A federal agency that highlights groundbreaking health care research has featured USC School of Social Work professor Kathleen Ell’s innovative efforts to improve depression treatment among low-income Hispanics with diabetes.
In 2005, Ell spearheaded a study that examined the effectiveness of a socioculturally tailored program designed to improve treatment adherence and reduce depression among diabetes patients in two safety net clinics in Los Angeles.
The Agency for Healthcare Research and Quality has featured the treatment tool on its Innovations Exchange website, which seeks to quickly translate research into real-world solutions by highlighting evidence-based innovations that improve health quality and reduce disparities.
“It’s recognition of the importance of this model,” Ell said. “Diabetes is the most significant health problem in this country, particularly with the level of obesity, and it is the most costly. You throw in depression, and you have the perfect storm.”
The federal exchange uses a rigorous review process to select the most effective and significant research for inclusion. Ell’s study received the agency’s highest rating for evidence quality and strength, indicating a high likelihood that the treatment model could be successfully implemented elsewhere.
Ell and her colleagues found that low-income Hispanic individuals with diabetes are more likely to experience depression and face significant barriers to accessing and adhering to depression treatment due to socioeconomic and cultural factors.
Patients enrolled in the two-year study received eight weeks of culturally tailored psychotherapy from trained, bilingual social workers. Participants also received support for other medical and social service needs, as well as follow-up phone calls from social workers who emphasized treatment adherence and monitored depression-related symptoms.
Evidence showed that study participants were more likely to remain on antidepressant medication, report fewer symptoms of depression and experience higher levels of satisfaction with their mental health care compared to those receiving usual care for diabetes. In addition, study data indicated that social worker-based depression care is highly cost-effective.
“The ultimate goal is uptake in everyday care,” Ell said of the treatment model. “Research is great and fun to do, but if it just gets published in journals and sits on the library shelf and there’s no uptake in real-world practice, that very much limits your contribution.”
Based on the success of the study, Los Angeles County health officials have required depression screening for all diabetes care providers and are hiring social workers to serve in county clinics.
Ell is leading a larger study of 1,500 patients to explore the effectiveness of adaptions to her depression care model that uses technology to further reduce costs and streamline the treatment process. In addition, Ventura County officials are working with Ell to submit a proposal to duplicate her model countywide.
“It is clear people are using that exchange,” she said. “It is a way of getting out to a wider audience.”
A diverse array of individuals use the federal exchange, according to its website, including nurses, health administrators, policymakers, researchers, physicians and clinical workers.