Effectiveness of the Engagement and Counseling for Latinos (ECLA) intervention in low-income Latinos
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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. DESIGN: Multisite randomized controlled trial. SETTING: Eight community health clinics in Boston, Massachusetts and San Juan, Puerto Rico. PARTICIPANTS: 257 Latino patients recruited from primary care between May 2011 and September 2012. MAIN OUTCOME MEASURES: 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 AND RELEVANCE: 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.
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The mood symptom effects in this heterogeneous minority elder sample were comparable to those seen in Latino adults receiving similar mental or physical health interventions.
“Our effects on mood symptoms in a heterogeneous sample of minority elders was comparable to those observed with Latino adults (45) using similar mental or physical health interventions (65).”
From Effectiveness of a Disability Preventive Intervention for Minority and Immigrant Elders: The Positive Minds-Strong Bodies Randomized Clinical Trial (2019) · cites this paper as [45]
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Assessing Linguistic Accessibility's Impact on Counseling Outcomes for Diverse Communities
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Audio-Based Care for Managing Mental Health and Substance Use Disorders in Adults
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- Authors
- Alegría, M., Ludman, E., Kafali, E. N., Lapatin, S., Vila, D., Shrout, P. E., Keefe, K., Cook, B., Ault, A., Li, X., Bauer, A. M., Epelbaum, C., Alcantara, C., Pineda, T. I. G., Tejera, G. G., Suau, G., Leon, K., Lessios, A. S., Ramirez, R. R., & Canino, G.
- Affiliations
- Kaiser Permanente Washington Health Research Institute (US)
- University of Puerto Rico, Medical Sciences Campus (PR)
- New York University (US)
- Clark University (US)
- University of Washington (US)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Kafali, E. Nilay
- Cook, Benjamin
- Ault, Andrea
- Li, Xinliang
- Pineda, Tulia I. G.
- Leon, Karla
- Lessios, Anna S.
- ORCID
- Venue
- Medical Care
- Published
- 2014-11
- Volume
- 52
- Issue
- 11
- Pages
- 989-997
- ISSN
- 0025-7079 (ISSN-L)
- PMC
- PMC4201237
- OpenAlex
- W2331876670
- Cited by
- 54
- References
- 50
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 6 · 2023: 5 · 2022: 4 · 2021: 7 · 2020: 5 · 2019: 5 · 2018: 3 · 2017: 1 · 2016: 9 · 2015: 1
- FWCI
- 5.42
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Medical Care (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5p60md002261-05)
- National Institute on Minority Health and Health Disparities (P60MD002261-S1, P60-MD-002261)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- cognitive behavioral therapy, care management, telephone-delivered intervention, face-to-face intervention, primary care, mental health disparities, treatment initiation, functional disability, culturally tailored interventions
- MeSH terms
- Adolescent, Adult, Aged, Major Depressive Disorder, Female, Hispanic or Latino, Humans, Male, Poverty, Psychiatric Status Rating Scales, Cognitive Behavioral Therapy, Treatment Outcome, Case Management, Cultural Competency, Young Adult
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