

Objectives: This study evaluates Empower@Home, an older adult-centered, layperson-supported internet-based cognitive behavioral therapy (iCBT) program for depression using a concurrent mixed-methods design.

Methods: Adults aged 50+ with at least mild depressive symptoms enrolled in the program and were assessed pre-and post-treatment (N=224). A subset participated in qualitative interviews post-treatment (N=148). Paired t-tests and mixed-effects modeling assessed quantitative program effects, while qualitative data identified key themes of impact.

Results: Program completion was 90%. Depression symptoms significantly decreased (Cohen’s d = 0.9 overall; d = 1.4 for those with moderate depression at baseline). Anxiety and social isolation also declined significantly. Moderation analyses showed that participants with lower education, antidepressant use, and more childhood adversities experienced faster symptom reduction. Qualitative findings aligned with quantitative results, highlighting symptom reduction as a key theme. Additional themes included increased self-awareness, enhanced mental health literacy, application of CBT skills, greater sense of agency, and sustained engagement.

Conclusions: Older adult-centered, layperson-supported iCBT shows promise in reducing depression and improving mental well-being in older adults.

Clinical Implications: Findings offer insights for improving mental health treatment and outcomes for older adults.

Keywords: iCBT, digital mental health intervention, human support, geriatric depression

Funding and acknowledgement:
This work was supported by funds from the Michigan Health Endowment Fund, Center of Medicare and Medicaid Services through the Michigan Department of Health and Human Services, the National Center for Advancing Translational Sciences (UL1TR002240), and the National Institute of Mental Health (R01MH137064) at the National Institutes of Health. We thank the following research assistants who participated in qualitative coding: Sari Bircoll, Asha Dimoji, Carly Gosdzinski, Nicole Kodkany, Glory Kubicek, Hailey Mauro, Nicole Mueller, Sofia Ruiz-Sierra, and Chuxuan Zheng. We also thank the following social service agencies for sending referrals: A&D Home Health Care, Inc., Northern Lakes Community Mental Health Authority/Northern Health Care Management, Region 2 Area Agency on Aging, Region VII Area Agency on Aging, Senior Resources, Grand Traverse Commission on Aging, EightCAP, Inc., Ypsilanti Meals on Wheels, and Catholic Human Services. Special thanks to the study participants who volunteered their time.