Exploring the impact of Pasos Adelante on depressive symptoms and mental health-related quality of life in a border population

Pasos Adelante, or Steps Forward, is a 12-week community-based program aimed at preventing chronic disease, improving quality of life and reducing depressive symptoms among primarily older Hispanics. The community program was delivered by promotoras, or community health workers, and included educational sessions about nutrition, physical activity and chronic disease risk factors, as well as walking groups. A convenience sample of participants (n=216) was recruited in a Southwestern border community and assessed at baseline, post-intervention and at 12 weeks post-intervention. Among all participants, depressive symptom scores decreased significantly from baseline to post-intervention and from baseline to follow-up, although the clinical significance of this finding is questionable given symptom scores were below the clinical distress cut-point at all time points. Among participants who reported diabetes at baseline (n=46), CES-D scores did not significantly change from baseline to post-intervention or from baseline to follow-up. For participants who reported depressive symptoms at baseline above a clinical distress cut-point (n=66), mean CES-D scores decreased significantly from baseline to post-intervention and from baseline to follow-up, but did not decrease below the clinical distress cut-point suggesting participants were still distressed post-intervention. The number of days in the last thirty that participants' mental health was not good was also examined in each group, with reductions in the number of poor mental health days among all participants and those distressed at baseline. Pasos Adelante may have positive mental health impacts for some participants, while others may benefit from interventions that focus more specifically on mental health issues