“We are the sun for our community:” Partnering with community health workers/promotores to adapt, deliver and evaluate a home-based collaborative care model to improve equity in access to quality depression care for older U.S. Latino adults who are underserved

Authors: Lesley E Steinman, Amelia Gasca, Theresa J Hoeft, Patrick J Raue, Stuart Henderson, Rosa Perez, Alfredo Huerta, Alex Fajardo, Melinda A Vredevoogd, Katherine James, Ladson Hinton, Laura Rath, Jurgen Unutzer

The purpose of this study was to evaluate the implementation and effectiveness of PEARLS, a home-based collaborative care model, adapted with and for community health workers/promotores (CHWs/Ps). An instrumental case study design was utilized to understand the following components of PEARLS: adaptations to fit local context; acceptability, feasibility, and fidelity; clinical effectiveness; and contextual determinants of implementation success or failure. The results uncovered that adaptations could be made to PEARLS content, context, and implementation strategies to support CHWs/Ps and older adults. In addition, PEARLS was found to be acceptable, feasible, and delivered with fidelity. These findings suggest that addressing social and health needs alongside depression care, and providing regular internal and external coaching and consultation to support CHWs can strengthen the implementation of PEARLS among older Latinos.