Building a community-academic partnership: implementing a community-based trial of telephone cognitive behavioral therapy for rural latinos.

Eugene Aisenberg,Daniela Golinelli,Meagan Dwight-Johnson,Mary O'Brien,Evette J Ludman

doi:10.1155/2012/257858

Abstract

Concerns about the appropriate use of EBP with ethnic minority clients and the ability of community agencies to implement and sustain EBP persist and emphasize the need for community-academic research partnerships that can be used to develop, adapt, and test culturally responsive EBP in community settings. In this paper, we describe the processes of developing a community-academic partnership that implemented and pilot tested an evidence-based telephone cognitive behavioral therapy program. Originally demonstrated to be effective for urban, middle-income, English-speaking primary care patients with major depression, the program was adapted and pilot tested for use with rural, uninsured, low-income, Latino (primarily Spanish-speaking) primary care patients with major depressive disorder in a primary care site in a community health center in rural Eastern Washington. The values of community-based participatory research and community-partnered participatory research informed each phase of this randomized clinical trial and the development of a community-academic partnership. Information regarding this partnership may guide future community practice, research, implementation, and workforce development efforts to address mental health disparities by implementing culturally tailored EBP in underserved communities.

Highlights

Despite substantial efforts by researchers, policy makers, and federal funding sources to improve access to mental health care for ethnic minority patients, disparities in access to, quality of, and outcomes of mental health interventions persist [1,2,3,4]
Depression Research and Treatment (RCTs) which serve as scientific gold standard of effective practice, (2) the failure to include communities of color and the health systems that serve them in the processes of defining, implementing, and evaluating evidencebased practices (EBPs), (3) the dearth of ethnic minority researchers within academia, (4) the shortage of ethnic minority mental health providers to deliver EBPs, and (5) the lack of responsiveness to cultural context and norms of ethnic minority communities within the content and structure of the EBPs themselves [13]
He learned that due to earlier experiences, Yakima Valley Farm Workers Clinic (YVFWC) personnel were initially reluctant to partner with University of Washington (UW) researchers because previous research projects had not resulted in tangible or lasting benefits to YVFWC clinics or patients

Summary

Introduction

Despite substantial efforts by researchers, policy makers, and federal funding sources to improve access to mental health care for ethnic minority patients, disparities in access to, quality of, and outcomes of mental health interventions persist [1,2,3,4]. From 1986 to 1994, nearly 10,000 subjects participated in RCTs evaluating the efficacy of interventions for the aforementioned disorders; in total, only 561 African Americans, 99 Latinos, 11 Asian Americans/Pacific Islanders, and 0 American Indians/Alaskan Natives were identified [14, 15]. This lack of inclusion of adult ethnic populations is found among 27 studies from 1986–1997 forming the evidence base for the American Psychiatric Association guidelines for depression care. If RCTs of EBPs are not conducted with ethnically diverse participants, they have typically been normed or standardized void of cultural context and realities, challenging the ability of the EBP to later be successfully implemented among diverse populations [13]

Methods

Results

Conclusion