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Partnering with community-based organizations to improve equitable access to depression care for underserved older adults in the U.S.: Qualitative formative research

BACKGROUND: Embedding evidenced-based programs (EBPs) like PEARLS outside clinical settings can help reduce inequities in access to depression care. Trusted community-based organizations (CBOs) reach older adults who are underserved; however, PEARLS adoption has been limited. Implementation science...

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Autores principales: Steinman, Lesley E., Parrish, Amanda T., Kohn, Marlana J., Wu, Sherry, Hara-Hubbard, KeliAnne K., Brown, Lori, Imam, Syed, Baquero, Barbara, Hannon, Peggy A., Snowden, Mark B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9922751/
https://www.ncbi.nlm.nih.gov/pubmed/36793362
http://dx.doi.org/10.3389/fpubh.2022.1079082
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author Steinman, Lesley E.
Parrish, Amanda T.
Kohn, Marlana J.
Wu, Sherry
Hara-Hubbard, KeliAnne K.
Brown, Lori
Imam, Syed
Baquero, Barbara
Hannon, Peggy A.
Snowden, Mark B.
author_facet Steinman, Lesley E.
Parrish, Amanda T.
Kohn, Marlana J.
Wu, Sherry
Hara-Hubbard, KeliAnne K.
Brown, Lori
Imam, Syed
Baquero, Barbara
Hannon, Peggy A.
Snowden, Mark B.
author_sort Steinman, Lesley E.
collection PubMed
description BACKGROUND: Embedding evidenced-based programs (EBPs) like PEARLS outside clinical settings can help reduce inequities in access to depression care. Trusted community-based organizations (CBOs) reach older adults who are underserved; however, PEARLS adoption has been limited. Implementation science has tried to close this know-do gap, however a more intentional focus on equity is needed to engage CBOs. We partnered with CBOs to better understand their resources and needs in order to design more equitable dissemination and implementation (D&I) strategies to support PEARLS adoption. METHODS: We conducted 39 interviews with 24 current and potential adopter organizations and other partners (February–September 2020). CBOs were purposively sampled for region, type, and priority older populations experiencing poverty (communities of color, linguistically diverse, rural). Using a social marketing framework, our guide explored barriers, benefits and process for PEARLS adoption; CBO capacities and needs; PEARLS acceptability and adaptations; and preferred communication channels. During COVID-19, interviews also addressed remote PEARLS delivery and changes in priorities. We conducted thematic analysis of transcripts using the rapid framework method to describe the needs and priorities of older adults who are underserved and the CBOs that engage them, and strategies, collaborations, and adaptations to integrate depression care in these contexts. RESULTS: During COVID-19, older adults relied on CBO support for basic needs such as food and housing. Isolation and depression were also urgent issues within communities, yet stigma remained for both late-life depression and depression care. CBOs wanted EBPs with cultural flexibility, stable funding, accessible training, staff investment, and fit with staff and community needs and priorities. Findings guided new dissemination strategies to better communicate how PEARLS is appropriate for organizations that engage older adults who are underserved, and what program components are core and what are adaptable to better align with organizations and communities. New implementation strategies will support organizational capacity-building through training and technical assistance, and matchmaking for funding and clinical support. DISCUSSION: Findings support CBOs as appropriate depression care providers for older adults who are underserved, and suggest changes to communications and resources to better fit EBPs with the resources and needs of organizations and older adults. We are currently partnering with organizations in California and Washington to evaluate whether and how these D&I strategies increase equitable access to PEARLS for older adults who are underserved.
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spelling pubmed-99227512023-02-14 Partnering with community-based organizations to improve equitable access to depression care for underserved older adults in the U.S.: Qualitative formative research Steinman, Lesley E. Parrish, Amanda T. Kohn, Marlana J. Wu, Sherry Hara-Hubbard, KeliAnne K. Brown, Lori Imam, Syed Baquero, Barbara Hannon, Peggy A. Snowden, Mark B. Front Public Health Public Health BACKGROUND: Embedding evidenced-based programs (EBPs) like PEARLS outside clinical settings can help reduce inequities in access to depression care. Trusted community-based organizations (CBOs) reach older adults who are underserved; however, PEARLS adoption has been limited. Implementation science has tried to close this know-do gap, however a more intentional focus on equity is needed to engage CBOs. We partnered with CBOs to better understand their resources and needs in order to design more equitable dissemination and implementation (D&I) strategies to support PEARLS adoption. METHODS: We conducted 39 interviews with 24 current and potential adopter organizations and other partners (February–September 2020). CBOs were purposively sampled for region, type, and priority older populations experiencing poverty (communities of color, linguistically diverse, rural). Using a social marketing framework, our guide explored barriers, benefits and process for PEARLS adoption; CBO capacities and needs; PEARLS acceptability and adaptations; and preferred communication channels. During COVID-19, interviews also addressed remote PEARLS delivery and changes in priorities. We conducted thematic analysis of transcripts using the rapid framework method to describe the needs and priorities of older adults who are underserved and the CBOs that engage them, and strategies, collaborations, and adaptations to integrate depression care in these contexts. RESULTS: During COVID-19, older adults relied on CBO support for basic needs such as food and housing. Isolation and depression were also urgent issues within communities, yet stigma remained for both late-life depression and depression care. CBOs wanted EBPs with cultural flexibility, stable funding, accessible training, staff investment, and fit with staff and community needs and priorities. Findings guided new dissemination strategies to better communicate how PEARLS is appropriate for organizations that engage older adults who are underserved, and what program components are core and what are adaptable to better align with organizations and communities. New implementation strategies will support organizational capacity-building through training and technical assistance, and matchmaking for funding and clinical support. DISCUSSION: Findings support CBOs as appropriate depression care providers for older adults who are underserved, and suggest changes to communications and resources to better fit EBPs with the resources and needs of organizations and older adults. We are currently partnering with organizations in California and Washington to evaluate whether and how these D&I strategies increase equitable access to PEARLS for older adults who are underserved. Frontiers Media S.A. 2023-01-30 /pmc/articles/PMC9922751/ /pubmed/36793362 http://dx.doi.org/10.3389/fpubh.2022.1079082 Text en Copyright © 2023 Steinman, Parrish, Kohn, Wu, Hara-Hubbard, Brown, Imam, Baquero, Hannon and Snowden. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Steinman, Lesley E.
Parrish, Amanda T.
Kohn, Marlana J.
Wu, Sherry
Hara-Hubbard, KeliAnne K.
Brown, Lori
Imam, Syed
Baquero, Barbara
Hannon, Peggy A.
Snowden, Mark B.
Partnering with community-based organizations to improve equitable access to depression care for underserved older adults in the U.S.: Qualitative formative research
title Partnering with community-based organizations to improve equitable access to depression care for underserved older adults in the U.S.: Qualitative formative research
title_full Partnering with community-based organizations to improve equitable access to depression care for underserved older adults in the U.S.: Qualitative formative research
title_fullStr Partnering with community-based organizations to improve equitable access to depression care for underserved older adults in the U.S.: Qualitative formative research
title_full_unstemmed Partnering with community-based organizations to improve equitable access to depression care for underserved older adults in the U.S.: Qualitative formative research
title_short Partnering with community-based organizations to improve equitable access to depression care for underserved older adults in the U.S.: Qualitative formative research
title_sort partnering with community-based organizations to improve equitable access to depression care for underserved older adults in the u.s.: qualitative formative research
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9922751/
https://www.ncbi.nlm.nih.gov/pubmed/36793362
http://dx.doi.org/10.3389/fpubh.2022.1079082
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