141st APHA Annual Meeting

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292471
Tomando-plus: Increasing the impact of a chronic disease self-management program by addressing minor depression among latinos

Monday, November 4, 2013

Jaime Corvin, PhD, MSPH , Global Health, Univeristy of South Florida, Tampa, FL
Claidia Aguado-Loi
Elizabeth Powers , University of South Florida
Jennifer Burges, BA , College of Public Health, University of South Florida, Tampa, FL
Isabela Chan
Minor depression and co-occurring chronic disease disproportionally burden Latinos. Left untreated, these costly conditions can result in increased morbidity and mortality. Chronic disease self-management programs (CDSMPs) can be valuable in addressing both chronic disease and depression. However, few studies examine the effects of CDSMPs long-term. This presentation describes a pilot study which targeted Latinos with depression and chronic illness (ICDs) and their family members (FMs) to assess strategies for improving health outcomes. Using a community-driven, mixed-methods approach, a CDSMP (Tomando Control de su Salud) was augmented to enhance the effects for ICDs and FMs over time. ICDs (n=129) were randomized into a 6-week control or 9-week “Plus” program; 75 FMs (n=75) were attached to the same arm as their relatives. Participants completed assessments at baseline, post, 3-month, and 6-month post intervention. Analysis of variance was employed to assess the impact of the intervention on PHQ-9 scores for depression status. Findings suggest a significant reduction in depression status across all four time points for both the control and Plus groups. Significant reduction in depression status in the Plus group compared to the Control, (F(3,101)=30.99, p<.0005) was observed, suggesting differences in the long-term effectiveness of the two programs. Results emphasize the important role of ‘translating' evidence based CDSMPs into community-settings to reduce health disparities and enhance positive physical and mental health outcomes. Results support the need to transcreate programs for differing needs within the local population. Lessons learned also suggest the key role of the family in the management of chronic disease.

Learning Areas:
Chronic disease management and prevention
Program planning

Learning Objectives:
Discuss the impact of co-occurring chronic illness and minor depression among Latinos. Identify transcreated elements of a CDSMP that significantly enhanced the effects of an evidence based intervention over time. Discuss implications of CDSMPs for improved mental health outcomes. Discuss the need for transcreated interventions to better meet the needs of underserved populations.

Keywords: Depression, Chronic Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an assistant Professor at the University of South Florida College of Public Health, with a background in health disparities, chronic disease self management, and Latino health issues. I was PI of this project and responsible for collecting and analyzing this data.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.