Outcomes for Youths From Racial-Ethnic Minority Groups in a Quality Improvement Intervention for Depression Treatment

Abstract

Objective This study examined racial-ethnic differences in the impact of the Youth Partners in Care quality improvement intervention. The intervention was designed to improve access to evidence-based depression care, primarily cognitive-behavioral therapy and medication, through primary care. Previous analyses have shown that the quality improvement intervention was associated with improved depression and quality-of-life outcomes at the end of the six-month intervention period. Methods A randomized controlled trial comparing quality improvement and usual care for youths from diverse racial-ethnic groups from five health care organizations, including managed care, the public sector, and academic center clinics, was conducted. Depressed youths (N=325), who self-identified as black (N=59), Latino (N=224), and white (N=42), aged 13–21 years, were included in these analyses. To evaluate intervention effects within racial-ethnic groups, regression models were constructed, which adjusted for baseline and study site variation in depression symptoms, mental health status, satisfaction with mental health care, and mental health service utilization. Results Differential intervention effects were found across racial-ethnic groups. Black youths in the intervention group experienced significant reductions in depression symptoms and had higher rates of use of specialty mental health care at the six-month follow-up. Among Latino youths, the intervention was associated with significantly greater satisfaction with care. Intervention effects were weak among white youths. Conclusions Quality improvement interventions may help to reduce disparities in mental health care for youths from racial-ethnic minority groups.

Effectiveness of interventions to promote help-seeking for mental health problems: systematic review and meta-analysis

“…Primary care professionals increasingly play a role in providing mental health services (Angermeyer et al , 2017). Some interventions provided training for primary care staff and for improved collaboration between mental health services and primary care, which had long-term effects on mental health service use among individuals in primary care settings (Ngo et al , 2009; Wells et al , 2013). However, short- and medium-term effects of these interventions warrant further research.…”

The Practice of Evidence-Based Treatments in Ethnic Minority Youth

“…In examining the differential effects of the YPIC intervention in Latino, African American, and Caucasian youth, African Americans in YPIC were found to have significantly greater improvement in depressive symptoms than those in usual care, and YPIC Latino adolescents reported significantly greater treatment satisfaction than those in usual care. No intervention effects were found for Caucasian youth[38]. …”

“…This assessment of EBTs should also determine whether or not the intervention relies on techniques or materials that might violate local norms and beliefs or require human, infrastructural, and fiscal resources necessary to implement the EBT. From the summary of interventions presented in this chapter,[E4] there is evidence to suggest that EBTs are effective for ethnic minority populations, and in some cases, more effective than in the majority group[38]. Thus it is prudent for clinicians to choose EBTs over other less well-studied interventions, even if data is not available for the specific population to be treated, unless there is evidence that an EBT is ineffective in that population[20].…”

A Review of Treatments for Young Black Males Experiencing Depression

“…Another service environment quality improvement analysis was conducted by Ngo et al (2009) and utilized the same RCT intervention as Asarnow et al (2009) called the “Youth Partners in Care” study. Ngo et al (2009) sought to track ethnic differences in outcomes.…”