Depression treatment preferences by race/ethnicity and gender and associations between past healthcare discrimination experiences and present preferences in a nationally representative sample

Sonik, Rajan A.; Creedon, Timothy B.; Progovac, Ana M.; Carson, Nicholas; Delman, Jonathan; Delman, Deborah; Cook, Benjamin Lê; Soffer, Tali Fleitman; Chambers, Valeria; Quinerly, Catherine Rodriguez; Mann, Ziva; Nabisere, Ruth; Shaikh, Farah N.; Jordan, Dierdre; Moradi, Alireza; Castro, Selma de; Abolaban, Heba; Lee, Esther; Hou, Sherry Shu-Yeu; Busch, Susan H.; Carle, Adam C.; Cortés, Dharma E.; McCormick, Danny; Flores, Michael; Román, María José Sánchez; Lu, Frederick; Kaushal, Natasha

doi:10.1016/j.socscimed.2020.112939

Cited by 20 publications

(11 citation statements)

References 37 publications

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“…(Check all that apply: race/color, ethnicity, language/accent, sexual orientation, and gender).” Survey results showed that health care discrimination experiences were much more common for Black and Hispanic/Latino respondents. Moreover, and contrary to prior studies in primary care settings, this community-based sample reported no significant differences by race/ethnicity in preferences between medication versus talk therapy for treatment of depression, except in cases where Black respondents had also experienced discrimination (Sonik et al, 2020).…”

Section: Introductioncontrasting

confidence: 99%

Understanding the Role of Past Health Care Discrimination in Help-Seeking and Shared Decision-Making for Depression Treatment Preferences

Progovac

Cortés

Chambers³

et al. 2020

Qual Health Res

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As a part of a larger, mixed-methods research study, we conducted semi-structured interviews with 21 adults with depressive symptoms to understand the role that past health care discrimination plays in shaping help-seeking for depression treatment and receiving preferred treatment modalities. We recruited to achieve heterogeneity of racial/ethnic backgrounds and history of health care discrimination in our participant sample. Participants were Hispanic/Latino ( n = 4), non-Hispanic/Latino Black ( n = 8), or non-Hispanic/Latino White ( n = 9). Twelve reported health care discrimination due to race/ethnicity, language, perceived social class, and/or mental health diagnosis. Health care discrimination exacerbated barriers to initiating and continuing depression treatment among patients from diverse backgrounds or with stigmatized mental health conditions. Treatment preferences emerged as fluid and shaped by shared decisions made within a trustworthy patient–provider relationship. However, patients who had experienced health care discrimination faced greater challenges to forming trusting relationships with providers and thus engaging in shared decision-making processes.

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Section: Introductioncontrasting

confidence: 99%

Understanding the Role of Past Health Care Discrimination in Help-Seeking and Shared Decision-Making for Depression Treatment Preferences

Progovac

Cortés

Chambers³

et al. 2020

Qual Health Res

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“…Perceiving discrimination may contribute to decreased provider visits ( Facione & Facione, 2007 ) and reduced utilization of preventive healthcare services ( Trivedi & Ayanian, 2006 ). Moreover, patient experiences of discrimination are associated with delays in filling prescriptions, treatment nonadherence, and varied treatment preference ( Burgess et al, 2007 ; Casagrande et al, 2007 ; Progovac et al, 2020 ; Sonik et al, 2020 ). For example, Alcalá and Cook (2018) found that perceived racial or ethnic discrimination in healthcare in the US was associated with higher odds of delaying or forgoing medical care or prescriptions in the past 12 months.…”

Section: Introductionmentioning

confidence: 99%

Perceived healthcare discrimination and well-being among older adults in the United States and Brazil

Dixon

Adams

2022

SSM - Population Health

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“…First, analyses of prescriber data should account for patient preference. Although provider bias may influence antidepressant prescription, other factors including cultural attitudes, mental health stigma, and experiences of discrimination may contribute to refusal of antidepressants [17][18][19][20]. Second, diagnostic disclosure and consent to treatment deserve careful consideration for fostering patient trust [21], particularly among patient populations that have experienced exclusion and oppression within the institutions of medicine.…”

Section: Discussionmentioning

confidence: 99%

Racial and Ethnic Differences in Psychiatry Resident Prescribing: a Quality Improvement Education Intervention to Address Health Equity

et al. 2021

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Objective Quality improvement (QI) tools can identify and address health disparities. This paper describes the use of resident prescriber profiles in a novel QI curriculum to identify racial and ethnic differences in antidepressant and antipsychotic prescribing. Methods The authors extracted medication orders written by 111 psychiatry residents over an 18-month period from an electronic medical record and reformatted these into 6133 unique patient encounters. Binomial logistic models adjusted for covariates assessed racial and ethnic differences in antipsychotic or antidepressant prescribing in both emergency and inpatient psychiatric encounters. A multinomial model adjusted for covariates then assessed racial and ethnic differences in primary diagnosis. Models also examined interactions between gender and race/ethnicity. Results Black (adjusted OR 0.66; 95% CI, 0.50-0.87; p < 0.01) and Latinx (adjusted OR, 0.65; 95% CI, 0.49-0.86; p < 0.01) patients had lower odds of receiving antidepressants relative to White patients despite diagnosis. Black and Latinx patients were no more likely to receive antipsychotics than White patients when adjusted for diagnosis. Black (adjusted OR 3.85; 95% CI, 2.9-5.2) and Latinx (adjusted OR 1.60; 95% CI, 1.1-2.3) patients were more likely to receive a psychosis than a depression diagnosis when compared to White patients. Gender interactions with race/ethnicity did not significantly change results. Conclusions Our findings suggest that racial/ethnic differences in antidepressant prescription likely result from alternatively higher diagnosis of psychotic disorders and prescription of antipsychotics in Black and Latinx patients. Prescriber profiles can serve as a powerful tool to promote resident QI learning around the effects of structural racism on clinical care.

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Depression treatment preferences by race/ethnicity and gender and associations between past healthcare discrimination experiences and present preferences in a nationally representative sample

Cited by 20 publications

References 37 publications

Understanding the Role of Past Health Care Discrimination in Help-Seeking and Shared Decision-Making for Depression Treatment Preferences

Understanding the Role of Past Health Care Discrimination in Help-Seeking and Shared Decision-Making for Depression Treatment Preferences

Perceived healthcare discrimination and well-being among older adults in the United States and Brazil

Racial and Ethnic Differences in Psychiatry Resident Prescribing: a Quality Improvement Education Intervention to Address Health Equity

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