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RCT OF AN ONLINE MENTAL HEALTH INTERVENTION AMONG OLDER PLWH DURING COVID-19 PANDEMIC - Improved Depression, Anxiety & Loneliness
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CROI 2021 March 6 Reported by Jules Levin
Jeff Berko1, Peter Mazonson1, Duncan Short2, Cassidy Gutner3, Maile Karris4, Gregory Huhn5, Lynsay MacLaren Ehui6, Theoren Loo1, Sarah-Marie Chan1, Frank Spinelli3, Andrew Zolopa3
1Mazonson and Santas, Inc., Larkspur, CA, 2ViiV Healthcare, London, UK, 3ViiV Healthcare, Research Triangle Park, NC, USA, 4University of California San Diego, San Diego, CA, USA, 5Ruth M Rothstein CORE Center, Chicago, IL, USA, 6Whitman-Walker Health, Washington, DC, USA
program abstract
Background: Older adults (≥50 y) living with HIV (OALWH) may experience elevated levels of depression, anxiety, and loneliness. Online mindfulness lessons have the potential to ameliorate these problems and enhance access, especially during the COVID-19 pandemic. The objective of this randomized controlled trial was to determine the effectiveness of online mindfulness lessons in reducing feelings of depression, anxiety, and loneliness among OALWH.
Methods: The study was conducted between May and August 2020. Individuals with any degree of self-reported loneliness at baseline were eligible to participate. Outcomes of interest included depression, measured using the Center for Epidemiologic Studies Depression Scale (CES-D-10), anxiety measured using the Generalized Anxiety Disorder (GAD-7), and loneliness measured using both the Three-item Loneliness Scale (3IL) and a Daily Diary that asked "How lonely do you feel today?" Two sample t-tests were used to compare group scores at follow-up.
Results: Of 214 participants who were randomized, the mean (SD) age was 60.4 (5.9) years, 89% were male, 69% were white, and 74% were gay or lesbian. At the end of the 25-day intervention, the intervention group demonstrated reduced levels of depression (2.6 point improvement [20% better than control group] p<0.01), and reduced levels of anxiety (1.5 point improvement; p=0.03[22% better than the control group]) compared to the control group (Table 1). Among the subset of participants with elevated baseline depression scores (defined as CES-D-10 ≥ 8), the between-group improvement in depression scores was greater (4.2 point improvement; p<0.01 [26% better than the control group]). Similarly, among the subset of participants with elevated baseline anxiety scores (defined as GAD-7 ≥ 5), the between-group improvement in anxiety scores was greater (2.4 point improvement; p<0.01[26% better than control group]). Loneliness improved significantly, as indicated by the Daily Diary, for those with at least moderate loneliness at baseline (0.7 point improvement; p<0.01[18.9% better than control group]).
Plus, they looked at 3 special sub-groups: "Hispanic, Black or female" [depression 26.8% better & anxiety 36.2% better the control], "income <50,000" [18.5% better depression & 27.0% for anxiety better than control group], and "obesity, diabetes, or COPD" (18.8% for depression & 29.7% better for anxiety than control group.
Conclusion: This randomized controlled trial is the first to show that a series of brief, online mindfulness audio lessons improves mental health outcomes.
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