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Symposia

Dissemination & Implementation Science

Expanding and Extending the Workforce to Improve Mental Health: Diverse Applications of Task-Sharing Models

2 - (SYM 72) Results from a Mixed Methods Feasibility Study: Digital Peer Support for Depression Among Diverse Older Adults

Sunday, November 23, 2025
2:27 PM - 2:48 PM CST
Location: Empire D, Level 2
Keywords: Evidence-Based Practice, Underserved Populations, Community-Based
Recommended Readings: Areán, P. A., O’Connor, S., & Sherrill, J. (2025). The Promise and Perils of Using Peers and Other Paraprofessionals as Mental Health Service Professionals. JAMA Psychiatry, 82(2):107-108. doi:10.1001/jamapsychiatry.2024.4276,   Barnett, M. L., Gonzalez, A., Miranda, J., Chavira, D. A., & Lau, A. S. (2018). Mobilizing Community Health Workers to Address Mental Health Disparities for Underserved Populations: A Systematic Review. Administration and policy in mental health, 45(2), 195–211. https://doi.org/10.1007/s10488-017-0815-0,   O’Connell, W. P., Renn, B. N., Areán, P. A., Raue, P. J., & Ratzliff, A. (2024). Behavioral health workforce development in Washington State: Addition of a behavioral health support specialist. Psychiatric Services, 75(10), 1042-1044. doi: 10.1176/appi.ps.20230312,   Singla, D. R. (2021). Scaling up psychological treatments: Lessons learned from global mental health. American Psychologist, 76(9), 1457-1467. doi: 10.1037/amp0000944,   Dorsey, S., Gray, C. L., Wasonga, A. I., Amanya, C., Weiner, B. J., Belden, C. M., ... & Whetten, K. (2020). Advancing successful implementation of task-shifted mental health care in low-resource settings (BASIC): Protocol for a stepped wedge cluster randomized trial. BMC Psychiatry, 20, 1-14. doi:10.1186/ s12888-019-2364-4
Abstract Body

Multiple barriers to mental health service access exist for older adults, and access is more difficult for low-income White and minoritized older adults who are at higher risk of mental health problems. We evaluated the feasibility of a one-to-one digital peer support intervention focused on improving coping strategies and delivered by older adult peer coaches. We used an open pilot study design. Assessments were conducted at baseline, 8 weeks and 3 months and post-study, and semi-structured interviews were conducted with those who completed the intervention. Preliminary outcomes included depression, self-efficacy, emotional well-being and social functioning. Among 28 participants enrolled, the mean age was 67 years, 93% were women, 50% self-identified as Black, Hispanic or mixed race and 50% were White. Participants experienced an average decrease of 1.93 (SD: 4.06) points in PHQ-9 scores at post-study compared to their baseline levels that increased when assessed at 3 months. Greater than 80% completed 80% of meetings with peer coaches. Peer coaches initially found navigating the videoconferencing application challenging, however continued training and on-demand support from study staff were crucial to their mastery of the platform. A few participants encountered significant technology barriers and were only able to attend meetings over the phone, due to difficulty accessing video or discomfort showing themselves and their homes on video.

Conclusion: Use of videoconferencing and texts to deliver peer support was feasible with technology support. Older adult peer coaches can be trained and may be able to improve depression and quality of life indicators. Increased structure in peer support, training and continuous supervision may be needed to observe impact on outcomes.