Article Figures & Data
Tables
Variables n (%) n 275 Mean Age [SD], years 44.92 [13.61] Mean PHQ-9 [SD], score 18.10 [4.32] Gender Female 202 (73.5) Male 73 (26.5) Race White 171 (62.2) Black/African American 43 (15.6) Asian 4 (1.5) American Indian/Alaskan Native 5 (1.8) Native Hawaiian/Pacific Islander 1 (0.4) More than one race 4 (1.5) Unknown/not reported 47 (17.1) Patient ethnicity Latino 135 (49.1) Not Latino 140 (50.9) Patient's preferred language English 248 (90.2) Spanish 27 (9.8) SD, standard deviation; PHQ-9, Patient Health Questionnaire-9.
- Table 2.
Logistic Regression of Demographic Characteristics Predicting Combined Depression Treatment Recommendations
Variable Model 1 Model 2 Model 3 P = .27 P = .29 P = .04* OR P 95% CI OR P 95% CI OR P 95% CI Constant 1.96 .13 1.76 .22 4.24 .02 Age 0.98 .07 0.97, 1.00 0.98 .06 0.97, 1.00 0.98 .03 0.96, 1.00 Male gender 0.88 .63 0.51, 1.51 0.88 .64 0.51, 1.52 0.92 .76 0.53, 1.60 White race 1.18 .51 0.72, 1.95 1.20 .48 0.73, 1.98 1.20 .47 0.73, 2.00 Latino ethnicity 1.30 .29 0.80, 2.10 1.58 .08 0.94, 2.65 Spanish language 0.39 .04 0.16, 0.95 Classification = 56.7% Classification = 54.2% Classification = 54.2% ↵* P < .05.
OR, odds ratio; CI, confidence interval.
- Table 3.
Logistic Regression of Demographic Characteristics Predicting Depression Treatment Recommendations-Sensitivity Analysis Including Monotherapy
Variable Model 1 Model 2 Model 3 P = .39 P = .04* P = .26 OR P 95% CI OR P 95% CI OR P 95% CI Constant 20.97 .001 41.02 .001 47.47 .001 Age 0.98 .16 0.95, 1.01 0.98 .12 0.95, 1.01 0.98 .08 0.94, 1.00 Male gender 1.57 .33 0.64, 3.86 1.60 .31 0.65, 3.96 1.61 .31 0.65, 3.99 White race 0.98 .96 0.40, 2.38 1.00 .99 0.41, 2.46 0.97 .94 0.39, 2.39 Latino ethnicity 0.40 .05* 0.16, 1.00 0.35 .03 0.14, 0.89 Spanish language 2.29 .30 0.48, 10.91 Classification = 90.9% Classification = 90.9% Classification = 90.9% ↵* P < .05.
OR, odds ratio; CI, confidence interval.
Theme/Subtheme/Frequency Supporting Quotes Perceptions of treatment options Most Latinos (5 Spanish; 4 English) had negative feelings about pharmacotherapy and preferred psychotherapy (4 Spanish; 5 English), although 4 English-speaking Latinos were willing to try depression medication “Me hace mucho daño la medicina y trato de evitarla lo más que puedo. Translation: “Medicine does a lot of damage to me and so I try to avoid it as much as I can.” (Spanish-speaking, White Latina) 3 English-speaking non-Latinos had negative experiences with psychotherapy; 4 preferred pharmacotherapy “Counseling works better for me. I'm taking [depression] medication right now but I don't know if it's working on me…because I still cry a lot. I come out of counseling feeling good.” (English-speaking White Latina) “Medications have definitely helped because the times I run out of refills, there's a noticeable difference. I've tried counseling off and on but it hasn't helped.” (English-speaking, White non-Latino) Receipt of combined treatment recommendation Only 2 Spanish-speaking Latinos received combined treatment recommendations; all 6 received psychotherapy referrals “My doctor actually had someone go with me to behavioral health to set up the appointment on the spot and asked how I felt about depression medication. I said ok and he said he would send a prescription to my pharmacy to try it out” (English-speaking, White non-Latina) Most English-speakers (5 Latinos; 5 non-Latinos) received combined treatment recommendations. “He [doctor] asked about my medication and if I was following through with behavioral health.” (English-speaking White non-Latino) Barriers impacting uptake of treatment recommendations 4 Spanish-speaking Latinos stated that there were no bilingual therapists available; English-speakers (2 Latinos; 2 non-Latinos) stated that appointments were very limited “No podía con el consejero en esos días porque solo había una persona disponible en inglés.Yo hablo ingles pero para sacar tus sentimientos, para sacar todo lo que traes, necesitaba hacerlo en español. Me dijeron que estaban buscando la ayuda también en español. Translation: “I could not see the counselor in those days because there was only one person available in English. I speak English but to get your feelings out, to get out everything you have, I needed to do it in Spanish. They told me that they were looking for help in Spanish as well.” (Bilingual, Spanish-preferred White Latino) English-speakers (2 Latinos; 2 non-Latinos) reported issues with medication refills or requests for medication adjustments “I called separately about Behavioral Health to see if I could get a counselor and I was told that it was all the way backed up until next year” (English-speaking, African-American non-Latino) Interviews conducted with 18 patients: 6 Spanish-speaking Latinos; 6 English-speaking Latinos; 6 English-speaking non-Latinos. Quotes include subgroup language, race, and gender—referring to females as Latina and males as Latino.
