Measurement, Education and Tracking in Integrated Care METRIC: use of a culturally adapted education tool versus standard education to increase engagement in depression treatment among Hispanic patients: study protocol for a randoReportar como inadecuado




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Trials

, 18:363

First Online: 03 August 2017Received: 31 May 2017Accepted: 15 July 2017

Abstract

BackgroundSignificant mental health disparities exist for Hispanic populations, especially with regard to depression treatment. Stigma and poor communication between patients and their providers result in low use of antidepressant medications and early treatment withdrawal. Cultural factors which influence treatment decisions among Hispanics include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking medications. Primary care settings often are the gateway to identifying undiagnosed or untreated mental health disorders, particularly for people with co-morbid physical health conditions. Hispanics, in particular, are more likely to receive mental healthcare in primary care settings. Recent recommendations from the U.S. Preventive Services Task Force are that primary care providers screen adult patients for depression only if systems are in place to ensure adequate treatment and follow-up.

MethodsWe are conducting a randomized controlled trial among 150 depressed adult Hispanics in a primary care safety net setting, testing the effectiveness of a culturally appropriate depression education intervention to reduce stigma and increase uptake in depression treatment among Hispanics, and implement a Measurement-Based Integrated Care MBIC model with collaborative, multidisciplinary treatment and culturally tailored care management strategies.

DiscussionThis study protocol represents the first randomized control trial of the culturally adapted depression education fotonovela, Secret Feelings, among Hispanics in a primary care setting. The education intervention will be implemented after diagnosis using an innovative screening technology and enrolled in measurement-based integrated care for the treatment of depression, which will help build the evidence around cultural adaptations in treatment to reduce mental health disparities.

Trial registrationClinicalTrials.gov, NCT02702596. Registered on 20 March 2016.

KeywordsDepression Education Hispanics Stigma Primary care iPad screening Fotonovela Measurement-based integrated care Care management AbbreviationsBABehavioral activation

DCMDepression care manager

DEFDepression education fotonovela

DKMDepression Knowledge Measure

EHRElectronic health record

FQHCFederally qualified health center

GAD-7Generalized Anxiety Disorder-7

HHSU.S. Department of Health and Human Services

LCSWLicensed clinical social worker

LEPLimited English proficiency

LSASLatino Scale for Antidepressant Stigma

MBIC + DEFMeasurement-based integrated care with depression education fotonovela

MBIC + SEMeasurement-based integrated care with standard education

MBICMeasurement-based integrated care

METRICMeasurement, Education, and Tracking in Integrated Care

NIMHNational Institute of Mental Health

PAQPatient Adherence Questionnaire

PCPPrimary care provider

PHQ-99-item Patient Health Questionnaire

PIPrincipal Investigator

PST-PCProblem Solving Treatment for Primary Care

SCMHCStigma concerns about mental health care

SDSocial Distance Scale

SEStandard education

Electronic supplementary materialThe online version of this article doi:10.1186-s13063-017-2109-y contains supplementary material, which is available to authorized users.

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Autor: Katherine Sanchez - Brittany H. Eghaneyan - Michael O. Killian - Leopoldo Cabassa - Madhukar H. Trivedi

Fuente: https://link.springer.com/







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