Improving access and reducing barriers to depression treatment for Latino elders: Un Nuevo Amanecer (A New Dawn).

Abstract

Cultural adaptations to evidenced-based practices have the potential to bridge scientifically rigorous interventions to underserved populations. Un Nuevo Amanecer (A New Dawn) is a depression treatment program for Latino older adults and elders (age 60 years and older) with depressive disorders (i.e., major depression, minor depression, and dysthymia). We have implemented an evidence-based practice, originally designed for older adults in a primary care setting, into a community center setting serving Latino elders. Implementation of the evidence-based practice involved relatively little adaptation of the clinical protocol, which facilitated fidelity to the evidence-based model. The major adaptations were cultural adaptations in response to the target population and the community center setting. Treatment outcomes provide preliminary support for a significant reduction in depressive symptoms for Un Nuevo Amanecer clients. In this article, we introduce the presenting concems and the implemented evidencebased practice; delineate key cultural adaptations to the evidence-based practice specific to our population and setting; offer a case example; and provide preliminary outcome data.

Barriers and Facilitators of Hispanic Older Adult Mental Health Service Utilization in the USA

“…One study modifying a depression care management intervention to be more culturally appropriate for Hispanic elders resulted in over a 50% reduction in depressive symptoms, as measured by the Patient Health Questionnaire (PHQ-9), and boasted a retention rate of almost 97% (Chavez-Korell et al, 2012). Further, 98% of participants indicated that they found the services helpful and that they would recommend the services to a friend or family member (Chavez-Korell et al, 2012).…”

“…One study modifying a depression care management intervention to be more culturally appropriate for Hispanic elders resulted in over a 50% reduction in depressive symptoms, as measured by the Patient Health Questionnaire (PHQ-9), and boasted a retention rate of almost 97% (Chavez-Korell et al, 2012). Further, 98% of participants indicated that they found the services helpful and that they would recommend the services to a friend or family member (Chavez-Korell et al, 2012). In that study, the modifications to the Improving Mood -Providing Access to Collaborative Treatment (IMPACT) model included adapting the depression care management intervention to take place in a community center, providing materials and services in Spanish, adapting materials for low literacy and illiterate participants, decreasing the amount of clients for each depression care manager, and providing culturally appropriate activities and adaptations that were sensitive to the beliefs and values of Hispanic elders, including familismo, marianismo, and respect for elders (Chavez-Korell et al, 2012).…”

The Implementation and Evaluation of Health Promotion Services and Programs to Improve Cultural Competency: A Systematic Scoping Review

“…Another innovative community-focused strategy was the use of non-clinical, community spaces to increase the acceptability and accessibility of health interventions for the target groups. Community spaces included local churches ( 25 , 31 ) or other religious facilities ( 24 ), a community center ( 32 ), and a community health center ( 33 ) and tribal clinic ( 34 ).…”

“…Chavez-Korell et al ( 32 ) reported on a culturally adapted depression treatment for older Latino adults delivered through a community center located in an area with a high older Spanish-speaking, low-acculturated, and first-generation immigrant population. The target population had a strong sense of trust and identification with the center, and already attended regularly for a variety of services and programs.…”

Risk Factors Associated With Depression And Anxiety In Older Adults Of Mexican Origin

“…The literature on the effectiveness of various psychological treatment modalities for ethnic minority groups-as well as the risk factors associated with anxiety and depression, specifically among elders of Mexican origin (Chavez-Korell et al, 2012;Vink, Aartsen, & Schoevers, 2008)-is limited. While the need is significant; too few mental health professionals from ethnic and non-ethnic minority groups are interested in geropsychology (Karel et al, 2012).…”