Louise M. Quijano

Healthy IDEAS: A Depression Intervention Delivered by Community-Based Case Managers Serving Older Adults

This study evaluated an evidence-based intervention for depression delivered by case managers in three community-based service agencies to high-risk, diverse older adults. Case managers were trained to provide screening and assessment, education, referral and linkage, and behavioral activation. Outcomes addressed depression, general health status, social and physical activation, and mental health services use at baseline and 6 months. Participants (n = 94) were predominantly women (79%) and Hispanic (44%), with a mean age of 72 years. Mean Geriatric Depression Scale—15 scores differed significantly between baseline and 6 months (9.0 versus 5.5). At 6 months, significantly more participants knew how to get help for depression (68% versus 93%), reported that increasing activity helped them feel better (72% versus 89%), and reported reduced pain (16% versus 45 %). The authors conclude that nonspecialty providers can be trained to successfully implement an evidence-based self-management intervention for depression with frail, high-risk, and diverse older adults.

Primary Care Clinicians Evaluate Integrated and Referral Models of Behavioral Health Care For Older Adults: Results From a Multisite Effectiveness Trial (PRISM-E)

BACKGROUND Recent studies have shown that integrated behavioral health services for older adults in primary care improves health outcomes. No study, however, has asked the opinions of clinicians whose patients actually experienced integrated rather than enhanced referral care for depression and other conditions. METHOD The Primary Care Research in Substance Abuse and Mental Health for the Elderly (PRISM-E) study was a randomized trial comparing integrated behavioral health care with enhanced referral care in primary care settings across the United States. Primary care clinicians at each participating site were asked whether integrated or enhanced referral care was preferred across a variety of components of care. Managers also completed questionnaires related to the process of care at each site. RESULTS Almost all primary care clinicians (n = 127) stated that integrated care led to better communication between primary care clinicians and mental health specialists (93%), less stigma for patients (93%), and better coordination of mental and physical care (92%). Fewer thought that integrated care led to better management of depression (64%), anxiety (76%), or alcohol problems (66%). At sites in which the clinicians were rated as participating in mental health care, integrated care was highly rated as improving communication between specialists in mental health and primary care. CONCLUSIONS Among primary care clinicians who cared for patients that received integrated care or enhanced referral care, integrated care was preferred for many aspects of mental health care.

How Immigration Enforcement Affects the Lives of Older Latinos in the United States

The purpose of this study was to examine the impact of U.S. immigration enforcement on the lives of older Latinos in the United States. Data were drawn from the 2007 Pew Hispanic Center National Survey of Latinos. The sample consisted of 326 participants who were age 55 years or older. Multivariate ordinal logistic regressions indicated that participants who had greater hardships as a result of U.S. immigration enforcement (a) had lower use of government services, (b) perceived the situation for Latinos worse today, (c) had a greater fear of deportation, and (d) perceived a lower quality of life for themselves.

Assisted Living Facility Administrator and Direct Care Staff Views of Resident Mental Health Concerns and Staff Training Needs

This community needs assessment surveyed 21 administrators and 75 direct care staff at 9 larger and 12 smaller assisted living facilities (ALFs) regarding perceptions of resident mental health concerns, direct care staff capacity to work with residents with mental illness, and direct care staff training needs. Group differences in these perceptions were also examined. Both administrators and directcare staff indicated that direct care staff would benefit from mental health-related training, and direct care staff perceived themselves as being more comfortable working with residents with mental illness than administrators perceived them to be. Implications for gerontological social work are discussed.

Best of Both Worlds: A Conceptual Model for Integrating an Aging Specialization Within an Advanced Generalist MSW Program

Must a master’s of social work (MSW) program’s orientation be either advanced generalist or some form of specialist? Or is there the possibility of a hybrid curriculum that provides enough breadth to prepare MSW graduates for a wide range of social work jobs, but that also addresses students’ and community agencies’ demands for student specialization? This article suggests a model for integrating an aging specialization within an advanced generalist curriculum. Although this model specifically concerns an aging specialization, the model is also applicable to any number of other specializations as well. We describe lessons learned and discuss implications for integrating specializations within other advanced generalist MSW programs.

An ounce of prevention: an interactive health and safety CD for 4-H youth

Agricultural workers in Australia experience poorer health due to elevated rates of cancer, cardiovascular disease, obesity, diabetes and mental illness. They also can have reduced access to health services due to time constraints and motivation as well as distance, availability and cost of these services. The National Centre for Farmer Health (NCFH) has recognized this gap and has carried out free health checks staffed by qualified health professionals at two recent, well-attended and publicized agricultural events in Hamilton, Victoria: the Weaner Sales and the Beef Expo and with collaboration of local municipal councils, stock agents and local show societies. Mobile facilities for confidential health assessment were set up at both events where attendees were invited for health screening. Following written informed consent, participants completed a questionnaire relating to general health and wellbeing, smoking and alcohol consumption, farm safety including chemical usage and protective equipment, and psychological distress (Kessler K10). Participant health screening was then undertaken: height, weight, vision and spot measurements of blood pressure, glucose and cholesterol. Following discussion with the NCFH health professional, participants were given a written “health passport” with these results, with instructions to visit their GP if these were abnormal, and also invited to attend the comprehensive clinics. Preliminary results: 152 screened (M 132, F20), mean age 55 (range 18–90), overweight or obese (BMI > 25) 73%, hypertension (>140/90) 58.6%, raised random blood glucose (>6.5 mmol/l) 17.8%, raised random cholesterol 42%. Clients with abnormal results were referred to their GP, especially for repeat blood glucose and cholesterol when fasting. Further results will be presented. The health checks were well received, attracted considerable media and agricultural industry attention and for many participants was their first health assessment for some time. It was also rewarding for the health professionals working “out in the field”. Therefore further checks are planned at similar agricultural events in the future.