By Eric Lindberg
Major depression coupled with other chronic health problems, such as heart disease or diabetes, can place a severe burden on low-income, culturally diverse individuals who are less comfortable interacting with doctors and navigating complex health care systems.
A new community-based research project led by Kathleen Ell, the Ernest P. Larson Professor of Health, Ethnicity and Poverty at the USC School of Social Work, will test whether community members trained to provide basic health information and promote healthy behaviors represent an effective strategy to help those individuals access treatment and improve health outcomes.
“Multiple chronic illnesses, particularly among these underserved populations, are a real challenge,” Ell said. “Managing one illness is tough enough; managing multiple illnesses is complicated in many ways.”
The three-year study, supported by a $1.3 million award from the Patient-Centered Outcomes Research Institute (PCORI), will involve recruiting 350 patients with major depression and a chronic illness from two health clinics overseen by the Los Angeles County Department of Health Services.
Some participants will be randomly selected to receive typical clinical services, while others will participate in A Helping Hand, a program in which promotoras—Hispanic and Latino community members who are trained to provide basic health education—offer training and advice. They will help patients interact with health care providers, adhere to treatment, manage stress and fatigue, attend clinic appointments, and advocate for personal treatment preferences, among other strategies to improve their health.
Maria Aranda, associate professor at the School of Social Work and project co-investigator, said promotoras are particularly well-suited to deliver health care information about depression and chronic illness while respecting cultural and community traditions.
“These community health care workers have amazing characteristics and an amazing aptitude for bringing needed services to underserviced populations,” she said. “They can break down some of the typical barriers in terms of health care access and coordination of health care systems.”