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Determining Depression Treatment Preferences of Low-Income Latinos in Primary Care Settings

Not Applicable
Completed
Conditions
Depression
Interventions
Behavioral: Collaborative care treatment
Behavioral: Enhanced usual care
Registration Number
NCT00260169
Lead Sponsor
University of Southern California
Brief Summary

This study will determine ways to make depression care more responsive to the needs of consumers in primary care clinics serving low-income Latinos.

Detailed Description

Depression is a serious illness that is difficult to diagnose and treat, especially in populations that underutilize mental health services. The Latino population is one such group. Accommodating patient preferences for care, provider capacities, and administrator priorities is essential to the development of effective depression care interventions that are sustainable in public sector systems. However, little is understood regarding the depression treatment preferences of low-income Latinos who have not received quality depression care and who may not feel that they can voice their opinions about their health care. In addition, little is known about the preferences, capabilities, and priorities of providers and administrators in primary care clinics. This study will determine ways to make depression care more responsive to the needs of consumers in primary care clinics serving low-income Latinos. The study will also evaluate the effectiveness of various treatments in reducing depression.

Following baseline assessments of depression treatment preferences and resources, participants in this open label study will be randomly assigned to receive collaborative care either immediately or after a waiting period. Individuals assigned to receive immediate care will undergo treatment for 12 weeks. Other participants will receive treatment at a later time. All participants will have the option to receive one of the following treatments: (1) medication management from the Depression Care Specialist (DCS) and antidepressant medication from their primary care provider (PCP); (2) cognitive-behavioral therapy from the DCS; or (3) a combination of both treatments. Depression treatment outcomes and preferences will be measured post-intervention. Provider and administrator preferences will also be measured post-intervention and potential strategies for implementing patient-centered depression care programs will be identified.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
432
Inclusion Criteria

For Participating Patients:

  • Attending one of the study clinics for primary care
  • English or Spanish-speaking
  • Screens positive for major depressive disorder or dysthymia

For Providers:

  • All primary care providers providing at least one day of services at one of the study clinics

For Administrators:

  • Administrative, medical, and nursing directors from each study site and directors of affiliated local mental health clinics
Exclusion Criteria

For Participating Patients:

  • Acutely suicidal
  • Screens positive for bipolar disorder, psychotic disorder, or cognitive impairment

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1Collaborative care treatmentParticipants will receive collaborative care
2Enhanced usual careParticipants will receive enhanced usual care
Primary Outcome Measures
NameTimeMethod
Depression treatment preferences as measured by a conjoint analysis survey and qualitative interviewsMeasured at Week 16
Secondary Outcome Measures
NameTimeMethod
Depression outcomes as measured by the Patient Health Questionnaire-9Measured at Week 16

Trial Locations

Locations (3)

LAC+USC Outpatient Department

🇺🇸

Los Angeles, California, United States

H. Claude Hudson Comprehensive Health Center

🇺🇸

Los Angeles, California, United States

USC Family Practice Center at California Hospital

🇺🇸

Los Angeles, California, United States

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