title: Effectiveness of the Engagement and Counseling for Latinos (ECLA) intervention in low-income Latinos.
abstract: BACKGROUND
  Persistent disparities in access and quality of mental health care for Latinos indicate a need for evidence-based, culturally adapted, and outside-the-clinic-walls treatments.
  
  
  OBJECTIVE
  Evaluate treatment effectiveness of telephone (ECLA-T) or face-to-face (ECLA-F) delivery of a 6-8 session cognitive behavioral therapy and care management intervention for low-income Latinos, as compared to usual care for depression.
  
  
  METHODS
  Multisite randomized controlled trial.
  
  
  METHODS
  Eight community health clinics in Boston, Massachusetts and San Juan, Puerto Rico.
  
  
  METHODS
  257 Latino patients recruited from primary care between May 2011 and September 2012.
  
  
  METHODS
  The primary outcome was severity of depression, assessed with the Patient Health Questionnaire-9 and the Hopkins Symptom Checklist-20. The secondary outcome was functioning over the previous 30 days, measured using the World Health Organization Disability Assessment Schedule (WHO-DAS 2.0).
  
  
  RESULTS
  Both telephone and face-to-face versions of the Engagement and Counseling for Latinos (ECLA) were more effective than usual care. The effect sizes of both intervention conditions on Patient Health Questionnaire-9 were moderate when combined data from both sites are analyzed (0.56 and 0.64 for face-to-face and telephone, respectively). Similarly, effect sizes of ECLA-F and ECLA-T on the Hopkins Symptom Checklist were quite large in the Boston site (0.64 and 0.73. respectively) but not in Puerto Rico (0.10 and 0.03).
  
  
  CONCLUSIONS
  The intervention appears to help Latino patients reduce depressive symptoms and improve functioning. Of particular importance is the higher treatment initiation for the telephone versus face-to-face intervention (89.7% vs. 78.8%), which suggests that telephone-based care may improve access and quality of care.
authors.affiliation: *Center for Multicultural Mental Health Research, Somerville, MA †Group Health Research Institute, Seattle, WA ‡Behavioral Sciences Research Institute, University of Puerto Rico Medical School, San Juan, PR §Department of Psychology, New York University, NY ∥Department of Psychology, Clark University, MA ¶Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA #Beth Israel Deaconess Medical Center, Boston, MA **Columbia University Medical Center, New York, NY ††Department of Psychiatry, MSC-University of Puerto Rico, San Juan, PR.
authors.forename: Margarita
authors.initials: M
authors.lastname: Alegría
authors.forename: Evette
authors.initials: E
authors.lastname: Ludman
authors.forename: E Nilay
authors.initials: EN
authors.lastname: Kafali
authors.forename: Sheri
authors.initials: S
authors.lastname: Lapatin
authors.forename: Doriliz
authors.initials: D
authors.lastname: Vila
authors.forename: Patrick E
authors.initials: PE
authors.lastname: Shrout
authors.forename: Kristen
authors.initials: K
authors.lastname: Keefe
authors.forename: Benjamin
authors.initials: B
authors.lastname: Cook
authors.forename: Andrea
authors.initials: A
authors.lastname: Ault
authors.forename: Xinliang
authors.initials: X
authors.lastname: Li
authors.forename: Amy M
authors.initials: AM
authors.lastname: Bauer
authors.forename: Claudia
authors.initials: C
authors.lastname: Epelbaum
authors.forename: Carmela
authors.initials: C
authors.lastname: Alcantara
authors.forename: Tulia I G
authors.initials: TI
authors.lastname: Pineda
authors.forename: Gloria G
authors.initials: GG
authors.lastname: Tejera
authors.forename: Gloria
authors.initials: G
authors.lastname: Suau
authors.forename: Karla
authors.initials: K
authors.lastname: Leon
authors.forename: Anna S
authors.initials: AS
authors.lastname: Lessios
authors.forename: Rafael R
authors.initials: RR
authors.lastname: Ramirez
authors.forename: Glorisa
authors.initials: G
authors.lastname: Canino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019090:Case Management; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D054521:Cultural Competency; D003865:Major Depressive Disorder / Q000208:ethnology / Q000628:therapy*; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D011203:Poverty / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D055815:Young Adult