Resilience Against Depression Disparities (Also Known as Resilience Education to Reduce Depression Disparities)

Depressive symptoms and disorders are among the most common adult health conditions and are a
leading cause of disability /morbidity worldwide. Although evidence-based approaches such as
cognitive behavioral therapy (CBT), antidepressant medications, and depression collaborative
care and quality improvement (QI) programs integrating depression care into primary health
care can improve depression outcomes and disparities, racial / ethnic disparities continue to
persist. Concurrently, according to a 2011 Institute of Medicine (IOM) report notes little
information exists on how to address the high rates of depression among sexual and gender
minorities, largely composed of lesbian, gay, and bisexual (LGBTQ) individuals. Limited
comparative effectiveness data exists to know what treatments and services options improve
health disparities due to patient characteristics such as race / ethnicity, and sexual
orientation.

"Resilience Against Depression Disparities (RADD)" randomizes enrolled depressed, LGBTQ,
racial / ethnic minority adults (n=320) to an agency-level, evidence-based depression quality
improvement (QI) intervention [Resources for Services (RS)] training and technical support
and then randomizes individuals to Resources for Services alone or to Resiliency Class+, a
7-session resiliency, depression cognitive behavioral therapy class + automated mobile text
reminders about basic reminders and care follow-up impact on improving adult patients'
depressive symptoms over 6- and 12-months. RS training will be offered to three clusters of
four to five LGBTQ-focused programs: two clusters in LA (Hollywood and South LA) and one
cluster in NO. Clusters are comprised of one primary care, one mental health, and two to
three community agencies (e.g., faith-based, social services/support, advocacy). All programs
will receive RS (depression QI training). All enrolled adult depressed patients will be
within programs participating in RS (depression QI) trainings. Half of enrolled participants
will be randomized to the Resilience Class +.

Inclusion Criteria:

1. Age 18 or older

2. moderately to severely depressed (PHQ-8≥10)

3. Able to be contacted by phone (voice or text message), e-mail, or Facebook.

4. English or Spanish speaker

Exclusion Criteria:

1. Under age 18 years

2. Not moderately to severely depressed (PHQ-8≤10)

3. Does not currently have a phone, an email address, or a Facebook profile