Behavioral Activation for the PreVention of Post-strokE Depression in LoW-incomE Older Stroke Survivors

Behavioral Activation for the PreVention of Post-strokE Depression in LoW-incomE Older Stroke Survivors (LIVE-WEL)

The overall objective of the project is to determine the effectiveness of tele-delivered behavioral activation (BA) by trained lay counselors (Tele-BA-S) to prevent Post-stroke depression (PSD) in low-income, older stroke survivors with subthreshold depression (SD).

Inclusion Criteria:

• Enrollment within 3-months +2 weeks of a first-time ischemic or hemorrhagic stroke
• 24-item HDRS score < 15 indicating subthreshold depression defined as the absence of depressive symptoms or presence of mild symptoms of depression
• Single person income less than or equal to $45,000
• Residing in a community residence
• Ability to speak and read in English or Spanish
• Mini-MoCA score > or equal to 11

Exclusion Criteria:

• Stroke event unrelated to vascular risk factors (e.g., drug use) or transient ischemic attack
• 24-item HDRS score > or equal to 15 indicating moderate to severe depression
• Actively participating in psychotherapy
• high suicide risk or severe psychiatric illness (e.g., bipolar disorder and active psychosis) and/or actively taking antipsychotics
• Diagnosed dementia and/or currently taking cognitive enhancers, amyloid-targeting medications, or orexin receptor antagonists
• Patient Health Questionnaire 9 score > or equal to 10 and/or answers positive to Q9
• Diagnosed aphasia and/or severe cognitive impairments
• high-risk alcohol or drug misuse
• receiving medications for mood disorders and a change in dose or type within the last 4 weeks