¡HOLA, Amigos! Toward Preventing Anxiety and Depression in Older Latinos

Abstract

Given the prevalence and morbidity of depression and anxiety in later life, the inadequacies of current treatment approaches for averting years living with disability, the disparities in access to the mental healthcare delivery system, and the workforce shortages to meet the mental health needs of older Latinos, development and testing of innovative strategies to prevent depression and anxiety are of great public health significance and have the potential to change practice.Although impediments to good depression and anxiety outcomes exist for all older adults, they are even more pronounced for older Latinos, who tend to have fewer socioeconomic resources.These factors underscore the need for prevention-based interventions that are effective, scalable, relevant, respectful, and specific to this population.The Happy Older Latinos are Active (HOLA) program is a community health worker–led, multicomponent, health promotion intervention.The diverse needs and circumstances of older Latinos (highly sedentary, culture-specific health beliefs, service disparities) were incorporated into the design of HOLA to reduce risk factors and improve health-related outcomes associated with common mental disorders in this group.The authors describe HOLA (highlighted in this case example) and why health promotion interventions like HOLA may hold promise as effective, practical, and nonstigmatizing interventions for preventing common mental disorders in older Latinos who are at risk for developing these disorders.

Suicide Among Older Adults Living in or Transitioning to Residential Long-term Care, 2003 to 2015

“…Randomized clinical trials have demonstrated that these programs can positively influence mental health, 44 , 45 , 46 , 47 and other such trials are underway. 48 , 49 There are also ongoing efforts to address barriers to navigating LTC transitions for both residents and family members. 50 , 51 These findings emphasize the importance of such efforts for the mental health of older adults.…”

Older Latino Mental Health: A Complicated Picture

“…Preliminary results from the pilot study indicate that HOLA is feasible and acceptable and highlights the significant impact the intervention can have in lowering depression and anxiety vulnerability when it is relevant, respectful, and specific to the needs of the older Latino population ( Jimenez et al, 2018 ). A randomized prevention trial to examine the effectiveness of HOLA in reducing the risk for and incidence/recurrence of major depression and generalized anxiety disorder in a diverse sample of older Latinos is currently under way (NCT03870360).…”

The Leveraging Exercise to Age in Place (LEAP) Study: Engaging Older Adults in Community-Based Exercise Classes to Impact Loneliness and Social Isolation

“… 33 Our findings are consistent with the benefits of a social support on participants’ mental health highlighted in a pilot study of Latino older adults engaged in group exercise. 34 Additionally, the use of a coach to facilitate behavioral intervention has been shown previously to positively impact social connectedness when compared to a friendly caller program. 35 Our program health coach functioned similarly to the “social prescribing” pathway recently described in England, where primary care providers can refer patients to a health coach for connection to community programming which led to decreased loneliness.…”