The remarkable growth of the Latino population in the United States can no longer be ignored. Many challenges face this group and contribute to high rates of depression, including the stress associated with the migration experience, low levels of acculturation, inadequate housing, financial burdens, unemployment, low educational attainment, discrimination, and the language barrier. Recently, a promising psychotherapeutic treatment for depression, Behavioral Activation (BA), has performed well in a large randomized trial, suggesting it is as effective as anti-depressant medication for moderate-to-severe depression. BA is a simple, pragmatic approach that activates patients to achieve environmental change and thus may be well suited to Latino depression. Thus, the primary purpose of this exploratory research project is to increase scientific knowledge on the development and delivery of a culturally and linguistically adapted version of BA for depressed Latinos. Some initial work on BA-Latino has already been completed including the completion of an initial manual and a small pilot study.
The specific aims of the current project are to: 1) Continue the process of developing the treatment manual for BA-Latinos with focus groups and additional pilot cases, and 2) Compare BA-Latino to treatment-as-usual with a randomized clinical trial in a Latino community clinic. The project will continue the development of an empirically-supported approach to Latino depression that potentially has strengths at retaining patients in treatment and targeting the specific environmental variables that influence depression in this population. This project also will lead to further evaluations of BA-Latino compared to CBT rather than TAU, larger effectiveness studies that allow for more powerful analyses of relapse and remission, attempts to study the dissemination of the BA-Latino training methods to additional community clinics, and creation of a model for the adaptation of BA for other minority populations, including African Americans, Native Americans and Asian Americans.

Public Health Relevance

This project will develop and evaluate a culturally and linguistically adapted version of Behavioral Activation (BA) for Latinos with depression. BA is a simple, pragmatic approach that activates patients to achieve environmental change and thus may be well suited to Latino depression, which often is characterized by seemingly overwhelming environmental obstacles. This project will lead to further evaluations of BA-Latino, larger effectiveness studies that explore depression relapse and remission, attempts to study the dissemination of the BA-Latino training methods to additional community clinics, and creation of a model for the adaptation of BA for other minority populations, including African Americans, Native Americans and Asian Americans.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Planning Grant (R34)
Project #
5R34MH085109-03
Application #
8044870
Study Section
Interventions Committee for Adult Mood and Anxiety Disorders (ITMA)
Program Officer
Vitiello, Benedetto
Project Start
2009-05-01
Project End
2013-03-31
Budget Start
2011-04-01
Budget End
2013-03-31
Support Year
3
Fiscal Year
2011
Total Cost
$148,600
Indirect Cost
Name
University of Wisconsin Milwaukee
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
627906399
City
Milwaukee
State
WI
Country
United States
Zip Code
53201
Santos, Maria M; Rae, James R; Nagy, Gabriela A et al. (2017) A client-level session-by-session evaluation of behavioral activation's mechanism of action. J Behav Ther Exp Psychiatry 54:93-100
Kanter, Jonathan W; Santiago-Rivera, Azara L; Santos, MarĂ­a M et al. (2015) A randomized hybrid efficacy and effectiveness trial of behavioral activation for Latinos with depression. Behav Ther 46:177-92