# Health Promotion in the Prevention of Anxiety and Depression: The Happy Older Latinos are Active (HOLA Study)

> **NIH NIH R01** · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · 2023 · $668,726

## Abstract

Abstract
 Given the prevalence and morbidity of depression in later life, the inadequacies of
current treatment approaches for averting years living with disability, the inequities in access to
the mental health care delivery system, and the workforce shortages to meet the mental health
needs of older Latinos, development and testing of innovative strategies to prevent depression
and anxiety are of great public health significance and have the potential to change practice.
In the proposed study, 240 older Latinos age 60+ with subthreshold depression or anxiety –
defined as ≥ 5 on the PHQ-9 OR GAD-7 – will be randomized to either HOLA (n=120) or the
healthy lifestyles education program (n=120). Participants will be followed for up to 24 months
with repeated assessments of clinical, health-related, and psychosocial outcomes (at baseline,
post intervention, 6, 12, 18, and 24 months post intervention). The study has three specific
aims: (1a) to compare the effectiveness of HOLA and healthy lifestyles education in reducing
risk factors for major depression and generalized anxiety disorder among older Latinos with
subthreshold depression or anxiety; (1b) to compare the impact of HOLA and healthy lifestyles
education in reducing the 2-year incidence and recurrence of major depression and generalized
anxiety disorder among older Latinos with subthreshold depression or anxiety; (2) To compare
the effectiveness of HOLA and healthy lifestyles education in improving health-related outcomes
among older Latinos with minor or subthreshold depression or anxiety (e.g. pro and anti-
inflammatory cytokines, objective measures of physical fitness, and health-related quality of life)
among older Latinos with minor or subthreshold depression or anxiety; (3) and to identify
biological and psychosocial sources of variability that are predictive of either therapeutic or
adverse outcomes to treatment in older Latinos with subthreshold depression or anxiety. For
Aims 1a and 2, the primary analytic strategy will be mixed effect modeling for main effects of
group, time, and time-by-treatment interaction. For Aim 1b, the primary analytic strategy will be
survival analysis of time to major depressive episode or generalized anxiety disorder in HOLA,
healthy lifestyles education, and wait list control. For Aim 3, we will use a “joint” model that
integrates time-to-event models (i.e. Cox proportional hazards) with models for risk factor
trajectories to explore the strongest predictors of treatment response or non-response, which is
defined as a 50% decrease in symptom severity. Finally, we will determine whether preventive
intervention effects, if detected, are mediated or moderated by changes in perceived social
support or systemic inflammation. Health promotion interventions represent a potential solution
to the multiple disparities experienced by older Latinos. Such an approach could appeal to older
Latinos as a nonstigmatizing and culturally acceptable alternative to traditio...

## Key facts

- **NIH application ID:** 10556389
- **Project number:** 5R01MD012610-05
- **Recipient organization:** UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
- **Principal Investigator:** Daniel Enrique Jimenez
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $668,726
- **Award type:** 5
- **Project period:** 2019-05-09 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10556389

## Citation

> US National Institutes of Health, RePORTER application 10556389, Health Promotion in the Prevention of Anxiety and Depression: The Happy Older Latinos are Active (HOLA Study) (5R01MD012610-05). Retrieved via AI Analytics 2026-06-01 from https://api.ai-analytics.org/grant/nih/10556389. Licensed CC0.

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