TY - JOUR
T1 - Promotora assisted depression care among predominately Hispanic patients with concurrent chronic illness
T2 - Public care system clinical trial design
AU - Ell, Kathleen
AU - Aranda, María P.
AU - Wu, Shinyi
AU - Oh, Hyunsung
AU - Lee, Pey Jiuan
AU - Guterman, Jeffrey
N1 - Funding Information:
The AHH study is supported by a grant contract (the general terms, conditions, and policy requirements, and collaboration) from the Patient-Centered Outcomes Research Institute ( PCORI ) to Dr. Kathleen Ell ( AD-1304-7364 ). PCORI is engaged with the study PI (Ell) and study co-investigators. Trial Registration: NCT02147522, clinicaltrials.gov/ct. We also acknowledge the LAC-DHS clinics, providers, and patients participating in the AHH study.
Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Depression frequently negatively affects patient overall self-care and social stress management within United States safety net care systems. Rates of major depression are significantly high among low-income predominantly Hispanic/Latino with chronic illness, such as diabetes and heart disease. The study design of the A Helping Hand to Activate Patient-Centered Depression Care among Low-income Patients (AHH) randomized clinical trial aims to enhance patient depression care receipt and overall bio-psychosocial self-care management. The AHH trial is conducted in collaboration with three Los Angeles County Department of Health Services (DHS) safety net clinics that provide Patient-Centered Medical Home (PCMH) care. The study compares AHH intervention (AHH) in which community-based bilingual promotoras provide in-person or telephone patient engagement and intervention aimed to reduce the burden and strain on patients, families, and care providers by assessing, enhancing, and facilitating patient depression and co-morbid illness self-care management skill, and activating patient communication with clinic medical providers versus DHS PCMH team usual care (PCMHUC). AHH independent bilingual recruiters screened 1957 and enrolled 348 predominantly Hispanic/Latino patients, of whom 296 (85%) had diabetes, 14 (4%) with heart disease, and 38 (11%) with both diseases. Recruiters identified depressed patients by baseline Patient Health Questionnaire-9 scores of 10 or more, completed baseline assessments, and randomized patients to either AHH or PCMHUC study group. The comprehensive assessments will be repeated at 6 and 12 months by an independent bilingual follow-up interviewer. Baseline and outcome data include mental health assessment and treatment receipt, co-morbid illness self-care, social relationships, and environmental stressor assessments.
AB - Depression frequently negatively affects patient overall self-care and social stress management within United States safety net care systems. Rates of major depression are significantly high among low-income predominantly Hispanic/Latino with chronic illness, such as diabetes and heart disease. The study design of the A Helping Hand to Activate Patient-Centered Depression Care among Low-income Patients (AHH) randomized clinical trial aims to enhance patient depression care receipt and overall bio-psychosocial self-care management. The AHH trial is conducted in collaboration with three Los Angeles County Department of Health Services (DHS) safety net clinics that provide Patient-Centered Medical Home (PCMH) care. The study compares AHH intervention (AHH) in which community-based bilingual promotoras provide in-person or telephone patient engagement and intervention aimed to reduce the burden and strain on patients, families, and care providers by assessing, enhancing, and facilitating patient depression and co-morbid illness self-care management skill, and activating patient communication with clinic medical providers versus DHS PCMH team usual care (PCMHUC). AHH independent bilingual recruiters screened 1957 and enrolled 348 predominantly Hispanic/Latino patients, of whom 296 (85%) had diabetes, 14 (4%) with heart disease, and 38 (11%) with both diseases. Recruiters identified depressed patients by baseline Patient Health Questionnaire-9 scores of 10 or more, completed baseline assessments, and randomized patients to either AHH or PCMHUC study group. The comprehensive assessments will be repeated at 6 and 12 months by an independent bilingual follow-up interviewer. Baseline and outcome data include mental health assessment and treatment receipt, co-morbid illness self-care, social relationships, and environmental stressor assessments.
KW - Depression
KW - Diabetes
KW - Heart disease
KW - Low-income Hispanics
KW - Promotora
KW - Safety net care system
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U2 - 10.1016/j.cct.2015.11.012
DO - 10.1016/j.cct.2015.11.012
M3 - Article
C2 - 26600285
AN - SCOPUS:84947753616
SN - 1551-7144
VL - 46
SP - 39
EP - 47
JO - Contemporary Clinical Trials
JF - Contemporary Clinical Trials
ER -