Implementing PEARLS (the Program to Encourage Active and Rewarding Lives for Seniors) to older immigrants: A pilot study using trained interpreters

Background: PEARLS is an evidence-based depression care management program for homebound elders. Exclusion of non-English speaking clients is a major barrier to implementing PEARLS at a local area agency on aging (AAA), as 30% of their client population speak other languages.

Aims: To test PEARLS delivery with Russian- and Somali-speaking elders using trained interpreters. These two immigrant communities represent two of the largest ethnic groups at the AAA. We selected an interpreter model for feasibility reasons (the AAA cannot sustain training native language counselors for the 80+ languages spoken by their clients).

Methods: Interpreters received a brief training on PEARLS and study protocol. PEARLS materials were translated and back-translated, and minor modifications were made to improve cultural appropriateness. In addition to monitoring program effectiveness (depression outcomes and client satisfaction), we assessed feasibility and acceptability of using interpreters through a brief qualitative interview with clients and interpreters.

Results: 179 clients (55 Russian and 124 Somali) were pre-screened for PEARLS eligibility between May and October 2009. 31 were screened at home and 20 clients (10 Russian and 10 Somali) enrolled. 17 clients completed PEARLS, reporting similar outcomes as the original research trial: 76% response (decrease PHQ-9 ≥ 50%) and 82% remission (no longer met criteria for clinical depression). Clients are satisfied with PEARLS and find the interpreter model acceptable.

Implications: Preliminary findings suggest PEARLS can be delivered using interpreters to reach clients with limited English proficiency. The AAA is encouraged by these findings and has continued implementing PEARLS with their Russian clients.