The Right to Counsel in Illinois: Evaluation of Adult Criminal Trial-Level Indigent Defense Services

This study shows there are two overarching reasons why the State of Illinois is defaulting on its constitutional right to counsel obligations. First, the state requires counties and courts to provide and predominantly fund indigent defense systems in a way that bakes in governmental interference with the right to counsel. Second, as one of only seven states with no state-level mechanism to oversee any aspect of trial-level right to counsel services, Illinois lacks information about every aspect of the varied indigent defense systems implemented by the county governments and courts in their efforts to fulfill the Sixth Amendment right to counsel responsibilities that the state has delegated to them. There is a path forward, and it is important for Illinois to get this right

Latinos’ Views of Chronic Disease and Minor Depression

Background: There are notable health disparities among Latinos in the US associated with chronic diseases (e.g., diabetes) and depression. Further, chronic diseases and minor depression tend to co-occur among Latino populations. This paper reports findings from a community-based participatory research study using dyadic focus groups with Latinos who have chronic disease and minor depression and their family members. The goal of this study was to better understand barriers and facilitators to chronic disease self-management among underserved Latinos living with both chronic illness and minor depression and their families using a socio-ecological approach.Methods: In total, five focus groups were conducted with individuals with chronic disease (n=25) and four with nominated family members (n=17). All focus groups were digitally recorded and transcribed by a professional transcription agency in Spanish. Transcripts were imported into Atlas.ti V 6.2 software program and analyzed in Spanish by a team of bilingual researchers using content analysis. Qualitative results are presented thematically by level of analysis or behavioral influence (i.e., individual, family, and community levels) and barriers and facilitators are discussed within each level.Results: Results revealed individual, family, and community level barriers (e.g., transportation, expressed emotion, and lack of health care providers) and facilitators to managing chronic disease and minor depression (e.g., acceptance, family support, and Spanish speaking support groups). Conclusion: Findings have important implications for the understanding of chronic disease management for Latinos and emphasize the need to use evidence based approaches that address barriers and facilitators across the social-ecological continuum

A Mixed-Methods Design Informed by CBPR for the Adaptation of an EBI for Latinos with Minor Depression and Chronic Disease

Background: A mixed methods design informed by community-based participatory research (CBPR) offers advantages to a single research approach by engaging community and academic partners in collecting context-rich and empirical data to inform the translation of evidence-based interventions (EBI). Purpose: This multiphase study sought to translate research findings for the adaptation of an EBI, self-management program (Tomando) for Latino individuals with chronic illness and minor depression (ICD). This presentation focuses on the mixed methods, CPPR approach used to guide phase I of the research. Methods: Mixed methods employed include: a) focus groups with ICD and family members and b) key stakeholder semi-structured interviews followed by a survey. A community-academic team informed key decisions about research design, recruitment, and presentation of findings. Results: Methodological issues arose regarding the heterogeneity of focus group members (e.g., rural versus urban, combining genders) and presence of illness in family members. Recruitment efforts indicated that depression was not well understood or endorsed by potential participants who exhibited depressive symptomatology. Other challenges include the limited health literacy of participants, the need for bi-lingual/bi-cultural staff to conduct and analyze research, and the need for a more diverse community sampling frame. Community partners; however, provided an insider perspective to overcome methodological challenges and the impact of stigma associated with depression on recruitment. Conclusion: This CBPR approach allowed for the identification of practical solutions to methodological challenges while demonstrating important strategies for informing and influencing the translation of EBIs aimed at reducing or eliminating health disparities into practice

Minor Depression and Chronic Disease Among Latinos: Translating Research Into Practice

Problem: Evidence based chronic disease self-management programs (CDSMPs) have reported success in improving health outcomes. Yet few attempt to address the complex issues associated with the co-occurrence of minor depression and chronic illness. With co-occurrence rates of depression and chronic illnesses (e.g. CVD, diabetes) reported as high as 30%, translation of health behavior research into practice is vital to improved health outcomes. This multiphase, community-based participatory research study was designed to better understand the needs and preferences of Latinos living with chronic illness and minor depression (ICDs), their families, and key stakeholders (i.e. service providers). Methods: This study employed a mixed methods design including: a) focus groups with ICDs (n=5) and family members (n=4) and b) semi-structured interviews followed by a survey with key stakeholders (n=31) to obtain views on living with chronic illness, barriers and facilitators to self-management, and the potential for adapting an evidence based CDSMP. Thematic analysis allowing for emergent themes was employed for qualitative data. Descriptive statistics were performed to summarize survey data. Results: Analysis identified perspectives on the needs of Latinos suffering from the co-occurrence of chronic illness and minor depression in managing their illnesses. Results suggested necessary elements for the successful adoption of CDSMP, including delivery by trusted community partners and cultural relativity for encouraging sustainable health promoting practices. Additionally, results indicate challenges and risks to adoption by key stakeholders that must be addressed. Conclusion: Findings will guide the adaptation of \u27Tomando,\u27 an evidence based CDSMP, for Latinos with chronic illness and minor depression