Improvement in Depressive Symptoms Among Hispanic/Latinos Receiving a Culturally Tailored IMPACT and Problem-Solving Intervention in a Community Health Center
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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 6 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.
KeywordsHispanic/Latinos Depression Integrated Care IMPACT
Special thanks to staff and administration of San Ysidro Health Center in San Diego County, CA. The study was supported by Grant Number P20MD002293-01, from the San Diego EXPORT Center, National Center of Minority Health and Health Disparities and grant number T32HL079891 from the National Heart Lung and Blood Institute, National Institutes of Health. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.
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