TY - JOUR
KW - Adult
KW - Aged
KW - California
KW - Combined Modality Therapy
KW - Cooperative Behavior
KW - Cultural Competency
KW - Depressive Disorder/ethnology/therapy
KW - Diabetes Mellitus, Type 2/ethnology/therapy
KW - Female
KW - Hispanic Americans
KW - Humans
KW - Interdisciplinary Communication
KW - Male
KW - Mass Screening
KW - Middle Aged
KW - Needs Assessment
KW - Patient Care Team
KW - Patient Education as Topic
KW - Poverty/ethnology
KW - Psychotherapy
KW - Social Work
AU - K. Ell
AU - W. Katon
AU - L. J. Cabassa
AU - B. Xie
AU - P. J. Lee
AU - S. Kapetanovic
AU - J. Guterman
A1 - 
AB - OBJECTIVE: This article describes design elements of the Multifaceted Depression and Diabetes Program (MDDP) randomized clinical trial. The MDDP trial hypothesizes that a socioculturally adapted collaborative care depression management intervention will reduce depressive symptoms and improve patient adherence to diabetes self-care regimens, glycemic control, and quality-of-life. In addition, baseline data of 387 low-income, 96% Hispanic, enrolled patients with major depression and diabetes are examined to identify study population characteristics consistent with trial design adaptations. METHODS: The PHQ-9 depression scale was used to identify patients meeting criteria for major depressive disorder (1 cardinal depression symptom + a PHQ-9 score of > or = 10) from two community safety net clinics. Design elements included sociocultural adaptations in recruitment and efforts to reduce attrition and collaborative depression care management. RESULTS: Of 1,803 diabetes patients screened, 30.2% met criteria for major depressive disorder. Of 387 patients enrolled in the clinical trial, 98% had Type 2 diabetes, and 83% had glycated hemoglobin (HbA1c) levels > or = 7%. Study recruitment rates and baseline data analyses identified socioeconomic and clinical factors that support trial design and intervention adaptations. Depression severity was significantly associated with diabetes complications, medical comorbidity, greater anxiety, dysthymia, financial worries, social stress, and poorer quality-of-life. CONCLUSION: Low-income Hispanic patients with diabetes experience high prevalence of depressive disorder and depression severity is associated with socioeconomic stressors and clinical severity. Improving depression care management among Hispanic patients in public sector clinics should include intervention components that address self-care of diabetes and socioeconomic stressors.
BT - International journal of psychiatry in medicine
C5 - Healthcare Disparities
CP - 2
CY - United States
IS - 2
JF - International journal of psychiatry in medicine
N2 - OBJECTIVE: This article describes design elements of the Multifaceted Depression and Diabetes Program (MDDP) randomized clinical trial. The MDDP trial hypothesizes that a socioculturally adapted collaborative care depression management intervention will reduce depressive symptoms and improve patient adherence to diabetes self-care regimens, glycemic control, and quality-of-life. In addition, baseline data of 387 low-income, 96% Hispanic, enrolled patients with major depression and diabetes are examined to identify study population characteristics consistent with trial design adaptations. METHODS: The PHQ-9 depression scale was used to identify patients meeting criteria for major depressive disorder (1 cardinal depression symptom + a PHQ-9 score of > or = 10) from two community safety net clinics. Design elements included sociocultural adaptations in recruitment and efforts to reduce attrition and collaborative depression care management. RESULTS: Of 1,803 diabetes patients screened, 30.2% met criteria for major depressive disorder. Of 387 patients enrolled in the clinical trial, 98% had Type 2 diabetes, and 83% had glycated hemoglobin (HbA1c) levels > or = 7%. Study recruitment rates and baseline data analyses identified socioeconomic and clinical factors that support trial design and intervention adaptations. Depression severity was significantly associated with diabetes complications, medical comorbidity, greater anxiety, dysthymia, financial worries, social stress, and poorer quality-of-life. CONCLUSION: Low-income Hispanic patients with diabetes experience high prevalence of depressive disorder and depression severity is associated with socioeconomic stressors and clinical severity. Improving depression care management among Hispanic patients in public sector clinics should include intervention components that address self-care of diabetes and socioeconomic stressors.
PP - United States
PY - 2009
SN - 0091-2174; 0091-2174
SP - 113
EP - 132
EP - 
T1 - Depression and diabetes among low-income Hispanics: design elements of a socioculturally adapted collaborative care model randomized controlled trial
T2 - International journal of psychiatry in medicine
TI - Depression and diabetes among low-income Hispanics: design elements of a socioculturally adapted collaborative care model randomized controlled trial
U1 - Healthcare Disparities
U2 - 19860071
VL - 39
VO - 0091-2174; 0091-2174
Y1 - 2009
ER -