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Homebound status and depressive symptoms form a feedback loop to influence each other. Improving the outdoor mobility of older adults may have immediate benefits for reducing depressive symptoms.

Disparities in access to primary health care have led to health disadvantages among Latinos and other non-White racial groups. To better identify and understand which policies are most likely to improve health care for Latinos, we examined differences in access to primary care between Latinos with proficient English language skills and Latinos with limited English proficiency (LEP) and estimated the extent of access to primary care providers (PCPs) among Latinos in the U.S. Method: We used agent-based modeling techniques to estimate the effects of English proficiency, insurance coverage, Latinos with LEP seeking care from English-speaking PCPs, distance to PCP, PCP availability, and Spanish-speaking PCP availability on access to primary care. We used NetLogo 6.0 to simulate a community of 10,000 Latinos seeking care for a 6-month period, running 5 controlled experiments to determine if population-level outcomes varied by scenario. Results: Models suggested that Latinos with LEP would likely delay care less often if policies were implemented to expand health insurance coverage, address linguistic barriers and promote an inclusive health care climate for patients with LEP, reduce mobility barriers, increase the number of PCPs, and train more Spanish-speaking PCPs. Conclusions: Findings support results from prior studies suggesting that policies and programs that help Latino patients overcome linguistic and cultural barriers to health care will improve Latinos' access to care.

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Decline in depressive symptoms is a reliable predictor of improvement in self-efficacy and adherence to diabetes management. Further studies are recommended to study psychosocial mechanisms related to social relationships other than social support that affect diabetes management.

Objective This study explored whether depression remission and problem-solving therapy (PST) receipt are associated with more frequent self-care behaviors via cross-sectional and prospective analyses. Method We analyzed data from a randomized clinical trial (N = 387) that tested collaborative depression care among predominantly Hispanic patients with diabetes in safety-net clinics. Data at 12-month follow-up, measured with the Patient Health Questionnaire-9 and Hopkins Symptom Checklist-20, were used to define depression remission. PST was provided by a bilingual social worker. Multivariate regression analysis was used to examine associations between predictors and frequency change of each self-care behavior (healthy diet, exercise, self-blood glucose monitoring, and foot care between baseline and 12-month (N = 281), 18-month (N = 249), and 24-month (N = 235) follow-up surveys. Results Inconsistent relationships were observed depending on the instrument to identify depression remission, type of self-care behaviors, and time when self-care behavior was measured. Significant associations were more likely to be observed in cross-sectional analyses. PST receipt was not associated with self-care behaviors. Conclusions Depression remission or the receipt of PST may not be a reliable antecedent for more frequent self-care behaviors among this group. A few recommendations for studies were offered to enhance existing depression care for diabetes patients.

BACKGROUND: More Reserve and Guard members have been activated in the past few years than in any other time in history. In addition to the high rates of psychological and behavioral challenges among military personnel, there are other equally important post-deployment reintegration challenges. Post-deployment reintegration challenges are particularly important to Reserve and Guard members, who transition rapidly from civilian-military-civilian. OBJECTIVE: This study aims to describe the scope of challenges that a battalion of National Guard members (NGM) report experiencing after returning from a one-year deployment to Iraq. METHOD: This article reports data from a sample of 126 NGM who recently returned from a one-year deployment to Iraq. The scope of post-deployment problems at baseline, 3-and 6-month post-deployment are presented. RESULTS: Overall, the rates of post-deployment psychological and behavioral problems were elevated upon returning from deployment and remained fairly constant for up to 6 months post-deployment. Approximately 30% of respondents were unsatisfied with their relationship and upwards of 30% reported family reintegration challenges. CONCLUSIONS: Comparisons with similar research and implications for prevention and improvement of post-deployment quality of life are addressed.

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