Beat the Blues Decreases Depression in Financially Strained Older African-American Adults

Objectives: Financial strain, defined as inadequate income to cover basic needs, is related to depression in minority populations. It is unclear whether interventions can improve depression in those reporting financial strain. Design: Randomized controlled trial. Setting: Philadelphia senior center. Participants: A total of 208 African-American adults 55 years of age and older with mild to severe depressive symptoms. Measurements: Beat the Blues (BTB) depression intervention, which includes care management, referral/linkage, stress reduction, depression education, and behavioral activation. Measurements included responses to the Patient Health Questionnaire-9, financial strain, and age. Results: Although financial strain was related to depressive symptoms at baseline, participants receiving BTB at all levels of financial strain showed reduced depressive symptoms compared with a waitlist control group at 4 months. BTB participants reporting financial strain had a mean (standard deviation) decrease of 6.4 (0.85) points on the Patient Health Questionnaire-9, reflecting a clinically meaningful improvement. Conclusions: This nonpharmacologic intervention reduced depressive symptoms in both African-American subjects with and without financial strain. However, screening for and helping people manage financial strain may boost the magnitude of intervention benefit for those with financial strain and should be explored as part of depression care.