Chinese Americans have a distinct pattern of underutilization of mental health services, characterized by delayed onset of treatment and higher attrition rates. Previous studies have shown that many Chinese Americans with major depressive disorder (MDD) remain untreated due to high stigma associated with treatment of psychiatric disorders. Preliminary research has demonstrated that Tai Chi has beneficial effects on a range of psychological well-being measures in varied populations including mood, anxiety/depression, general stress management, exercise self-efficacy, and quality of life. We recently completed a non-controlled prospective cohort study which suggests that Tai Chi could be a well-received, culturally appropriate, effective and safe intervention for Chinese Americans with MDD. In this application, we propose to conduct a pilot randomized control trial (RCT) evaluating the efficacy and safety of using Tai Chi to treat Chinese Americans with MDD. A total of 60 Chinese Americans with MDD will be recruited from Boston's Chinese community, and randomized to a 12-week Tai Chi intervention group (n=20), attention control group to receive psychoeducation (n=20), or waitlist control group (n=20). We hypothesize that at the conclusion of 12-weeks, Tai Chi participants, as compared to control groups, will demonstrate a) greater improvement in depressive symptoms (Hamilton Depression Severity Index-17, Beck Depression Inventory);b) greater improvement in functional status, general health and well being (Clinical Global Impressions Scale, SF-36 Health Survey [SF-36(R))], Mindfulness, and Exercise Self-Efficacy);and c) greater social support (Multidimensional Scale of Perceived Social Support). We will also use mixed methods (qualitative and quantitative analyses) to a) identify facilitators and barriers to adherence to the Tai Chi training protocol, b) explore characteristics of responders and non-responders to the Tai Chi intervention, and c) assess participants'willingness/intention to continue practice of Tai Chi beyond the study period. The findings of this study will provide the feasibility, safety, acceptability, and preliminary efficacy data required to design a large scale RCT on the use of Tai Chi for treating depressed Chinese Americans.
To counter pervasive disparities in healthcare for Chinese Americans with mental illnesses, culturally-sensitive and effective, community-based interventions are needed. This randomized clinical will examine the feasibility, safety, acceptability, and efficacy of using Tai Chi to treat Chinese Americans with major depressive disorder. The findings of this study will provide the preliminary evidence for a larger and more definitive study.
