Patient-Centered Depression Care for African Americans

NCT00243425 | Unknown

• 1 other identifier: R01HS013645
• Study Type: interventional
• Target: 250
• Locations: 1 country
• Sites: 5

Brief Summary

The investigators propose to answer the following research question: Does a multifaceted, culturally tailored intervention that focuses on the specific concerns and preferences of African American patients with depression and their primary care providers improve the processes and outcomes of care for African Americans to a greater degree than a standard state-of-the art depression intervention? This study will determine whether two new educational programs can improve the care for depression in African Americans. These programs may include visits with a depression case manager and access to educational materials, such as a videotape, a calendar, pamphlets, and books. One program is a standard quality improvement program for depression that has been shown to be effective in most patients. The other program is similar, but has materials that focus more on the patient's specific culture, beliefs, values, and preferences.

Conditions

Major Depressive Disorder

Keywords

Major Depressive Disorder;; African Americans;; Disparities;; Quality Improvement;; Patient Centered Care;; Primary Care;; Patient-Physician Relationship;

Outcome Measures

Primary Outcomes (1)

• Compare the effectiveness of a culturally tailored intervention with the effectiveness of a standard intervention by evaluating its impact on patient outcomes (remission of depression, depression symptom level, functional status) at 6 and 12 months.

Secondary Outcomes (1)

• Evaluating intervention impact on processes of care (satisfaction of care, guideline concordant care, patient involvement in participatory decision making, communication skills) rated by patients and providers at 6 and 12 months.

Interventions

Standard Quality Improvement PROCEDURE

Patient-centered Intervention PROCEDURE

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients who have experienced two weeks or more of depressed mood/ loss of interest in the past year
• Patients who have experienced one week or more of depressed mood or loss of interest in the past month
• Self defined race or ethnicity African American
• Able to give written consent

You may not qualify if:

• Current alcohol or drug abuse
• History of mania
• Grief reaction or bereavement within the past 2 months
• Pregnancy
• Life expectancy less than 1 year
• Non English speaking
• Current specialty mental health care (at least 2 visits in past 6 weeks and appt scheduled in future
• Plan to change health care or primary care Provider in next 12 months
• Active suicidal thoughts and plans
• Residing in US for less than 5 years

Sponsors & Collaborators

• Agency for Healthcare Research and Quality (AHRQ): lead
• Aetna, Inc.: collaborator
• National Institute of Mental Health (NIMH): collaborator

Study Sites (5)

Christiana Care Health Services

Wilmington, Delaware, 19803, United States

RECRUITING

Johns Hopkins Community Phsyicians

Baltimore, Maryland, 21211, United States

RECRUITING

Sinai Hospital

Baltimore, Maryland, 21215, United States

RECRUITING

Baltimore Medical Systems, Middlesex Health Center

Baltimore, Maryland, 21221, United States

RECRUITING

Johns Hopkins School of Medicine

Baltimore, Maryland, 21287, United States

RECRUITING

Related Publications (9)

• Kaplan SH, Greenfield S, Ware JE Jr. Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Med Care. 1989 Mar;27(3 Suppl):S110-27. doi: 10.1097/00005650-198903001-00010.

  PMID: 2646486 BACKGROUND

• Roter DL, Stewart M, Putnam SM, Lipkin M Jr, Stiles W, Inui TS. Communication patterns of primary care physicians. JAMA. 1997 Jan 22-29;277(4):350-6.

  PMID: 9002500 BACKGROUND

• Gallo JJ, Marino S, Ford D, Anthony JC. Filters on the pathway to mental health care, II. Sociodemographic factors. Psychol Med. 1995 Nov;25(6):1149-60. doi: 10.1017/s0033291700033122.

  PMID: 8637945 BACKGROUND

• Cooper-Patrick L, Crum RM, Ford DE. Characteristics of patients with major depression who received care in general medical and specialty mental health settings. Med Care. 1994 Jan;32(1):15-24. doi: 10.1097/00005650-199401000-00002.

  PMID: 8277799 BACKGROUND

• Cooper-Patrick L, Gallo JJ, Powe NR, Steinwachs DM, Eaton WW, Ford DE. Mental health service utilization by African Americans and Whites: the Baltimore Epidemiologic Catchment Area Follow-Up. Med Care. 1999 Oct;37(10):1034-45. doi: 10.1097/00005650-199910000-00007.

  PMID: 10524370 BACKGROUND

• Cooper LA, Gonzales JJ, Gallo JJ, Rost KM, Meredith LS, Rubenstein LV, Wang NY, Ford DE. The acceptability of treatment for depression among African-American, Hispanic, and white primary care patients. Med Care. 2003 Apr;41(4):479-89. doi: 10.1097/01.MLR.0000053228.58042.E4.

  PMID: 12665712 BACKGROUND

• Cooper LA, Roter DL, Johnson RL, Ford DE, Steinwachs DM, Powe NR. Patient-centered communication, ratings of care, and concordance of patient and physician race. Ann Intern Med. 2003 Dec 2;139(11):907-15. doi: 10.7326/0003-4819-139-11-200312020-00009.

  PMID: 14644893 BACKGROUND

• Cooper-Patrick L, Powe NR, Jenckes MW, Gonzales JJ, Levine DM, Ford DE. Identification of patient attitudes and preferences regarding treatment of depression. J Gen Intern Med. 1997 Jul;12(7):431-8. doi: 10.1046/j.1525-1497.1997.00075.x.

  PMID: 9229282 BACKGROUND

• Cooper LA, Ford DE, Ghods BK, Roter DL, Primm AB, Larson SM, Gill JM, Noronha GJ, Shaya EK, Wang NY. A cluster randomized trial of standard quality improvement versus patient-centered interventions to enhance depression care for African Americans in the primary care setting: study protocol NCT00243425. Implement Sci. 2010 Feb 23;5:18. doi: 10.1186/1748-5908-5-18.

  PMID: 20178624 DERIVED

MeSH Terms

Conditions

Depressive Disorder, Major

Condition Hierarchy (Ancestors)

Depressive Disorder; Mood Disorders; Mental Disorders

Study Officials

• Lisa A Cooper, MD, MPH

  Johns Hopkins University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Bri K Ghods, B.S.

CONTACT

410-522-6500; bghods@jhmi.edu

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: FED

Study Record Dates

• First Submitted: October 21, 2005
• First Posted: October 24, 2005
• Study Start: March 1, 2004
• Study Completion: March 1, 2007
• Last Updated: October 24, 2005

Record last verified: 2005-10

Locations

US (5)