Challenges of adaptation the evidence-based depression care model "IMPACT" in a low-income Latino population

Depressive disorders have a high prevalence among older adults in primary care settings and have been associated with significant impairment in the levels of social, physical and mental functioning. The IMPACT model has been widely promoted as an effective treatment model for depression in the primary care setting among the English-speaking general population. Community Health Centers predominantly serve non-English speaking indigent populations who face challenges from life's competing crises. We implemented the IMPACT model in a large Community Health Center serving a predominately Spanish-speaking, low-income Latino population in a US/Mexico border city. Several aspects of the IMPACT protocol were found to be culturally incongruent with our Latino patients. Counselors reported that patients found the following elements of the IMPACT model irrelevant: Proposing pleasant activities in their daily lives, using problem solving therapy to address life stressors, and the approach to depression education was not culturally sensitive. Recommendations for making cultural and linguistic adaptations to the IMPACT model will be presented.