Tomando-plus: Increasing the impact of a chronic disease self-management program by addressing minor depression among latinos

Minor depression and co-occurring chronic disease disproportionally burden Latinos. Left untreated, these costly conditions can result in increased morbidity and mortality. Chronic disease self-management programs (CDSMPs) can be valuable in addressing both chronic disease and depression. However, few studies examine the effects of CDSMPs long-term. This presentation describes a pilot study which targeted Latinos with depression and chronic illness (ICDs) and their family members (FMs) to assess strategies for improving health outcomes. Using a community-driven, mixed-methods approach, a CDSMP (Tomando Control de su Salud) was augmented to enhance the effects for ICDs and FMs over time. ICDs (n=129) were randomized into a 6-week control or 9-week “Plus” program; 75 FMs (n=75) were attached to the same arm as their relatives. Participants completed assessments at baseline, post, 3-month, and 6-month post intervention. Analysis of variance was employed to assess the impact of the intervention on PHQ-9 scores for depression status. Findings suggest a significant reduction in depression status across all four time points for both the control and Plus groups. Significant reduction in depression status in the Plus group compared to the Control, (F(3,101)=30.99, p<.0005) was observed, suggesting differences in the long-term effectiveness of the two programs. Results emphasize the important role of ‘translating' evidence based CDSMPs into community-settings to reduce health disparities and enhance positive physical and mental health outcomes. Results support the need to transcreate programs for differing needs within the local population. Lessons learned also suggest the key role of the family in the management of chronic disease.