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

Primary Purpose

Depression

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Collaborative care treatment
Enhanced usual care
Sponsored by
University of Southern California
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Depression focused on measuring Treatment Preferences, Public sector, Latino

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

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

Sites / Locations

  • H. Claude Hudson Comprehensive Health Center
  • USC Family Practice Center at California Hospital
  • LAC+USC Outpatient Department

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

1

2

Arm Description

Participants will receive collaborative care

Participants will receive enhanced usual care

Outcomes

Primary Outcome Measures

Depression treatment preferences as measured by a conjoint analysis survey and qualitative interviews

Secondary Outcome Measures

Depression outcomes as measured by the Patient Health Questionnaire-9

Full Information

First Posted
November 29, 2005
Last Updated
December 9, 2013
Sponsor
University of Southern California
Collaborators
National Institute of Mental Health (NIMH)
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1. Study Identification

Unique Protocol Identification Number
NCT00260169
Brief Title
Determining Depression Treatment Preferences of Low-Income Latinos in Primary Care Settings
Official Title
Patient-Centered Depression Care in the Public Sector
Study Type
Interventional

2. Study Status

Record Verification Date
December 2013
Overall Recruitment Status
Completed
Study Start Date
November 2005 (undefined)
Primary Completion Date
October 2007 (Actual)
Study Completion Date
January 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Southern California
Collaborators
National Institute of Mental Health (NIMH)

4. Oversight

5. Study Description

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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Depression
Keywords
Treatment Preferences, Public sector, Latino

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
432 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
Participants will receive collaborative care
Arm Title
2
Arm Type
Active Comparator
Arm Description
Participants will receive enhanced usual care
Intervention Type
Behavioral
Intervention Name(s)
Collaborative care treatment
Intervention Description
Patients receiving collaborative care treatment choose 12 weeks of CBT and/or medication management (antidepressants prescribed by patients' primary care provider) from the study depression care specialist (DCS).
Intervention Type
Behavioral
Intervention Name(s)
Enhanced usual care
Intervention Description
Usual care participants are assigned to a 16-week wait-list for the study treatment, during which they are free to receive treatment elsewhere. A letter is given to participants' primary care providers (PCP) that indicates they screened positive for depression. In addition, patients receive an information booklet about depression and a community resource list.
Primary Outcome Measure Information:
Title
Depression treatment preferences as measured by a conjoint analysis survey and qualitative interviews
Time Frame
Measured at Week 16
Secondary Outcome Measure Information:
Title
Depression outcomes as measured by the Patient Health Questionnaire-9
Time Frame
Measured at Week 16

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
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
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Isabel T. Lagomasino, MD, MSHS
Organizational Affiliation
University of Southern California
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Megan Dwight-Johnson, MD, MPH
Organizational Affiliation
VA Medical Center-West Los Angeles
Official's Role
Principal Investigator
Facility Information:
Facility Name
H. Claude Hudson Comprehensive Health Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90007
Country
United States
Facility Name
USC Family Practice Center at California Hospital
City
Los Angeles
State/Province
California
ZIP/Postal Code
90015
Country
United States
Facility Name
LAC+USC Outpatient Department
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
21041350
Citation
Dwight-Johnson M, Lagomasino IT, Hay J, Zhang L, Tang L, Green JM, Duan N. Effectiveness of collaborative care in addressing depression treatment preferences among low-income Latinos. Psychiatr Serv. 2010 Nov;61(11):1112-8. doi: 10.1176/ps.2010.61.11.1112.
Results Reference
result

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

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