title: Improving health-related quality of life in older African American and non-Latino White patients.
abstract: OBJECTIVE
  To compare the effect of problem-solving therapy against a health-promotion intervention (dietary practices) on health-related quality of life (HRQOL) and examine if there is a differential effect on non-Latino white patients and African American patients between the two interventions. This paper also explores participant characteristics (problem-solving style and physical functioning) as potential predictors of HRQOL.
  
  
  METHODS
  Secondary analysis of data from a randomized depression prevention trial involving 247 older adults (154 non-Latino white, 90 African American, 3 Asian). Participants were randomly assigned to receive either problem solving therapy for primary care (PST-PC) or coaching in healthy dietary practices (DIET).
  
  
  RESULTS
  Both PST-PC and DIET improved HRQOL over two years and did not differ significantly from each other. African American patients in both conditions had greater improvements in mental health-related quality of life (MHRQOL) compared with non-Latino white patients. In addition, higher social problem-solving and physical functioning were predictive of improved MHRQOL.
  
  
  CONCLUSIONS
  PST-PC and DIET have the potential to improve health-related quality of life in a culturally relevant manner. Both hold promise as effective and potentially scalable interventions that could be generalized to highly disadvantaged populations in which little attention to HRQOL has been paid.
authors.affiliation: University of Miami Center on Aging, Miami, FL; Dartmouth Centers for Health and Aging, Geisel School of Medicine at Dartmouth, Hanover, NH. Electronic address: dej18@med.miami.edu.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Jimenez
authors.affiliation: NIMH Center for Late Life Depression Prevention and Treatment, University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, PA.
authors.forename: Amy
authors.initials: A
authors.lastname: Begley
authors.affiliation: Dartmouth Centers for Health and Aging, Geisel School of Medicine at Dartmouth, Hanover, NH.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Bartels
authors.affiliation: Center for Multicultural Mental Health Research, Cambridge Health Alliance, Somerville, MA.
authors.forename: Margarita
authors.initials: M
authors.lastname: Alegría
authors.affiliation: Center for Health Equity, School of Public Health, University of Maryland, College Park, MD.
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Thomas
authors.affiliation: Center for Health Equity, School of Public Health, University of Maryland, College Park, MD.
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Quinn
authors.affiliation: NIMH Center for Late Life Depression Prevention and Treatment, University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, PA.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Reynolds
mesh_terms: D001741:Black or African American; D000368:Aged; D003863:Depression / Q000517:prevention & control*; D004032:Diet / Q000379:methods; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011340:Problem Solving / Q000502:physiology*; D011613:Psychotherapy / Q000379:methods*; D011788:Quality of Life; D016896:Treatment Outcome; D044465:White People
keywords: African Americans; health promotion; health-related quality of life; older adults; problem-solving therapy