Daniel E Jimenez1, Amy Begley2, Stephen J Bartels3, Margarita Alegría4, Stephen B Thomas5, Sandra C Quinn5, Charles F Reynolds2. 1. University of Miami Center on Aging, Miami, FL; Dartmouth Centers for Health and Aging, Geisel School of Medicine at Dartmouth, Hanover, NH. Electronic address: dej18@med.miami.edu. 2. NIMH Center for Late Life Depression Prevention and Treatment, University of Pittsburgh School of Medicine and Graduate School of Public Health, Pittsburgh, PA. 3. Dartmouth Centers for Health and Aging, Geisel School of Medicine at Dartmouth, Hanover, NH. 4. Center for Multicultural Mental Health Research, Cambridge Health Alliance, Somerville, MA. 5. Center for Health Equity, School of Public Health, University of Maryland, College Park, MD.
Abstract
OBJECTIVE: To compare the effect of problem-solving therapy against a health-promotion intervention (dietary practices) on health-related quality of life (HRQOL) and examine if there is a differential effect on non-Latino white patients and African American patients between the two interventions. This paper also explores participant characteristics (problem-solving style and physical functioning) as potential predictors of HRQOL. METHODS: Secondary analysis of data from a randomized depression prevention trial involving 247 older adults (154 non-Latino white, 90 African American, 3 Asian). Participants were randomly assigned to receive either problem solving therapy for primary care (PST-PC) or coaching in healthy dietary practices (DIET). RESULTS: Both PST-PC and DIET improved HRQOL over two years and did not differ significantly from each other. African American patients in both conditions had greater improvements in mental health-related quality of life (MHRQOL) compared with non-Latino white patients. In addition, higher social problem-solving and physical functioning were predictive of improved MHRQOL. CONCLUSION: PST-PC and DIET have the potential to improve health-related quality of life in a culturally relevant manner. Both hold promise as effective and potentially scalable interventions that could be generalized to highly disadvantaged populations in which little attention to HRQOL has been paid.
RCT Entities:
OBJECTIVE: To compare the effect of problem-solving therapy against a health-promotion intervention (dietary practices) on health-related quality of life (HRQOL) and examine if there is a differential effect on non-Latino whitepatients and African American patients between the two interventions. This paper also explores participant characteristics (problem-solving style and physical functioning) as potential predictors of HRQOL. METHODS: Secondary analysis of data from a randomized depression prevention trial involving 247 older adults (154 non-Latino white, 90 African American, 3 Asian). Participants were randomly assigned to receive either problem solving therapy for primary care (PST-PC) or coaching in healthy dietary practices (DIET). RESULTS: Both PST-PC and DIET improved HRQOL over two years and did not differ significantly from each other. African American patients in both conditions had greater improvements in mental health-related quality of life (MHRQOL) compared with non-Latino whitepatients. In addition, higher social problem-solving and physical functioning were predictive of improved MHRQOL. CONCLUSION:PST-PC and DIET have the potential to improve health-related quality of life in a culturally relevant manner. Both hold promise as effective and potentially scalable interventions that could be generalized to highly disadvantaged populations in which little attention to HRQOL has been paid.
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