Irvine, California, October 3, 2022 – The National Institutes of Health is awarding nearly $4.7 million over five years to support research teams from University of California, Irvine, Berkeley, and San Francisco campuses who are collaborating on a new project that combines peer support with the use of a digital platform to better address the mental health needs of Latino patients with limited English language skills.

Evidence-based digital health interventions, such as interventions that use the Internet and mobile technologies, can improve access in resource-poor environments by removing barriers such as cost, transportation and appointment scheduling. Improved accessibility can increase equality in mental health care for traditionally disadvantaged populations. The researchers hypothesize that supplementing existing digital interventions with peer support will increase scalability and sustainability and help address mental health workforce shortages, a reality particularly prevalent in the Latino community.

“We don’t have enough mental health care to treat people in need, period. We are severely underrepresented in terms of Hispanic providers, especially when compared to the population of Hispanic people seeking mental health care in California. We need a better portfolio of options to deliver care and increase equity in care,” said Stephen Schueller, UCI associate professor of psychological sciences and one of the project’s co-designers. A recent report found that in California, only 5 percent of psychiatrists, 9 percent of psychologists and 28 percent of social workers are Latino, which is highly disproportionate to the population.

The name of the new study is Support From Peers to Expand Access, and the acronym SUPERA is the Spanish word for “overcomes.” The researchers will evaluate the implementation of an evidence-based, Hispanic, digital, cognitive behavioral therapy intervention (SilverCloud) in primary care for Latino patients with depression and/or anxiety. Primary care is the actual treatment environment for these common mental health problems, and as shown previously, Latino patients tend to prefer this over referral to special mental health services.

SUPERA will simultaneously assess the most effective ways to integrate SilverCloud into primary care and how best to support patients using the digital tool so that they get the most out of it. The researchers will examine implementation strategies at the healthcare provider level by comparing the effectiveness of traditional healthcare provider referrals with the use of an in-clinic patient registry to identify candidates who could benefit from a digital mental health intervention. At the patient level, the researchers will contrast the effectiveness of two modes of delivery of the platform: self-directed versus peer-assisted by Latino community health professionals, known in this project as promoters.

Schueller noted that it’s usually best to have some form of human support available with digital interventions. promoters will contact patients and make sure they understand the digital lessons, but they will not provide additional therapy. The researchers enthusiastically measure how promoters can help patients navigate multiple cultural variables. “While the digital program is linguistically and culturally tailored, we hear from Hispanic – and other non-English speaking populations who use these tools – that there are many places where the adaptations and the cultural pieces don’t really land right. We hope that the promoters will be able to provide the enveloping cultural expertise to make this intervention more effective for this particular population,” Schueller said.

His team at UCI will evaluate and analyze data and manage relationships with the technology supplier. Clinical recruitment, cultural adjustment, and patient analysis will take place at primary care clinics at Zuckerberg San Francisco General Hospital led by Adrian Aguilera, co-designer of SUPERA and associate professor at UC Berkeley’s School of Social Welfare and UC San Francisco’s Department of Psychiatry and Behavioral Sciences.

He said: “I am excited to test a promising program and implementation strategies that address the urgent need for linguistically appropriate services for Spanish speakers. We recognize the importance of testing this approach in clinics that have a long history of serving this population and have the trust of community members. While we urgently need more Spanish-language providers, digital tools in Spanish can also be an essential resource.”

Schueller and Aguilera first crossed paths doing postdoctoral research at Zuckerberg San Francisco General Hospital under the guidance of shared mentor Ricardo Muñoz, professor emeritus of psychology at UCSF. Muñoz’s pioneering work in the treatment and prevention of depression began in the 1970s and lasted for four decades. The SUPERA team members, Schueller said, feel they are continuing his legacy of innovation.

About the UCI’s Brilliant Future campaign: The Brilliant Future campaign was publicly launched on October 4, 2019 and aims to raise awareness and support for the UCI. By employing 75,000 alumni and raising $2 billion in philanthropic investments, UCI aims to reach new heights of excellence in student success, health and wellness, research, and more. The School of Social Ecology plays a crucial role in the success of the campaign. Learn more at https://brilliantfuture.uci.edu/uci-school-of-social-ecology.

About the University of California, Irvine: Founded in 1965, UCI is a member of the prestigious Association of American Universities and is ranked in the top 10 public universities in the country by US news and world report. The campus has produced five Nobel laureates and is known for its academic achievements, world-class research, innovation and anteater mascot. Under the leadership of Chancellor Howard Gillman, UCI has more than 36,000 students and offers 224 degree programs. Located in one of the world’s safest and most economically vibrant communities, it is Orange County’s second largest employer, contributing $7 billion annually to the local economy and $8 billion statewide. For more information about UCI, visit www.uci.edu.

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