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Principal Investigator: Mariana Lazo Elizondo
Organization: DREXEL UNIVERSITY
Fiscal Year: 2024
Award: $1,208,123
Funding agency: National Institute on Minority Health and Health Disparities
Latinos in the U.S. experience significant disparities in access to mental health services due to lack of
health insurance, cost of services, limited awareness of mental health resources, mental health stigma, and
fear of deportation. Limited English proficiency coupled with an acute lack of bilingual and culturally competent
providers further impede Latinos’ adequate access to quality mental health services. The COVID-19 pandemic
has only amplified the need for mental health care and exacerbated mental health disparities for Latino
communities, making it urgent to identify low-cost, effective strategies to reduce these gaps. This 5-year
project seeks to develop and test a multi-level, community intervention to improve mental health
outcomes and promote access to culturally appropriate mental health treatment for Latino
communities in Philadelphia. CRISOL Mente will include components at various levels of the socio-ecological
model: a clinic-based, stepped-care program relying on Latino lay health workers (LHW) for the delivery of
mental health services (Aim 1), outreach and education activities to reduce mental health stigma in the
community (Aim 2), and efforts to strengthen Latino-serving organizations’ capacity to address mental health
and other syndemic conditions contributing to untreated mental health among Latinos (Aim 3). To improve
mental health symptoms and engagement in care, we will recruit, train and supervise a cohort of Latino LHW
who will be embedded into two Latino-serving clinics, extending the reach and effectiveness of the clinics’
mental health services. We will compare the impact of three different levels of LHW involvement: a)
community outreach/navigation (i.e. screening and referral of community members); b) auxiliary care (i.e.
screening, referral, and help overcoming barriers to better mental health); and c) task shifting (i.e. screening,
referral, assistance, and supervised delivery of basic mental health treatment). The LHWs will also conduct
outreach/education activities in the community (e.g. radio talks, info sessions, tables in community venues)
to reduce mental health stigma. Our experienced and largely Latino community-academic research team will
also engage in capacity building activities (i.e. monthly town halls, annual retreats, weekly newsletters,
provision of trainings and technical support) with the Latino Health Collective, a coalition of Latino-serving
organizations. Using mixed-methods and the RE-AIM framework, CRISOL Mente’s impact will be evaluated
with clinical data, baseline and 6-month patient survey data (N=200 from each level of LHW involvement), and
qualitative interviews with community members (N=30) referred to mental health services by the LHW (Aim 1);
pre/post mental health stigma data from two respondent driven sampling (RDS) surveys of Latinos (N=400
each) conducted in 2022 (preliminary study) and in 2027 (Aim 2); community capacity indicators from three
surveys of Latino-serving organizations conducted in 2019, 2021 (preliminary studies) and 2027, and key
informant interviews (KII) with Latino-serving providers (N=30) in 2019 (preliminary study) and 2027 (Aim 3).
Terms: <Access to Care><Active Follow-up><Acute><Address><Adherence><Advocacy><Awareness><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Caring><Client><Clinic><Clinical Data><Cognitive Discrimination><Communication><Communities><Community Outreach><Community Surveys><Complex><Coupled><Data><Decrease disparity><Decrease health disparities><Development><Discrimination><Disparities><Disparity><Economics><Education><Education and Outreach><Educational Achievement><Educational Activities><Educational Status><Educational aspects><Effectiveness><Evaluation><Evidence based treatment><Fear><Fright><Health><Health Insurance><Health Resources><Health Services Accessibility><Health disparity mitigation><Health disparity reduction><Healthcare><Immigrant><Impoverished><Instruction and Outreach><Intervention><Intervention Strategies><Interview><Jobs><Language><Latina><Latino><Latino Population><Latino group><Latino individual><Latino people><Latinos><Legal><Limited English Proficiency><Linguistic><Linguistics><Low-resource area><Low-resource community><Low-resource environment><Low-resource region><Low-resource setting><Lower disparity><Lower health disparities><Mental Depression><Mental Health><Mental Health Services><Mental Hygiene><Mental Hygiene Services><Mental disorders><Mental health disorders><Methods><Mitigate health disparities><Modeling><Newsletter><Non-Hispanic><Nonhispanic><Not Hispanic or Latino><Occupations><Outcome><Patients><Phase><Philadelphia><Population><Poverty><Professional Positions><Provider><Psychiatric Disease><Psychiatric Disorder><Psychological Health><Public Health><RE-AIM><Radio><Reach, Effectiveness, Adoption, Implementation, and Maintenance><Reduce health disparities><Reporting><Research><Research Resources><Resource-constrained area><Resource-constrained community><Resource-constrained environment><Resource-constrained region><Resource-constrained setting><Resource-limited area><Resource-limited community><Resource-limited environment><Resource-limited region><Resource-limited setting><Resource-poor area><Resource-poor community><Resource-poor environment><Resource-poor region><Resource-poor setting><Resources><Respondent><Rest><Risk><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Sampling><Services><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Site><Social Conditions><Social Service><Social Work><Societal Conditions><Stress><Survey Instrument><Surveys><Symptoms><Syndrome><Testing><Training><Training and Outreach><Tutoring and Outreach><Woman><access disparities><access to health care><access to health services><access to healthcare><access to services><access to treatment><accessibility disparities><accessibility of health care><accessibility to health care><accessibility to health services><accessibility to healthcare><active followup><availability of services><barrier to care><barrier to health care><barrier to healthcare><barrier to treatment><bilingual><bilingualism><care access><clinical anxiety><cohort><community engaged participatory research><community engaged research><community intervention><community level intervention><community partnered research><community setting><community-based intervention><community-engaged study><community-partnered study><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><cost><cultural competence><culturally adapted intervention><culturally appropriate intervention><culturally centered intervention><culturally competent><culturally focused intervention><culturally informed intervention><culturally responsive intervention><culturally tailored intervention><depression><design><designing><developmental><disparities in access><disparity in health><disparity reduction><economic><educational level><effectiveness testing><experience><follow up><follow-up><followed up><followup><health care><health care access><health care availability><health care service access><health care service availability><health disparity><health insurance plan><health service access><health services availability><healthcare access><healthcare accessibility><healthcare availability><healthcare service access><healthcare service availability><improve minority health><improved><improvement of minority health><inequality in access><inequity in access><inequity in accessibility><informant><interventional strategy><member><men><mental health care><mental healthcare><mental illness><mitigate disparity><novel><obstacle to care><obstacle to healthcare><outreach><peer><post-COVID><post-COVID-19><post-coronavirus disease 2019><post-trauma stress><post-traumatic stress><posttrauma stress><posttraumatic stress><programs><psychiatric illness><psychological disorder><psychological distress><racism><reach, efficacy, adoption, implementation, and maintenance><recruit><reduce disparity><reduction in disparity><screening><screenings><service availability><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><social stigma><stigma><syndemic><synergistic epidemic><training achievement><training level><training status><treatment access>