Lessons Learned from the Positive Minds—Strong Bodies Trial on Disability Prevention for Racial/Ethnic Minority Elders

Racial/ethnic minority elders (60+) have a higher prevalence of late life depression (LLD) and worse access to and quality of mental health care than their white counterparts. Past research has linked LLD to a decline in cognitive functioning and an increased risk of developing dementia and chronic physical conditions. Our Positive Minds-Strong Bodies (PM-SB) program aims to address the significant prevalence of physical and mental disability among racial/ethnic minority elders, a group that is projected to represent 40% of the US population by 2050. The intervention aimed to: (1) develop collaborative partnerships to evaluate the capacity of community-based organizations and clinics to provide disability prevention services; (2) evaluate the acceptability and efficacy of a combined behavioral health and disability prevention intervention; and (3) determine the organizational feasibility and sustainability of the intervention. The chapter begins with a background on the epidemiology of LLD and late-life anxiety, the difficulties in diagnosis and treatment engagement, and racial/ethnic disparities among elders. The background also highlights previous literature on the efficacy of mental health treatments and recent efforts to adapt culturally and linguistically community health worker (CHW) programs to improve mental health wellness among elders. Next, we describe the specific challenges in our CHW-based program related to participant recruitment and retention, including medical comorbidity and time commitments issues, as well as high staff turnover and logistical issues with intervention delivery. The chapter concludes with suggestions for future directions in mental health promotion with racial/ethnic minority elders in community-based settings.