Depression in Latinos:
A Focus on Overcoming Barriers

Please review the information below and click the "continue" button at the bottom of the page.

1 Credit Category AMA PRA™
1 Hour Category 2A, AOA

AAFP Prescribed Credit (EB-CME) pending

Target Audience
This activity is designed for primary care physicians, family medicine physicians, general practice physicians, internists, physician assistants, nurse practitioners and other healthcare professionals.

Activity Release and Expiration Date:

This activity was released on March 15, 2009 and expires on March 15, 2010. Credit cannot be awarded after this date.

Statement of Need
(click here to download a fully referenced needs assessment)
Once identified, depression can almost always be successfully treated either by psychotherapy, medication or both. Unfortunately, depression is underdiagnosed and undertreated, especially in primary care. Primary care clinicians are most likely to see patients when they first become depressed; yet only one-third to one-half of people with depression are correctly diagnosed by a primary care provider.

MDD is particularly burdensome for Latinos, an umbrella term referring to a person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin regardless of race. Latinos, who account for more than 45 million US residents and are the nation’s largest and fastest growing ethnic group, consistently report more depressive symptoms than other ethnicities, but are among the least likely to receive a depression diagnosis and, if diagnosed, remain poorly treated. While about 50 percent of Latinos who do receive some level of depression treatment receive it in a primary care setting, fewer than 13 percent receive guideline-based care that would be considered adequate, about half the rate compared to non-Latino whites.

Clinically speaking, just being Latino is a risk factor for MDD, although the risk for depressive symptoms is similar to that among non-Latino whites. Cultural and social factors and the absence of emotional social support in Latino communities can amplify stressful life events, which tend to be higher in Latinos. In addition, stigma associated with depression therapy, including antidepressants, is greater in Latinos than other ethnicities, negatively impacting treatment adherence; and among Latinos, simply being treated for depression is seen as implying “more severe illness, weakness or failure to cope with problems, and being under the influence of a drug.” These stigmata are significant concerns among Latinos, limiting the discussions with their clinicians about depressive symptoms, treatment adherence, follow-up visits and specialty referral, playing a part in low diagnosis and treatment rates of MDD.

Educational Objectives
Upon completion of this activity, attendees will have received information that should allow them to:

• Diagnose major depressive disorder (MDD) in Latinos more accurately and rapidly using information obtained through observation, discussions with the patient and other sources;
• Provide culturally and socially relevant communication and patient education to Latino patients and their families on signs and symptoms of MDD, and risks of non-treatment;
• Treat Latinos and their families who are diagnosed with MDD according to the most recent evidence-based clinical guidelines in a manner which encourages adherence;
• Provide linkages and assistance locating meaningful resources to aid Latinos and their families in getting help related to MDD symptoms, diagnosis and treatment.
  

Physicians Accreditation Statements
The University of North Texas Health Science Center at Fort Worth is accredited by the American Osteopathic Association to award continuing medical education to physicians.

The University of North Texas Health Science Center is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.

Physician Credit Designation
The University of North Texas Health Science Center has requested that the AOA Council on Continuing Medical Education approve this program for 1.0 hours of AOA Category 2A CME credits.  Approval is currently pending.

The University of North Texas Health Science Center at Fort Worth designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)™.

Physicians should only claim credit commensurate with the extent of their participation in the activity.

The American Academy o Family Physicians (AAFP) recognizes educational content based on information from evidence-based sources as value-added CME. Increased credit is pending for the evidence-based CME presentations in this activity and will be confirmed to learners when available.

Physician Assistants Credit Designation
The American Academy of Physician Assistants (AAPA) accepts AMA Category 1 CME credit for the PRA from organizations accredited by ACCME. The University of North Texas Health Science Center at Fort Worth is accredited by ACCME to provide continuing medical education for physicians, and will provide physician assistants who successfully complete the activity with a Statement of Participation indicating that the activity was designated for 1 AMA PRA Category 1 Credit(s)™.

Nurse Practitioners Credit Designation
The University of North Texas Health Science Center at Fort Worth is accredited by ACCME to provide continuing medical education for physicians, and will provide nurse practitioners who successfully complete the activity with a Statement of Participation indicating that the activity was designated for 1 AMA PRA Category 1 Credit(s)™.

Other healthcare professionals will receive a certificate for individual reporting.

Faculty Presenters

Larry Culpepper, MD, MPH
Professor of Family Medicine
Founding Chair
Department of Family Medicine
Boston University School of Medicine
Boston, Massachusetts

Dr. Culpepper has indicated that he has served on advisory boards for Forest Labs, Lilly, Pfizer, Wyeth, Takeda, and Astra Zeneca. He has also been on the speakers bureaus of Forest Labs, Pfizer, and Wyeth. Potential conflict of interest was resolved by limiting the presentation of diagnostic criteria and treatment advice to peer reviewed, evidence based recommendations.

Alan Podawiltz, DO, MS, FAPA
Acting Dean
Texas College of Osteopathic Medicine
Chair and Assistant Professor
Psychiatry & Behavioral Health
University of North Texas Health Science Center
Fort Worth, Texas

Dr. Podawiltz has indicated that he has no relationships with commercial interests to disclose.

Method of Instruction
To receive continuing education credit, participants must:

• Complete the pre-activity questionnaire
• Review the full content of the program.
• Successfully complete the post-activity questionnaire (70% or higher).
• Complete the activity evaluation
  

Your statement of credit (certificate) will be immediately available for download/printing.  Additional copies are available by requesting them here.

Fee
There is no charge to participate or earn creadit for this activity.

Commercial Support
This activity is commercially supported by Wyeth.

Disclaimer
The methods, techniques of clinical practice and practice recommendations are evidence-based and are used by recognized medical authorities for consideration for licensed healthcare professionals to incorporate into practice. Variations of practice, taking into account the needs of the individual patient, available resources and limitations unique to each practice setting, may be appropriate.

Hardware and Software Requirements

• PC with Windows OS -- Windows 98, Me, 2000, XP or Macintosh computer woith OS X or higher
• Windows Media Player installed on your computer
• Broadband Network connection (DSL, cable modem, ISDN and T1 connections are supported)
• Speakers or headphones
• Video Screen Resolution - 1024 x 768 pixels recommended
• Microsoft Internet Explorer 6.0 or greater OR
  Mozilla Firefox 2.0 or greater
• Adobe PDF Reader (for handouts and certificate)