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Table 2 Study Instruments

From: Rationale and design: telepsychology service delivery for depressed elderly veterans

Geriatric Depression Scale

(GDS)[51]

The GDS is one of the most widely used measures of depression in the elderly population using the generally accepted cutoff score of 11. This 30-item measure shows good test-retest reliability and internal consistency. The GDS exhibits good concurrent validity, and excellent sensitivity, specificity, and positive predictive power in assessing depression with older adults.

The Short Portable Mental Status Questionnaire[85]

This is a ten item test that is quickly completed and will be used to screen for cognitive impairment (cutoff ≥ 7). The screen is effective in identifying cognitive impairment in a variety of geriatric populations.

Structured Clinical Interview for DSM-IV

(SCID-IV)[50]

MDD and other psychopathology will be evaluated using this structured clinical interview based on the DSM-IV. The onset of the MDD will be specified. The SCID-IV has excellent interrater reliability on assessments of symptoms across a variety of disorders (overall kappa = 0.85).

Beck Depression Inventory

(BDI)[52]

The BDI is a 21-item self-report scale, is among the most widely used instruments to measure depression. The BDI has high internal consistency (α = 0.86 – 0.91).

Beck Anxiety Inventory

(BAI)[66]

The BAI is a 21-item self rating scale of anxiety symptomatology. Specific symptom clusters have been identified reflecting neurophysiological, subjective, panic, and autonomic dimensions. The BAI has good internal consistency and concurrent validity with the Hamilton Anxiety Rating Scale.

Medical Outcome Study Short Form-36 Health Survey (SF-36)[67]

The SF-36 is a 36-item questionnaire that measures health status and functioning over the past four weeks. The items vary from dichotomous (yes/no) responses, to ratings on a 6-point Likert scale. Responses are compiled into eight dimensions covering (a) Functional Status; (b) Well-Being; and (c) Overall Evaluation of Health. The SF-36 has good test-retest reliability as well as sensitivity to change in health status.

Medical Outcomes Study (MOS) Social Support Survey[86]

It measures four functional components of social support: 1) tangible support; 2) affection; 3) positive social interaction; and 4) emotional or informational support. The total scale (α = 0.97) and subscales (α = 0.91 to 0.96) have high internal consistency, good criterion and discriminant validity, and one-year test-retest reliability (0.72 to 0.76).

The Morisky Adherence Score[87]

This is a commonly used self-report tool to assess adherence to medications. It has good validity and reliability. This scale asks patients to respond "yes" or "no" to a set of 4 questions. A positive response to any question indicates a problem with adherence with a total possible score of 4; higher scores indicate poorer adherence.

Charleston Psychiatric Outpatient Satisfaction Scale (CPOSS)[53]

The CPOSS is 16-item measure, with a Likert scale response format, based on a general measure of patient satisfaction. In a sample of patients preliminary data showed the measure had excellent reliability (alpha = 0.96) and good convergent validity with relevant anchor items ("would you recommend this treatment to a friend or family member?").

Treatment Credibility Questionnaire[88]

To assess for differences in outcome expectancy, treatment credibility scales developed by Borkovec and Nau (1972) will be used. Four of the questions will be used for this study, with 10-point Likert scales. These include questions regarding how logical the treatment seems, how confident participants are about treatment, and their expectancy of success.

Service Delivery Perceptions Questionnaire

This questionnaire will be used to assess subjects' perceptions about variables specifically related to the mode of service delivery (e.g., the quality of communication, ease of use, willingness to use treatment).

Prior Experience with Computer and Audiovisual Technology Questionnaire

We will administer a short measure to learn more about participants' prior experiences and comfort level with computers and audiovisual technology.

Resource Utilization Questionnaire[89]

Previously validated questions on resource utilization will be administered as part of the baseline, 3-, and 12 month assessments. The questionnaires are 1 page long and capture information on hospitalizations, physician/professional visits, and medications. The baseline assessment will capture differences between groups and allow for the control of possible group variation during data analysis.