Depression education fotonovela for engagement of Hispanic patients in treatment: a randomized clinical trial

Background We report the primary outcomes from a randomized clinical trial testing a novel culturally-adapted patient education intervention to increase engagement of Hispanic patients in depression treatment. The Depression Education Fotonovela (DEF), Secret Feelings, incorporates popular images, cultural norms, and vivid pictures embedded within a soap opera narrative to increase depression knowledge and dispel myths about treatment. We then assessed engagement in a integrated care treatment model in response to the education intervention and subsequent changes in depression symptoms in a large community-based clinic whose patient population is majority Hispanic. Method The sample included 150 adult Hispanic patients with a confirmed diagnosis of depression who were randomly assigned to either: [1] integrated care + fotonovela; or [2] integrated care + standard education. Differences between treatment groups were examined as were changes in depression, anxiety, depression knowledge, and stigma scores over time and engagement in treatment. Results Results indicated that while depression scores significantly decreased over time for participants (F [2.811, 416.054] = 197.69, p < .001, η2 = .572), no differences between the two education groups were found (F [1, 148] = 0.70, p = .403, η2 = .005). At 12-month follow-up, 101 patients (80.8%) reported a 50% of greater reduction in depression scores from baseline. Conclusions We found little difference between the two education groups, suggesting that either may helpful for engaging Hispanic patients into care. Better tailoring of patient education, with the fotonovela or similarly adapted tools, will require more directly addressing the stigma associated with antidepressant medication. Trial registration The study was registered with www.clinicaltrials.gov: NCT02702596, on 03/20/2016. Retrospectively registered.

Stuck in Stage 3: The Case of an Effective Depression Intervention for African American Older Adults

Beat the Blues (BTB) is a culturally tailored depression program for older African Americans. Tested in an NIA Stage 3 efficacy trial, findings showed statistically and clinically significant benefits, including decreased depressive symptoms, improved depression knowledge and symptom recognition, and behavioral activation. The multi-component intervention was co-constructed in partnership with a large senior center. Drawn from previously tested depression programs and tailored to preferences/needs of the targeted population, its five components included care management, depression education and symptom recognition, resources/referrals, and stress reduction and behavioral activation techniques. Despite significant findings, strong effect sizes and high acceptability, moving BTB to NIA Stage 4 (effectiveness) or 5 (dissemination) has been challenging. Challenges that will be discussed include lack of senior center funding to support training and delivery and infrastructure to embed BTB in community-based programs, and reluctance of health systems to adopt BTB because of its focus on one racial group.

Gaining Faith, Losing Faith: How Education Shapes the Relationship between Religious Transitions and Later Depression

Using the life course perspective, we assess the “resources” and “risks” to mental health associated with transitions in religious attendance between early life and midlife and how this process may be influenced by education. Drawing on over 35 years of prospective panel data from the National Longitudinal Study of Youth, baseline models suggest that stable, frequent attendance accumulated between adolescence to midlife and increases to frequent attendance by adulthood are associated with the lowest depression relative to consistent nonattenders. Individuals who declined in their religious participation report higher depression. Education conditioned this association, whereby declines in religious participation negatively impacted the health of those without a college degree more strongly and increases benefitted the well-educated to a greater extent. We combine insights from the life course perspective and work on social stratification and religiosity to interpret our results and offer directives for future research.

DEVELOPMENT OF PUZZLES BASED INTERVENE FOR ADOLESCENTS TO ENHANCE THE KNOWLEDGE ON DEPRESSION MANAGEMENT

Informative puzzles can provide knowledge to the adolescents effectively as it was current trend nowadays. According to World Health Organization (WHO), globally it was found that 300 million people of all ages were suffering from depression. Their knowledge about its causes was inaccurate, lacking of understanding about depression and its healing makes this mental health issue remain unnoticed and untreated where they do not seek for any treatment. Therefore, introducing depression education through jigsaw puzzles gain more benefits together enhanced the knowledge and attitude level towards depression. This was a development study focusing on formulating and developing puzzle as an interventional approach to improve knowledge and attitude level on depression. Feasibility and acceptability of the puzzles has face validity by respondents and content validity by experts. The r=.81 which was high consider having high validity. Eight modules of puzzles developed named as (Knowledge, Depression Adolescents [KDA]-Puzzle) which consisted of Module 1 Sign and symptoms, Module 2 Types of depression, Module 3 Causes of depression, Module 4 Risk factors, Module 5 (Pharmacotherapy & medication) Medical treatment A, Module 6 Medical treatment B, Module 7 Alternative treatment and Module 8 Prevention of depression. Respondents and experts commented the puzzles really beneficial for the adolescents to learn and gain knowledge about depression. KDA-Puzzles gained positive feedback from the assessment. Newly develop KDA-Puzzles were feasible and acceptable among adolescents. This puzzles can be alternative game while staying at home during Movement Control Order (MCO) due to pandemic COVID 19, and create awareness towards depression.

Depression Education Fotonovela for Engagement of Hispanic Patients in Treatment: A Randomized Clinical Trial

Background We report the primary outcomes from a randomized clinical trial testing a novel culturally-adapted patient education intervention to increase engagement of Hispanic patients in depression treatment. The Depression Education Fotonovela (DEF), Secret Feelings, incorporates popular images, cultural norms, and vivid pictures embedded within a soap opera narrative to increase depression knowledge and dispel myths about treatment. We then assessed engagement in a integrated care treatment model in response to the education intervention and subsequent changes in depression symptoms in a large community-based clinic whose patient population is majority Hispanic.Method The sample included 150 adult Hispanic patients with a confirmed diagnosis of depression who were randomly assigned to either: (1) integrated care + fotonovela; or (2) integrated care + standard education. Differences between treatment groups were examined as were changes in depression, anxiety, depression knowledge, and stigma scores over time and engagement in treatment.Results Results indicated that while depression scores significantly decreased over time for participants (F [2.811, 416.054] = 197.69, p < .001, 𝜂2 = .572), no differences between the two education groups were found (F [1, 148] = 0.70, p = .403, 𝜂2 = .005). At 12-month follow-up, 101 patients (80.8%) reported a 50% of greater reduction in depression scores from baseline.Conclusions We found little difference between the two education groups, suggesting that either may helpful for engaging Hispanic patients into care. Better tailoring of patient education, with the fotonovela or similarly adapted tools, will require more directly addressing the stigma associated with antidepressant medication.Trial registrationThe study was registered with www.clinicaltrials.gov: NCT02702596, on 03/20/2016. Retrospectively registered.

Oral Dysphagia and Its Associations With Nutrition, Physical Functions, and Depression for the Elderly in the Community

Objectives: To explore the occurrence of oral dysphagia problems among elderly in community and to investigate whether the severity of oral dysphagia problems is associated with nutrition, physical functions and mental health. Methods: Trained nurses conducted a rigorous assessment of 679 elderly people living in communities in Zhuzhou. Basic personal information, The Short Form Mini Nutritional Assessment (MNASF), Activities of daily living (ADL), Patient Health Questionnaire-9 (PHQ-9) were used to assess each elderly. Oral dysphagia was assessed by means of a standardized questionnaire including clinically symptoms of oral dysphagia such as coughing and choking. Results: A total of 654 old people was enrolled in this study, including 250 (38.2%) developing the one or more symptoms of oral dysphagia, the most common symptoms were: drinking water choking (30.7%), followed by saliva (9.6%), dysphagia or pain (6.4%),food loss from the corner of the mouth (2.3%), foreign body sensation of the esophagus (1.8%),food residue (1.2%).The severity of oral dysphagia problems was linearly associated with nutrition, physical function, depression, education level and current care status. The higher the burden of oral symptoms, the lower the self-rated health. Conclusions: The occurrence of oral dysphagia symptom was associated in a stepwise fashion with nutrition, physical function, depression, education level and current care status. In the community, the early recognition, diagnosis and treatment of oral dysphagia is an important link of reducing the mortality and improving the rehabilitation outcome. Additionally, the psychological construction in the elderly should be taken seriously by their families and community workers.

HOUSE CALLS AND BEHAVIORAL HEALTH INTEGRATION: ADDRESSING MENTAL HEALTH LITERACY AND DEPRESSION CARE

The House Calls and Behavioral Health Integration project was an inter-agency collaboration to address depression in the older adult population by increasing knowledge and awareness of the condition and providing better access to care. Rowan Medicine, New Jersey Institute for Successful Aging (NJISA) and Jewish Family and Children Services (JFCS) partnered to deliver a comprehensive education, screening and referral program for residents of 3 senior housing facilities serving an estimated 300 elderly and disadvantaged residents. The goal of this year long project was to provide depression education for both housing residents and staff; offer on-going access to free depression screens (using PHQ-9) for residents; and refer residents to an appropriate resource (counseling/case management/house calls) depending on depression screen outcome. Depression education was provided to 15 housing staff and 78 older adult residents. A total of 34 depression screens were completed (82% female, average age=82 years); further evaluation of symptoms was indicated for 59% (n=20) of those screened. Seventeen of the 20 residents accepted a recommendation for a referral to supportive counseling; 3 declined. The average PHQ-9 score was 8.45 (SD=4.42; Range 1-24). Referrals to case management and house calls (n=4) were also made. Feedback from both housing residents and staff was positive and the project team learned valuable lessons about serving older adults in congregate living settings which has informed other programming. The project was successful in providing education, screening and referrals to residents who might not otherwise have access to specialized geriatric behavioral health interventions.