Minor depression alone and its co-occurrence with chronic diseases are under- recognized, under-treated and understudied. This proposed study uses theoretically driven mixed methodologies to understand key barriers and facilitators for the successful translation of an evidence-based intervention (EBI) - chronic disease self management programs (CDSMP) - into community settings for underserved Latinos who suffer from minor depression and co- occurring chronic disease. We have chosen CDSMP because of its strong evidence base and its ability to be delivered by lay health workers in various settings and reduce health disparities. New data show that minor depression exerts large costs, increases mortality when present in cardiac disease, and is not responsive to most interventions that are effective for major depression. This proposed study is aligned with CDC's performance goal to support prevention research to develop sustainable and transferable community-based behavioral interventions. We propose to partner with two community partners - Hispanic Service Council and Familia Sana and use ongoing funded community-based participatory research (CBPR) efforts for a three-phase study. This partnership will drive the understanding of important barriers and facilitators that need to be addressed for the successful adaptation of this EBI - that is, to make it contextually relevant, keep it effective and meet primary stakeholders'needs. In Hillsborough County area where we wish to do this work, the Latino population is over 20% and huge gaps in general and mental health services exist.
The specific aims of this project are to: identify key stakeholder perspectives on multi- dimensional barriers and facilitators to the adoption of CDSMP into community settings;employ mixed methods to adapt CDSMP to best address those priority needs;and test the feasibility of implementing the adapted CDSMP using a lagged intervention design with outcome measurements over months, to estimate intervention parameters in preparation for a future large scale cross-county implementation study. This research is exceptionally relevant to public health because it seeks to improve health and functioning outcomes in a poor minority population that suffers from an important, highly prevalent and disabling condition - minor depression that co-occurs with chronic diseases - using community engagement for the adaptation, implementation and sustainability of an EBI.
This research is exceptionally relevant to public health because it seeks to improve health and functioning outcomes in a poor minority population that suffers from an important, highly prevalent and disabling condition - minor depression that co-occurs with chronic diseases - using community engagement for the adaptation, implementation and sustainability of an EBI.
