Skip to main content

Bridges to Better Health and Wellness: An Adapted Health Care Manager Intervention for Hispanics with Serious Mental Illness


This study examined the feasibility, acceptability, and initial impact of bridges to better health and wellness (B2BHW), a culturally-adapted health care manager intervention for Hispanics with serious mental illness (SMI). Thirty-four Hispanics with SMI and at risk for cardiovascular disease were enrolled. Mixed-linear models were used to examine changes over 12-months on patient activation, self-efficacy, patient-rated quality of care, receipt of preventive primary care services, and quality of life. The majority of participants completed the intervention (85%) with high satisfaction. Significant improvements were found for patient activation, self-efficacy, patients’ ratings of quality of care, and receipt of preventive primary care.

This is a preview of subscription content, access via your institution.


  1. Alakeson, V., Frank, R. G., & Katz, R. E. (2010). Specialty care medical homes for people with severe, persistent mental disorders. Health Affairs, 29(5), 867–873.

    Article  PubMed  Google Scholar 

  2. American Diabetes Association. (2004). Consensus development conference on antipsychotic drugs and obesity and diabetes. Journal of Clinical Psychiatry, 65(2), 267–272.

    Article  Google Scholar 

  3. Baker, D. W., Williams, M. V., Parker, R. M., Gazmararian, J. A., & Nurss, J. (1999). Development of a brief test to measure functional health literacy. Patient Education and Counseling, 38(1), 33–42.

    CAS  Article  PubMed  Google Scholar 

  4. Bartels, S. J., Aschbrenner, K. A., Rolin, S. A., Hendrick, D. C., Naslund, J. A., & Faber, M. J. (2013). Activating older adults with serious mental illness for collaborative primary care visits. Psychiatric Rehabilitation Journal, 36(4), 278–288. doi:10.1037/prj0000024.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Cabassa, L. J., Gomes, A. P., Meyreles, Q., Capitelli, L., Younge, R., Dragatsi, D., …, Lewis-Fernandez, R (2014). Using the collaborative intervention planning framework to adapt a health-care manager intervention to a new population and provider group to improve the health of people with serious mental illness. Implement Science, 9, 178. doi:10.1186/s13012-014-0178-9.

    Article  Google Scholar 

  6. Cabassa, L. J., Gomes, A. P., Meyreles, Q., Capitelli, L., Younge, R., Dragatsi, D., …, Lewis-Fernandez, R (2014). Primary health care experiences of hispanics with serious mental illness: A mixed-methods study. Admnistration and Policy in Mental Health and Mental Health Services Research, 41(6), 724–736. doi:10.1007/s10488-013-0524-2.

    Article  Google Scholar 

  7. Campbell, M., Fitzpatrick, R., Haines, A., Kinmonth, A. L., Sandercock, P., Spiegelhalter, D., & Tyrer, P. (2000). Framework for design and evaluation of complex interventions to improve health. British Medical Journal, 321(7262), 694–696.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  8. Carliner, H., Collins, P. Y., Cabassa, L. J., McNallen, A., Joestl, S. S., & Lewis-Fernandez, R. (2014). Prevalence of cardiovascular risk factors among racial and ethnic minorities with schizophrenia spectrum and bipolar disorders: A critical literature review. Comprehensive Psychiatry, 55(2), 233–247. doi:10.1016/j.comppsych.2013.09.009.

    Article  PubMed  Google Scholar 

  9. Colton, C. W., & Manderscheid, R. W. (2006). Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Preventing Chronic Disease, 3(2), A42.

    PubMed  PubMed Central  Google Scholar 

  10. Cooper, H., Hedges, L. V., & Valentine, J. C. (2009). The handbook of research synthesis and meta-analysis (2nd edn.). New York: Russell Sage Foundation.

    Google Scholar 

  11. Davidson, L., Bellamy, C., Guy, K., & Miller, R. (2012). Peer support among persons with severe mental illnesses: A review of evidence and experience. World Psychiatry, 11(2), 123–128.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Davis, C. S. (2002). Statistical methods for the analysis of repeated measures. New York: Springer.

    Google Scholar 

  13. Druss, B. G., von Esenwein, S. A., Compton, M. T., Rask, K. J., Zhao, L., & Parker, R. M. (2010). A randomized trial of medical care management for community mental health settings: The primary care access, referral, and evaluation (PCARE) study. American Journal of Psychiatry, 167(2), 151–159.

    Article  PubMed  Google Scholar 

  14. Glasgow, R. E., Whitesides, H., Nelson, C. C., & King, D. K. (2005). Use of the patient assessment of chronic illness care (PACIC) with diabetic patients: Relationship to patient characteristics, receipt of care, and self-management. Diabetes care, 28(11), 2655–2661.

    Article  PubMed  Google Scholar 

  15. Hibbard, J. H., Mahoney, E. R., Stockard, J., & Tusler, M. (2005). Development and testing of a short form of the patient activation measure. Health Services Research, 40(6 Pt 1), 1918–1930.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Lord, O., Malone, D., & Mitchell, A. J. (2010). Receipt of preventive medical care and medical screening for patients with mental illness: A comparative analysis. General Hospital Psychiatry, 32(5), 519–543. doi:10.1016/j.genhosppsych.2010.04.004.

    Article  PubMed  Google Scholar 

  17. Lorig, K., Stewart, A., Ritter, P., González, V., Laurent, D., & Lynch, J. (1996). Outcome measures for health education and other health care interventions. Thousand Oaks: Sage Publications.

    Google Scholar 

  18. Lorig, K. R., Sobel, D. S., Ritter, P. L., Laurent, D., & Hobbs, M. (2001). Effect of a self-management program on patients with chronic disease. Effective Clinical Practice, 4(6), 256–262.

    CAS  PubMed  Google Scholar 

  19. Marin, G. S., & Gamba, R. J. (1996). A new measurement of acculturation for Hispanics: The bidimensional acculturation scale for Hispanics (BAS). Hispanic Journal of Behavioral Sciences, 18(3), 297–316.

    Article  Google Scholar 

  20. Nasrallah, H. A., Meyer, J. M., Goff, D. C., McEvoy, J. P., Davis, S. M., Stroup, T. S., & Lieberman, J. A. (2006). Low rates of treatment for hypertension, dyslipidemia and diabetes in schizophrenia: Data from the CATIE schizophrenia trial sample at baseline. Schizophrenia Research, 86(1–3), 15–22.

    Article  PubMed  Google Scholar 

  21. Palmer, R. M., & Meldon, S. W. (2003). Acute care. In W. R. Hazzard (Ed.), Principles of geriatric medicine and gerontology (pp. 157–168). Boston: McGraw-Hill.

    Google Scholar 

  22. Proctor, E. K. (2004). Research to inform mental health practice: Social work’s contribution. Social Work Research, 28(4), 195–197. doi:10.1093/swr/28.4.195

    Article  Google Scholar 

  23. Roberts, R., Atkinson, C., & Mendías, R. (1984). Assessing the client satisfaction questionnaire in english and spanish. Hispanic Journal of Behavioral Sciences, 6, 385–395.

    Article  Google Scholar 

  24. Salyers, M. P., Bosworth, H. B., Swanson, J. W., Lamb-Pagone, J., & Osher, F. C. (2000). Reliability and validity of the SF-12 health survey among people with severe mental illness. Medical Care, 38(11), 1141–1150.

    CAS  Article  PubMed  Google Scholar 

  25. United States Preventive Services Task Force. (2010). The guide to clinical preventive services 2010–2011: Recommendations of the U.S. preventive services task force. Washington: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services.

    Google Scholar 

  26. Wagner, E. H., Austin, B. T., Davis, C., Hindmarsh, M., Schaefer, J., & Bonomi, A. (2001). Improving chronic illness care: Translating evidence into action. Health Affairs, 20(6), 64–78.

    CAS  Article  PubMed  Google Scholar 

  27. Weinstein, L. C., Stefancic, A., Cunningham, A. T., Hurley, K. E., Cabassa, L. J., & Wender, R. C. (2016). Cancer screening, prevention, and treatment in people with mental illness. CA: A Cancer Journal for Clinicians, 66(2), 133–151. doi:10.3322/caac.21334.

    Google Scholar 

  28. Zayas, L. H., Cabassa, L. J., & Pérez, M. C. (2005). Capacity-to-consent in psychiatric research: Development and preliminary testing of a screening tool. Research on Social Work Practice, 15(16), 545–556.

    Article  Google Scholar 

Download references


The authors would like to acknowledge all of the people who worked on this project including Arminda P. Gomes, Lorena Maldonado, Seth Thompson, Analis Lopez, and Marina Soto.


This study was funded by the National Institute of Mental Health (NIMH) K01 MH091108.

Author information



Corresponding author

Correspondence to Leopoldo J. Cabassa.

Ethics declarations

Conflict of interest

Leopoldo J. Cabassa declares that he has no conflict of interest. Yamira Manrique declares that she has no conflict of interest. Quisqueya Meyreles declares that she has no conflict of interest. David Camacho declares that he has no conflict of interest. Lucia Capitelli declares that she has no conflict of interest. Richard Younge declares that he has no conflict of interest. Dianna Dragatsi declares that she has no conflict of interest. Juana Alvarez declares that she has no conflict of interest. Roberto Lewis-Fernández declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Appendix: Bridges to Better Health and Wellness Phases of Work

Appendix: Bridges to Better Health and Wellness Phases of Work

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Cabassa, L.J., Manrique, Y., Meyreles, Q. et al. Bridges to Better Health and Wellness: An Adapted Health Care Manager Intervention for Hispanics with Serious Mental Illness. Adm Policy Ment Health 45, 163–173 (2018).

Download citation


  • Hispanics
  • Latinos
  • Serious mental illness
  • Health care disparities
  • Health care management
  • Patient-centered care
  • Cultural adaptation