Category: Cultural Diversity / Vulnerable Populations

Symposium

Increasing Engagement of Low-Income, Monolingual Spanish-Speaking Immigrants With Behavioral Activation

Sunday, November 19
10:15 AM - 11:45 AM
Location: Indigo 202, Level 2, Indigo Level

Keywords: Behavioral Activation | Hispanic Americans | Dissemination
Presentation Type: Symposium

Background: Latinos, the largest ethnic minority group in the US (Passel, Cohn, & Lopez, 2011), are projected to double in size by 2050 (Passel & Cohn, 2008). There is evidence to suggest Latinos report comparable rates of major depression diagnoses, but possibly higher levels of depressive symptoms compared to non-Latino Whites (Mendelson, Rehkopf, & Kubzansky, 2008). Latinos face treatment engagement challenges (e.g., treatment uptake, adherence, retention), which may cause deleterious effects to clinical outcomes (Glenn et al., 2013; O’Brien, Fahmy, & Singh, 2009). 


Method: This study represents a hybrid efficacy-effectiveness trial in which we compared treatment-as-usual (TAU, n = 22) to BA for Latinos (BAL, n = 21) in a community mental health clinic setting with a sample of depressed, Spanish-speaking Latinos.


Results: We replicated the finding that BAL clients attended a greater number of sessions (M = 8.21/12, SD = 3.95) relative to TAU clients (M = 4.95/12, SD = 3.41), t(37) = 2.76, p = .009 (Kanter, Santiago-Rivera, Santos, et al., 2014). Findings support a significant Session × Treatment × Time interaction, F(2, 37.2) = 3.35, p = .046, such that BAL clients who attended 9–12 sessions indicated significant depression decreases, t(8) = 5.97, p d = 1.99. More BAL clients (47%) were classified as treatment completers compared to TAU clients (10%), Fisher’s Exact Test, p = .014,). Similar results emerged with regards to mental health functioning, F(2, 31.2) = 6.03, p = .006, such that there was a significant improvement for BAL clients who attended 9–12 sessions, t(9) = 4.02, p = .003, d = 1.27. BAL clients who attended 9-12 sessions also evidenced significant improvement in quality of life, t(8) = 4.27, p = .003, d = 1.42.


Conclusion: We aim to elucidate cultural factors that may be associated with and contribute to BAL’s success at engaging and retaining members of this population in treatments.  BAL was developed to target the problem of engagement and retention among Latinos by addressing cultural factors and encouraging session attendance and continuously discussing it in session. Recommendations are made for providers working with members of this population. 

Gabriela A. Nagy

Pre-doctoral Intern
Duke University Medical Center

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