Illness perceptions and perceived stress in patients with advanced gastrointestinal cancer.

Objective: According to the Common-Sense Model of Self-Regulation, when faced with a health threat, we make cognitive and emotional assumptions about the illness. The aims of this study were to (a) examine the role of sociodemographic and disease-specific factors on illness perception and perceived stress and (b) test the association between perceived stress and illness perception in participants diagnosed with gastrointestinal cancer.

Methods: Participants completed a battery of questionnaires including a Sociodemographic and Disease-Specific Questionnaire, the Illness Perception Questionnaire, Brief Version (Brief-IPQ), and the Perceived Stress Scale (PSS-14).

Cost-Effectiveness of a Technology-Facilitated Depression Care Management Adoption Model in Safety-Net Primary Care Patients with Type 2 Diabetes.

Background: The Diabetes-Depression Care-Management Adoption Trial is a translational study of safety-net primary care predominantly Hispanic/Latino patients with type 2 diabetes in collaboration with the Los Angeles County Department of Health Services.

Objectives: To evaluate the cost-effectiveness of an information and communication technology (ICT)-facilitated depression care management program.

Methods: Cost-effectiveness of the ICT-facilitated care (TC) delivery model was evaluated relative to a usual care (UC) and a supported care (SC) model.

Comparative Effectiveness of a Technology-Facilitated Depression Care Management Model in Safety-Net Primary Care Patients With Type 2 Diabetes: 6-Month Outcomes of a Large Clinical Trial.

Background: Comorbid depression is a significant challenge for safety-net primary care systems. Team-based collaborative depression care is effective, but complex system factors in safety-net organizations impede adoption and result in persistent disparities in outcomes. Diabetes-Depression Care-management Adoption Trial (DCAT) evaluated whether depression care could be significantly improved by harnessing information and communication technologies to automate routine screening and monitoring of patient symptoms and treatment adherence and allow timely communication with providers.

Associations Between Changes in Depressive Symptoms and Social Support and Diabetes Management Among Low-Income, Predominantly Hispanic Patients in Patient-Centered Care.

Objective: This study examined whether changes in depressive symptoms and social support prospectively predicted diabetes management among Hispanic patients with probable depression in patient-centered medical homes at safety-net clinics in East Los Angeles, CA.

Research Design And Methods: Data were collected from 251 patients enrolled in a randomized clinical trial testing the effectiveness of a self-management intervention assisted by a promotora (Hispanic community health worker). Cross-lagged analyses examined associations between changes in depression symptoms and social support between baseline and 6-month follow-up and self-efficacy and adherence to diabetes management at the 6- and 12-month follow-ups.

Exploring Motivational Interviewing to Engage Latinos in Advance Care Planning: A Community-Based Social Work Intervention.

Unlabelled: Advance care planning (ACP) does not readily occur in medical settings and often gets missed. Older Latinos need ACP information to encourage advance directive (AD) completion indicating preferences for end-of-life (EOL) care.

Objective: To explore the experiences with counseling using motivational interviewing (MI) techniques and social workers to encourage ACP communication among older Latinos with advance chronic diseases.

Promotora assisted depression and self-care management among predominantly Latinos with concurrent chronic illness: Safety net care system clinical trial results.

The study evaluated depression and self-care management among patients with diabetes and/or heart disease in a 12-month randomized trial conducted in Los Angeles County Department of Health Services (LAC-DHS) community clinics. We compared LAC-DHS clinic usual care (UC) versus A-Helping-Hand (AHH) intervention in which bilingual promotoras, hired and supervised by the research project, provided 6 weekly psychoeducational sessions followed by boosters. Of 1957 screened, 348 depressed patients (PHQ-9 score≥10) were enrolled, randomized to AHH (n=178) or UC (n=170) after baseline interview assessing mental health, treatment receipt, co-morbid illness, self-care management, and environmental stressors.

Self-care behavior change and depression among low-income predominantly Hispanic patients in safety-net clinics.

This study examined whether changes in self-care behaviors during a 12-month period predicted the likelihood of screening positive for depression concurrently and prospectively among low-income Hispanic patients with diabetes. Secondary analyses were conducted with longitudinal data collected from a randomized controlled trial that had tested effectiveness of collaborative depression care. We examined whether changes in self-care behaviors observed during the 12 months after baseline predicted the likelihood of screening positive for depression at 12-, 18-, and 24-month follow-up.

Implementing an Advance Care Planning Intervention in Community Settings with Older Latinos: A Feasibility Study.

Background: Older Latinos with serious medical conditions such as cancer and other chronic diseases lack information about advance care planning (ACP). ACP Intervention (ACP-I Plan) was designed for informational and communication needs of older Latinos to improve communication and advance directives (ADs).

Objective: To determine the feasibility of implementing ACP-I Plan among seriously ill, older Latinos (≥50 years) in Southern New Mexico with one or more chronic diseases (e.

Care transitions among Latino diabetics: barriers to study enrollment and transition care.

Objective: Latinos are disproportionately affected by diabetes and people with diabetes experience frequent hospital admissions and readmissions. Care transition interventions can help reduce rates of readmission; however, there are many barriers to recruiting Latinos for participation in intervention research. Exploring reasons for study refusal furthers understanding of low research participation rates to help researchers address barriers.

Association Between Chronic Physical Conditions and the Effectiveness of Collaborative Care for Depression: An Individual Participant Data Meta-analysis.

Importance: Collaborative care is an intensive care model involving several health care professionals working together, typically a physician, a case manager, and a mental health professional. Meta-analyses of aggregate data have shown that collaborative care is particularly effective in people with depression and comorbid chronic physical conditions. However, only participant-level analyses can rigorously test whether the treatment effect is influenced by participant characteristics, such as chronic physical conditions.

Depression remission, receipt of problem-solving therapy, and self-care behavior frequency among low-income, predominantly Hispanic diabetes patients.

Objective: This study explored whether depression remission and problem-solving therapy (PST) receipt are associated with more frequent self-care behaviors via cross-sectional and prospective analyses.

Method: We analyzed data from a randomized clinical trial (N=387) that tested collaborative depression care among predominantly Hispanic patients with diabetes in safety-net clinics. Data at 12-month follow-up, measured with the Patient Health Questionnaire-9 and Hopkins Symptom Checklist-20, were used to define depression remission.

Exploring Health Care Providers' Views About Initiating End-of-Life Care Communication.

Numerous factors impede effective and timely end-of-life (EOL) care communication. These factors include delays in communication until patients are seriously ill and/or close to death. Gaps in patient-provider communication negatively affect advance care planning and limit referrals to palliative and hospice care.

Automated Remote Monitoring of Depression: Acceptance Among Low-Income Patients in Diabetes Disease Management.

Background: Remote patient monitoring is increasingly integrated into health care delivery to expand access and increase effectiveness. Automation can add efficiency to remote monitoring, but patient acceptance of automated tools is critical for success. From 2010 to 2013, the Diabetes-Depression Care-management Adoption Trial (DCAT)-a quasi-experimental comparative effectiveness research trial aimed at accelerating the adoption of collaborative depression care in a safety-net health care system-tested a fully automated telephonic assessment (ATA) depression monitoring system serving low-income patients with diabetes.

Promotora assisted depression care among predominately Hispanic patients with concurrent chronic illness: Public care system clinical trial design.

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.

Demographic, clinical and psychosocial factors identify a high-risk group for depression screening among predominantly Hispanic patients with Type 2 diabetes in safety net care.

Objective: Identify biopsychosocial factors associated with depression for patients with Type 2 diabetes.

Method: A quasi-experimental clinical trial of 1293 patients was predominantly Hispanic (91%) female (62%), mean age 53 and average diabetes duration 10 years; 373 (29%) patients were depressed and assessed by Patient Health Questionnaire-9. Demographic, baseline clinical and psychosocial variables were compared between depressed and nondepressed patients.

Retaining Low-Income Minority Cancer Patients in a Depression Treatment Intervention Trial: Lessons Learned.

Previously published work finds significant benefit from medical and behavioral health team care among safety-net patients with major depression. This qualitative study assessed clinical social worker, psychiatrist and patient navigator strategies to increase depression treatment among low-income minority cancer patients participating in the ADAPt-C clinical depression trial. Patient care retention strategies were elicited through in-depth, semi-structured interviews with nine behavioral health providers.

Collaborative health literate depression care among predominantly Hispanic patients with coronary heart disease in safety net care.

Objective: To determine whether evidence-based socioculturally health literate-adapted collaborative depression care improves depression care, depressive symptoms, and quality of life among predominantly Hispanic patients with coronary heart disease.

Methods: The 12-month trial included 97 patients with coronary heart disease (79% of eligible patients) who met the depression criteria assessed by the Patient Health Questionnaire-9. Patients were recruited from 3 safety net clinics and offered depression team care by a bilingual clinical social worker and community patient navigator, a consulting psychiatrist, and a primary care physician.

A scope of the problem: Post-deployment reintegration challenges in a National Guard Unit.

Background: More Reserve and Guard members have been activated in the past few years than in any other time in history. In addition to the high rates of psychological and behavioral challenges among military personnel, there are other equally important post-deployment reintegration challenges. Post-deployment reintegration challenges are particularly important to Reserve and Guard members, who transition rapidly from civilian-military-civilian.

Collaborative depression care among Latino patients in diabetes disease management, Los Angeles, 2011-2013.

Introduction: The prevalence of comorbid diabetes and depression is high, especially in low-income Hispanic or Latino patients. The complex mix of factors in safety-net care systems impedes the adoption of evidence-based collaborative depression care and results in persistent disparities in depression outcomes. The Diabetes-Depression Care-Management Adoption Trial examined whether the collaborative depression care model is an effective approach in safety-net clinics to improve clinical care outcomes of depression and diabetes.

Technology-facilitated depression care management among predominantly Latino diabetes patients within a public safety net care system: comparative effectiveness trial design.

Health disparities in minority populations are well recognized. Hispanics and Latinos constitute the largest ethnic minority group in the United States; a significant proportion receives their care via a safety net. The prevalence of diabetes mellitus and comorbid depression is high among this group, but the uptake of evidence-based collaborative depression care management has been suboptimal.

Depression and family interaction among low-income, predominantly hispanic cancer patients: a longitudinal analysis.

Purpose: Among cancer patients, family interaction has been associated with depression. According to the stress generation theory, depression among cancer patients triggers stressful interpersonal events that contribute to poor family interactions and additional depression. This conflict may occur with a spouse/partner or other family member, including extended family.

Psychosocial concerns among Latinas with life-limiting advanced cancers.

Research has demonstrated that limited dialogue in end-of-life (EOL) care can negatively impact decision-making and place of death. Furthermore, when vulnerable populations are faced with EOL cancer care, they experience issues resulting from previous gaps in services attributed to sociocultural and economic issues that influence EOL care. These conditions place an additional burden on disadvantaged populations which can cause distress, especially as disparate conditions continue to persist.

Low-income cancer patients in depression treatment: dropouts and completers.

This study aims to explore reasons for depression treatment dropout among low-income, minority women with depression and cancer. Semi-structured telephone interviews are conducted with 20, predominately Latina, patients who dropped out of depression treatment and 10 who completed. Transcripts analyzed using techniques rooted in grounded theory.