Community-Based Behavioral Activation for Latinos with Depression

描述（由申请人提供）：拉丁美洲人口在美国的显着增长不能再被忽视。这一群体面临许多挑战，导致抑郁症发病率高，包括与移民经历相关的压力、文化适应程度低、住房不足、经济负担、失业、教育程度低、歧视和语言障碍。最近，一种很有前途的抑郁症心理治疗方法，行为激活（BA），在一项大型随机试验中表现良好，表明它与抗抑郁药物一样有效。BA是一种简单实用的方法，可以激活患者实现环境改变，因此可能非常适合拉丁裔抑郁症。因此，这个探索性研究项目的主要目的是增加关于为抑郁的拉丁裔开发和提供文化和语言适应版本的BA的科学知识。关于BA-拉丁裔的一些初步工作已经完成，包括完成一份初步手册和一项小型试点研究。当前项目的具体目标是：1）继续制定重点小组和额外试点病例的BA-拉丁美洲人治疗手册的过程，以及2）在拉丁美洲社区诊所进行随机临床试验，将BA-拉丁美洲人与常规治疗进行比较。该项目将继续开发一种治疗拉丁裔抑郁症的药物支持方法，这种方法可能在保留患者治疗和针对影响这一人群抑郁症的特定环境变量方面具有优势。该项目还将导致进一步评估BA-拉丁美洲人与CBT而不是TAU相比，更大的有效性研究，允许对复发和缓解进行更有力的分析，尝试研究BA-拉丁美洲人培训方法向其他社区诊所的传播，并创建一个模型，用于适应其他少数民族人群，包括非洲裔美国人，美洲原住民和亚裔美国人。 公共卫生相关性：该项目将开发和评估一个文化和语言适应版本的行为激活（BA）与抑郁症的拉丁美洲人。BA是一种简单实用的方法，可以激活患者实现环境改变，因此可能非常适合拉丁裔抑郁症，这种抑郁症的特点通常是看似压倒性的环境障碍。该项目将导致对BA-拉丁裔的进一步评估，探索抑郁症复发和缓解的更大有效性研究，试图研究将BA-拉丁裔培训方法传播到其他社区诊所，并为其他少数民族人口，包括非洲裔美国人，美洲原住民和亚裔美国人，创建适应BA的模型。

DESCRIPTION (provided by applicant): The remarkable growth of the Latino population in the United States can no longer be ignored. Many challenges face this group and contribute to high rates of depression, including the stress associated with the migration experience, low levels of acculturation, inadequate housing, financial burdens, unemployment, low educational attainment, discrimination, and the language barrier. Recently, a promising psychotherapeutic treatment for depression, Behavioral Activation (BA), has performed well in a large randomized trial, suggesting it is as effective as anti-depressant medication for moderate-to-severe depression. BA is a simple, pragmatic approach that activates patients to achieve environmental change and thus may be well suited to Latino depression. Thus, the primary purpose of this exploratory research project is to increase scientific knowledge on the development and delivery of a culturally and linguistically adapted version of BA for depressed Latinos. Some initial work on BA-Latino has already been completed including the completion of an initial manual and a small pilot study. The specific aims of the current project are to: 1) Continue the process of developing the treatment manual for BA-Latinos with focus groups and additional pilot cases, and 2) Compare BA-Latino to treatment-as-usual with a randomized clinical trial in a Latino community clinic. The project will continue the development of an empirically-supported approach to Latino depression that potentially has strengths at retaining patients in treatment and targeting the specific environmental variables that influence depression in this population. This project also will lead to further evaluations of BA-Latino compared to CBT rather than TAU, larger effectiveness studies that allow for more powerful analyses of relapse and remission, attempts to study the dissemination of the BA-Latino training methods to additional community clinics, and creation of a model for the adaptation of BA for other minority populations, including African Americans, Native Americans and Asian Americans. PUBLIC HEALTH RELEVANCE: This project will develop and evaluate a culturally and linguistically adapted version of Behavioral Activation (BA) for Latinos with depression. BA is a simple, pragmatic approach that activates patients to achieve environmental change and thus may be well suited to Latino depression, which often is characterized by seemingly overwhelming environmental obstacles. This project will lead to further evaluations of BA-Latino, larger effectiveness studies that explore depression relapse and remission, attempts to study the dissemination of the BA-Latino training methods to additional community clinics, and creation of a model for the adaptation of BA for other minority populations, including African Americans, Native Americans and Asian Americans.