Improvement in Depressive Symptoms Among Hispanic/Latinos Receiving a Culturally Tailored IMPACT and Problem-Solving Intervention in a Community Health Center

Abstract

The present study investigated whether a culturally-tailored problem-solving intervention delivered by a trained depression care specialist (DCS) would improve depressive symptoms over a six month period among Hispanic/Latino patients in a federally-qualified community health center by the California-Mexico border. Participants included 189 low income Hispanic/Latino patients of Mexican heritage. Based on the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) evidence-based treatment, patients received evidence-based problem-solving therapy. The Patient Health Questionnaire-9 (PHQ-9) was administered to assess changes in self-reported depressive symptoms between baseline and monthly for a 6-month follow up period. The majority of participants were female (72.5%) with a mean age of 52.5 (SD=11.7). The mean PHQ-9 at baseline was 16.9 (SD=4.0) and at the 6-month follow-up, the average PHQ-9 decreased to 9.9 (SD=5.7). A linear mixed model analysis showed significant improvement in PHQ-9 scores over a 6 month period (F=124.1; p<0.001) after controlling for age, gender, smoking and diabetes. There was a significant three way interaction between time, gender and smoking (p=0.01) showing that the depressive symptoms among male smokers did not improve as much as non-smoking males and females. Results suggest that a culturally-tailored problem solving approach can significantly reduce depressive symptoms among Hispanic/Latino low-income patients.

A systematic review of depression psychotherapies among Latinos

“…Two recent, relatively large OLT ( N =189 and N = 117) demonstrated the efficacy of PST among Latinos within community health centers and rural primary care clinics (Camacho et al, 2014; Schmaling & Hernandez, 2008). Contrary to PST RCT, both of these trials showed high attrition rates, with less than 20% of participants completing treatment.…”

Latino immigrants, depressive symptoms, and cognitive behavioral therapy: A systematic review

“…While new growth communities face a number of service challenges that must be addressed for an intervention to succeed, towns that bordered the United States and Mexico confront a unique set of problems related to cyclical migration and a hostile political climate for immigrants, particularly those who are undocumented (Lapeyrouse et al, 2012;Martínez-Donate et al, 2014). For example, we excluded two studies conducted in border towns (Camacho et al, 2015;Simoni et al, 2013) because they did not report the immigration status of their participants despite the fact that interventions were offered in Spanish. We contacted these authors for clarification of their sample; one reported that they chose not to ask participants about their nationality.…”

Different Depression Treatment Recommendations and Adherence for Spanish- and English-Speaking Patients

“…A sensitivity analysis was also conducted to assess the association of language and ethnicity on psychotherapy or pharmacotherapy depression treatment as standard of care recommendations after controlling for age, gender, and race in the first block. The model was not a significant fit to the data 2 Table 3).…”