Title

Sustaining Positive Health Outcomes Through the Augmentation of a Chronic Disease Self-management Program for Latinos

Document Type

Presentation

Publication Date

4-2013

Abstract

Background: The co-occurrence of minor depression and chronic diseases is often under-recognized, under-treated and under-studied. Among Latinos, complex structural and cultural barriers exist which further complicate the translation of evidence-based interventions (EBIs) aimed at managing chronic conditions for this population.

Objective: To better understand those barriers and deliver an EBI designed to best meet the needs of this. population, a multiphase, mixed methods study was employed with the goal of ‘translating ‘research findings directly into practice through the implementation of an augmented EBI (Tomando Control de su Salud) for Latinos with chronic illness and minor depression (ICD) and their family members (FM).

Methods: Forty ICDs and 32 FMs, along with 82 key stakeholders, participated in formative research through which findings informed the transformation of an EBI designed to help Latinos better manage their chronic illness and minor depression. Additionally, 125 ICDs and 65 FMs participated in the pilot intervention study to test this model. ICDs were randomized into either a standard 6-week course or an augmented 9-week course. Participants completed researcher-administered assessments at baseline, post, 3-month post and 6-month post intervention. Repeated measure analyses were completed to assess changes in health related outcomes over time. Differences in outcomes among subgroups (ICD and family; male and female) were also assessed.

Results: Results indicated changes in health related outcomes following participation in the intervention, with statistically significant differences found on several health related indicators, including depression scores (PHQ-9), weight changes and physical activity. Findings also suggested that differences exist between male and female participants. Female participants were significantly more likely to attend and complete the intervention, females were more likely to attend as an FM and, given their role as a ‘caregiver’, were important in the recruitment, retention and successful completion of male Latinos in chronic disease self management programs.

Conclusion and Implications: Many disease management interventions for minor depression have shown to have limited effect over time for people with co-occurring conditions. This study presents a promising ‘augmentation‘ model for enhancing the effects of an EBI to sustain positive outcomes over time among Latinos. Results emphasize the important role of ‘translating ‘ EBIs into community-settings to reduce health disparities, and highlight the need to not just translate but transcreate these programs for differing needs of the local population. Lessons learned regarding recruitment and retention also suggest the key role of women and caregivers in expanding the scope and reach of the program.

Sponsorship/Conference/Institution

Society for Public Health Education Annual Conference (SOPHE)

Location

Orlando, FL

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