University of Illinois at Chicago
Chicago
Depression
African American, Latino

Project

Patients receive motivational interviews and an Internet-based depression-prevention training program.

African American and Latino youth who show high risk for depressive disorders receive a series of in-person motivational interviews, and are enrolled in an Internet-based self-directed training program. This program includes learning and behavior-change strategies to reduce risk factors for depression, and to increase factors that promote resiliency against depressive symptoms. Components of the program are aimed at the adolescent patients as well as their parents. The program includes exercises that the patient can complete online and print out for later review. Patients also receive telephone coaching to encourage them to complete the training program and its suggested behavior changes. Participating sites include Federally Qualified Health Centers (FQHCs), school-based clinics and community-based clinics.

Rationale

Though depression is relatively common and efficacious treatments are available, adolescent patients show low rates of care-seeking, receiving high-quality care, and completing referrals for psychotherapy. As depression has long-term negative health outcomes, prevention of depression may be more cost-effective and less distressing than treatment of a full depressive episode.

This study uses motivational interviewing to engage youth and promote adherence to the Internet-based multimedia component, which targets both adolescents and parents. The prevention program has the potential to reduce both risk factors for a future depressive episode and actual depression incidence, and to enhance resiliency as well as functional outcomes. The training program is tailored to be ethnically and culturally appropriate, and incorporates a variety of learning strategies to improve the acceptance of the information provided. Telephone coaching calls are designed to increase adherence to the prevention training program.

Summary Results

This culturally-adapted depression intervention for African American and Latino adolescents in urban primary care settings faced major implementation barriers such as adolescents’ lack of trust in providers, fear of judgment, and  fear of being diagnosed with depression. Adolescents expressed a preference for accessing preventative treatment through social media or apps, rather than in a clinic setting. They also expressed a preference for receiving information regarding preventative programs in school via teachers or counselors, community centers, or social media rather than in a clinic setting from clinicians.

Publications

Chicago Urban Resiliency Building (CURB): An Internet-Based Depression-Prevention Intervention for Urban African-American and Latino Adolescents
Journal of Child and Family Studies. Online August 2012.
Full Article (subscription may be required)

Principal Investigators

• Karen Taylor-Crawford, MD (Professor of Psychiatry, University of Illinois at Chicago)
• Jennifer C. Froemel, MA, LCPC (Child and Adolescent Program Director, Family Service of Cicero)
• Henry Taylor, MPA (Executive Director, Mile Square Health Center)
• Ben Van Voorhees, MD, MPH (Associate Professor of Medicine, University of Illinois at Chicago)