This three year pilot study, Telephone-based Depression Care for Rural Latino Patients in Primary Care, tests a telephone-based CBT intervention for depressed low-income Latino primary care patients served by the Yakima Valley Farm Workers Clinic (YVFWC) in rural Eastern Washington State. A manualized telephone CBT intervention shown effective in an urban managed care setting among English-speaking patients was translated into Spanish and will be minimally adapted and then tested among 100 low-income Latino women and men with depressive disorder who will be identified through systematic screening. Participants will be randomized to the study intervention vs. usual care. Outcomes will be measured at baseline, 6 weeks, and 3 and 6 months. We will examine the effect of the intervention on depressive symptoms, as well as patient-rated improvement, patient satisfaction, disability, and health risk behaviors. Using qualitative exit interviews of patients and providers, the study will explore socio-cultural and practical barriers to depression care in this population and the need to further adapt the intervention to address these barriers. The study's ultimate objective is to develop a culturally appropriate, sustainable, and cost-effective depression treatment program that can be incorporated into routine primary care practices serving low-income rural Latinos and that can be tested in a full scale randomized controlled trial. To our knowledge, ours is the first study to examine the effectiveness of CBT in a rural Latino population.
National Institute of Mental Health