Collaborative Care for Depressed Patients With Chronic Medical Conditions: A Randomized Trial in Puerto Rico

This study examined whether a collaborative care model for depression would improve clinical and functional outcomes for depressed patients with chronic general medical conditions in primary care practices in Puerto Rico

Prolonged exposure for the treatment of Spanish-speaking Puerto Ricans with posttraumatic stress disorder: a feasibility study

<p>Abstract</p> <p>Background</p> <p>Most of the empirical studies that support the efficacy of prolonged exposure (PE) for treating posttraumatic stress disorder (PTSD) have been conducted on white mainstream English-speaking populations. Although high PTSD rates have been reported for Puerto Ricans, the appropriateness of PE for this population remains unclear. The purpose of this study was to examine the feasibility of providing PE to Spanish speaking Puerto Ricans with PTSD. Particular attention was also focused on identifying challenges faced by clinicians with limited experience in PE. This information is relevant to help inform practice implications for training Spanish-speaking clinicians in PE.</p> <p>Results</p> <p>Fourteen patients with PTSD were randomly assigned to receive PE (n = 7) or usual care (UC) (n = 7). PE therapy consisted of 15 weekly sessions focused on gradually confronting and emotionally processing distressing trauma-related memories and reminders. Five patients completed PE treatment; all patients attended the 15 sessions available to them. In UC, patients received mental health services available within the health care setting where they were recruited. They also had the option of self-referring to a mental health provider outside the study setting. The Clinician-Administered PTSD Scale (CAPS) was administered at baseline, mid-treatment, and post-treatment to assess PTSD symptom severity. Treatment completers in the PE group demonstrated significantly greater reductions in PTSD symptoms than the UC group. Forty percent of the PE patients showed clinically meaningful reductions in PTSD symptoms from pre- to post-treatment.</p> <p>Conclusions</p> <p>PE appears to be viable for treating Puerto Rican Spanish-speaking patients with PTSD. This therapy had good patient acceptability and led to improvements in PTSD symptoms. Attention to the clinicians' training process contributed strongly to helping them overcome the challenges posed by the intervention and increased their acceptance of PE.</p

Using Risk Communication Strategies for Zika Virus Prevention and Control Driven by Community-Based Participatory Research

Background: In this study, we use community-based participatory processes to engage community and academic partners in a meaningful exchange to identify and pilot test risk communication strategies for Zika virus prevention and control. Methods: Community members were actively involved in planning, developing, and implementing a risk communication initiative. Qualitative and quantitative data gathered through individual interviews, focus groups, and community advisory board input provided information for the identification of relevant risk communication strategies to increase the understanding about Zika virus and to promote behavior change. To examine its impact we obtained baseline and follow-up data from a random sample of 75 community residents. A face-to-face interview was conducted to assess community members&#8217; knowledge, attitudes, and behaviors regarding Zika virus infection. Results: Study activities focused on three risk communication strategies: Zika awareness health fair, health education through theater, and community forums and workshops. The risk communication initiative was implemented over a two-month period. Findings from baseline and follow-up data demonstrated significant positive changes in respondents&#8217; recognition of personal and community responsibility for the prevention of Zika infection, increased knowledge of prevention strategies, and enhanced engagement in preventive behaviors for mosquito control. Conclusion: Our findings sustain the benefits of community based participatory research for the design and implementation of risk communication strategies that are relevant to enable residents in low-income communities to take informed decisions for the protection against Zika virus and other mosquito-borne diseases