TY - JOUR
T1 - Culturally adapted depression education and engagement in treatment among Hispanics in primary care
T2 - Outcomes from a pilot feasibility study
AU - Sanchez, Katherine
AU - Killian, Michael O.
AU - Eghaneyan, Brittany H.
AU - Cabassa, Leopoldo J.
AU - Trivedi, Madhukar H.
N1 - Funding Information:
This study has some limitations. The funding opportunity from the CMS Hispanic Health Services Research Grant Program specified that funded projects be for educational intervention studies, which would inform populations-at-risk and that the intervention reach a minimum of 350 participants. This requirement made a comparison group from the same site impossible and introduced the limitations of a one-group, pretest-posttest design [19] There was also only one LCSW available at the clinic to train as the DE, so the effects of the clinician cannot be separated from the education intervention itself. As with all research studies, and primary care in general, a few participants were lost between the enrollment and the education visit (n = 27) and at one-month follow-up (n = 18), however these losses were attributed to typical life circumstances (phone disconnected, patient relocated) and the overall study retention rate was quite high (87%). Additionally, the outcome measure of engagement in depression treatment at one month follow up was a self-report item collected via phone, which introduces inaccuracy and potential response bias.
Publisher Copyright:
© 2019 The Author(s).
PY - 2019/10/21
Y1 - 2019/10/21
N2 - Background: Low use of anti-depressant medication, poor doctor-patient communication, and persistent stigma are key barriers to the treatment of depression in Hispanics. Common concerns include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking medications and seeking mental health treatments. In 2014, the Center for Medicare and Medicaid Services (CMS) funded the Depression Screening and Education: Options to Reduce Barriers to Treatment (DESEO) project to implement an education intervention designed to increase disease literacy and dispel myths about depression and its treatment among Hispanic patients thus reducing stigma and increasing treatment engagement. Methods: The DESEO study utilized a one-group pretest-posttest design to assess the effects a culturally-adapted Depression Education Intervention's (DEI) on depression knowledge, stigma, and engagement in treatment in a sample of 350 Hispanic primary care patients with depression. The DEI utilized a fotonovela, a health education tool available in English and Spanish that uses posed photographs, captions, and soap opera narratives to raise awareness about depression and depression treatments. Results: Participants reported significant decreases in depression symptoms and reported stigma about mental health care. Additionally, participants reported increased knowledge of depression yet greater negative perceptions about antidepressant medication. Finally, 89.5% of participants reported entering some form of treatment at follow-up. Conclusions: Culturally adapted depression education shows promise in increasing understanding of depression, decreasing stigma, and increasing treatment engagement among Hispanic patients in a community-based health center. Results have implications for practice in addressing common concerns about depression treatments which include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking psychotropic medications.
AB - Background: Low use of anti-depressant medication, poor doctor-patient communication, and persistent stigma are key barriers to the treatment of depression in Hispanics. Common concerns include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking medications and seeking mental health treatments. In 2014, the Center for Medicare and Medicaid Services (CMS) funded the Depression Screening and Education: Options to Reduce Barriers to Treatment (DESEO) project to implement an education intervention designed to increase disease literacy and dispel myths about depression and its treatment among Hispanic patients thus reducing stigma and increasing treatment engagement. Methods: The DESEO study utilized a one-group pretest-posttest design to assess the effects a culturally-adapted Depression Education Intervention's (DEI) on depression knowledge, stigma, and engagement in treatment in a sample of 350 Hispanic primary care patients with depression. The DEI utilized a fotonovela, a health education tool available in English and Spanish that uses posed photographs, captions, and soap opera narratives to raise awareness about depression and depression treatments. Results: Participants reported significant decreases in depression symptoms and reported stigma about mental health care. Additionally, participants reported increased knowledge of depression yet greater negative perceptions about antidepressant medication. Finally, 89.5% of participants reported entering some form of treatment at follow-up. Conclusions: Culturally adapted depression education shows promise in increasing understanding of depression, decreasing stigma, and increasing treatment engagement among Hispanic patients in a community-based health center. Results have implications for practice in addressing common concerns about depression treatments which include fears about the addictive and harmful properties of antidepressants, worries about taking too many pills, and the stigma attached to taking psychotropic medications.
KW - Depression
KW - Education, Hispanics
KW - Fotonovela
KW - Primary care
KW - Stigma
UR - http://www.scopus.com/inward/record.url?scp=85073731658&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85073731658&partnerID=8YFLogxK
U2 - 10.1186/s12875-019-1031-7
DO - 10.1186/s12875-019-1031-7
M3 - Article
C2 - 31638915
AN - SCOPUS:85073731658
SN - 1471-2296
VL - 20
JO - BMC Family Practice
JF - BMC Family Practice
IS - 1
M1 - 140
ER -