Study focuses on Latino depression

Study focuses on Latino depression 03/17/2007-PROVIDENCE – Latinos have a depression rate similar to non-Latino whites, yet studies show they receive less treatment and have poorer treatment outcomes for their depression.

For some reason Latino patients do not stick with their treatment, which often takes place in a different facility than the primary care settings where they are screened and diagnosed.
In an effort to find out why that is, the Neighborhood Health Plan of Rhode Island (NHPRI) was awarded a $261,000 grant from Finding Answers: Disparities Research for Change, an arm of the Robert Wood Johnson Foundation, to come up with ways to improve screening, diagnosis, and especially treatment of depression in primary care settings for Latino patients by closely monitoring and evaluating the effectiveness of the care they are getting. Ten other health-related organizations across the country received similar grants.
“There is an urgent need to move beyond documenting the existence of health care disparities and start finding solutions that will eliminate them,” said Marshall H. Chin, director of the Finding Answers Program, which hopes to eliminate racial and ethnic health care disparities in local communities.
The two-year study, scheduled to start up in the next few weeks, will look at 170 Latino Neighborhood Health Plan subscribers currently undergoing anti-depressant treatment in primary care, but who are not receiving behavioral treatment. Some will continue their current course of treatment while others will receive what NHPRI calls “a culturally appropriate, telephone-based depression care management program, called Depression Health Enhancement for Latino Patients (D-HELP), in addition to treatment as usual.
The study will evaluate D-HELP during and following its implementation by interviewing key stakeholders-participants, primary care physicians, the care management team, etc.-in order to get their views on the benefits of D-HELP, ways to improve it, barriers to participation and concerns about implementation.
“Depression care managers” will monitor patients currently undergoing depression and stress care, evaluate the effectiveness of their care, and recommend successful treatment strategies, according to Beth Ann Marootian, director of business development at NHPRI.
This method has proven effective with the English-speaking community, but this will be the first time this method has been tested within the Latino community.
NHPRI calls depression, “a disease for which evidence of racial and ethnic disparities in care is strong and the recommended standard of care is clear.
The testing will be done by Beacon Health Strategies, described as NHPRI’s behavioral health partner. Butler Hospital in Providence will evaluate the results.
The first 18 months of the grant are set aside for testing, and the remaining 6 months will be used for evaluation and reporting.
Progreso Latino, the largest bilingual, multi-cultural social service agency in the state of Rhode Island, will assist in conducting protocols and convening a patient focus group.
Ivan W. Miller, PhD, director of psychosocial research at Butler Hospital, said, “The research project, if found to be effective, will provide a cost-effective depression intervention that should help reduce the disparities in depression treatment and outcome among Latino patients,”
“We hope that our findings will help raise awareness and eliminate some of the fears and stereotypes that exist within the Latino community regarding the use of medication as a form of treatment for depression and stress,” said Jim Spink, Vice President for External Operations and Public Policy for Beacon Health Strategies.
Finding Answers plans to evaluate the results from all 11 organizations that received grants and inform health care stakeholders-doctors, hospitals and health plans-about promising interventions that demonstrate potential to reduce racial and ethnic disparities in health care.

By: Jim Baron

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