Angela J. Camilleri, MPH, MA¹, Eileen Crowley¹, Carlos N. Casas, MD², Lourdes Rangel², Vicki J Karlan, MPH³, Julia D Portale, MPH, MBA¹, Kenneth S. Babamoto, PharmD, MPH¹, and Miguel Trevino². (1) Community Health, Pfizer Health Solutions, 2400 Broadway, Suite 500, Santa Monica, CA 90404, 310-586-2516, angela.camilleri@pfizer.com, (2) Gateway Community Health Center, 2309 Saunders, Laredo, TX 78044, (3) Outcomes and Analytics, Pfizer Health Solutions, 2400 Broadway, Suite 500, Santa Monica, CA 90404

The true prevalence of depression in the Hispanic population is largely disputed, due to limited data and inconsistent findings. Frequently, the anecdotal incidence of depression in Hispanics is reported to be higher than published findings. Some authors have questioned the applicability of using common diagnostic tools with the Hispanic population. Many factors may contribute to this discrepancy in diagnosing and treating Hispanics with depression, including cultural beliefs, lack of access to care, denial due to stigma of mental illness, misunderstanding, and language issues.

To further understand the burden of depression among Hispanics with diabetes, Pfizer Health Solutions and Gateway Community Health Center in Laredo, Texas implemented a randomized controlled self-management education program called “Amigos en Salud”. In this program, Community Health Workers (CHWs), or promotores, were trained to educate and support Hispanics with diabetes and possible comorbid depression. A total of 540 Hispanic adults were randomized into the CHW intervention or control group. CHWs helped participants increase their awareness of depression and supported clinic providers by screening for depression through a self-administered survey, the Patient Health Questionnaire (PHQ). CHWs also provided diabetes self-management education. Preliminary results demonstrated increased depression awareness, improved referral to clinic providers including mental health specialists, and a 31% decrease in PHQ severity. Key process measures in supporting Hispanics with diabetes and comorbid depression include CHW-participant personal relationship, providing depression education, facilitating access to care, supporting participants and family members, and bridging cultural barriers. Program methods, CHW depression protocol, and results for completed cohorts will be presented.

Learning Objectives:

• Describe 3 barriers to appropriate depression diagnosis in Hispanic patients
• List 3 interventions to decrease depression burden
• Discuss the role of CHWs in depression management

Keywords: Depression, Diabetes

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employment