The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #67655

Kathleen Ell, DSW, Megan Dwight-Johnson, MD, Kathleen Sanchez, PhD, and Maria Aranda, PhD. School of Social Work, University of Southern California, MRF Building - MC0411, Los Angeles, CA 90089-0411, (213) 740-0298, ell@usc.edu

A socioculturally adapted depression care model was designed and piloted in a randomized study of 55 predominantly Latina women with breast or gynecologic cancer. Key intervention elements were aimed at not only positively affecting depression symptoms and cancer outcomes, but also on reducing socio-cultural patient/family, health care provider, and system barriers to depression care within the oncology care system (as few patients have access to a regular primary care physician). The depression care model included cultural sensitivity and competency enhancements such as: patient choice of first line treatment (antidepressant medication or Problem Solving Therapy (PST)), recognition of family roles and needs; the provision of PST tailored for Hispanic patients with cancer; and services provided by a bilingual, bicultural depression clinical specialist. Nearly a third of the women screened positive for depressive disorder or dysthymia. The majority of the women preferred psychotherapy over antidepressant medication but were often unable to keep their psychotherapy appointment(s). Facilitating factors and barriers affecting the intervention model fidelity, acceptability to patients and providers, and feasibility within public sector oncology care were identified. For many of the women, family members were observed to be either a motivator or a barrier to depression care. Other key barriers included concerns about treatment costs; transportation difficulties and apprehension about cancer treatment regimens. Sociocultural adaptations of this depression care model will be discussed indepth. Participants who attend this session will be able to identify specific barriers to depression care and to identify specific sociocultural adaptations to depression care management and PST.

Learning Objectives:

• Participants who attend this session will be able to identify specific barriers to depression are and to identify specific sociocultural adaptations to depression care management and PST.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.