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Pilot Program Invites Hispanic Participants

By Constance Burr

¿Sufre de transtorno bipolar o de depresión? ¿Le interesa participar en una investigación clinica? A bilingual pilot program is advertising in Spanish, recruiting people with bipolar disorder or major depression for screening and clinical trials conducted in Spanish at the National Institute of Mental Health.

To strengthen Hispanic participation in research studies, Dr. Carlos Zárate, Jr., chief of the mood disorders research unit, is directing trials with Spanish protocols and bilingual doctors, nurses, social workers and technicians. He is also getting the word out to the public. Because many in the Hispanic community prefer radio programs and advertising in Spanish, radio spots and print ads reach a new audience of potential patients. Ads from the mood disorders program call for volunteers on WACA 1540 AM-Radio America, a local Hispanic station, and in El Pregonero, a weekly newspaper, which together serve a market of some 400,000 Spanish speakers in the metropolitan Washington area.

With 80 calls from prospective subjects during the first 2 weeks of advertising, the program's voice mail capacity had to be increased. "The Spanish-speaking community is willing to take part because language and cultural barriers have been lowered," Zárate said. "It's a matter of trust. People feel we know where they are coming from."

Dr. Carlos Zárate, Jr.

On the air, announcers invite listeners suffering from mood disorders to enroll in studies that offer medical and psychiatric evaluations, treatment, and transportation at no cost. "Consultorio Comunitario," a public forum on health with Dr. Elmer Huerta, and "Informativo Mundial," morning and afternoon newscasts, run the ads on weekdays.

"Calentando La Mañana," a morning drive talk show, showcases personalities of Hispanic interest. In a recent interview with popular host Madeline Portalatin, Zárate explained symptoms of depression and bipolar disorder, the need to recognize and diagnose these illnesses, and various kinds of therapy. The benefits of research and treatment help dispel stigma and improve lives across cultures, he explained. Zárate encouraged listeners to call NIMH for a voice message in Spanish on how to take part.

Two protocols have been translated into Spanish. These trials are testing new uses for established drugs that cause changes in the brain similar to antidepressants. In both studies, PET scans compare brain activity in healthy controls and those with mental disorders.

An outgrowth of the Hispanic Research Initiative, chaired by Dr. Juan Saavedra, chief, section on pharmacology, the comprehensive plan to engage Spanish speakers in clinical trials sets the tone for future bilingual projects. The initiative steering committee, comprising Saavedra, Zárate, Dr. Catherine Roca and Dr. José Apud, advises the intramural program and institute director on outreach to the Hispanic community, translation and validation of forms and documents, Hispanic patient recruitment for intramural research, and the necessity of having bilingual therapists in the studies.

"This effort is part of a larger consideration — helping the Hispanic community participate in the life of the country," said Saavedra. "The trials offer Hispanic Americans and Latin American immigrants the opportunity to invest in a network of health care, education, and access to therapies."

The project is currently recruiting another essential team member, a bilingual clinical studies representative to approach the Hispanic community, invite subjects, screen patients and consult with other research branches on protocol consent, IRB involvement, bioethics and customer satisfaction.

"My goal for these studies is to broaden scientific knowledge and increase Hispanic participation," Zárate said. Recruitment ads in English are also appearing in the Washington Post, the Gazette and in fliers in movie theaters and health care facilities.

In addition to promoting clinical trials to local audiences, Zárate is aiming for Hispanic representation nationwide. He has spoken about the need for Latino volunteers at the Rocky Mountain College Physician Assistants Program in Billings, Mont.; Ponce Medical School, in Ponce, Puerto Rico; the University of Massachusetts, Worcester; and the Office of Mental Health, New York City. This summer he plans to address Latino physicians of Puerto Rico, continental U.S., and Latin America in Miami, and mental health organizations in Texas.

In Census 2000, of 281.4 million residents counted in the U.S., 35.3 million, or 12.5 percent were Hispanic, the nation's largest racial or ethnic minority group. By targeting Spanish speakers in clinical trials, NIMH is using a strategy that affirms its commitment to boosting minority participation in health research.

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