Resilience Against Depression Disparities (RADD): a protocol for a randomised comparative effectiveness trial for depression among predominantly low-income, racial/ethnic, sexual and gender minorities

Abstract

IntroductionDepression is the leading cause of adult disability and common among sexual and gender minority (SGM) adults. The current study builds on findings showing the effectiveness of depression quality improvement (QI) and delivery of cognitive behavioural therapy (CBT) skills provided by community health workers in reducing depression. Depression QI approaches across healthcare and social/community services in safety-net settings have shown improvements in mental wellness, mental health quality of life and depression over 12 months. Further, a randomised study showed improved depression among low-income racial/ethnic minorities enrolled in a CBT-informed resiliency class (Building Resilience and Increasing Community Hope (B-RICH)). The current protocol describes a comparativeness effectiveness study to evaluate whether predominantly low-income, SGM racial/ethnic minority adults randomised to a CBT-informed resiliency class have improvements in depressive symptoms over and above community-engaged QI resources and training only.Methods and analysisThe study approached three clusters of four to five programs serving predominantly SGM and racial/ethnic minority communities in the USA: two clusters in Los Angeles, California, and one in New Orleans, Louisiana. Clusters are comprised of one primary care, one mental health and two to three community agencies (eg, faith-based, social services/support, advocacy). All programs received depression QI training. The current study employed a community-partnered participatory research model to adapt the CBT-informed resiliency class, B-RICH+, to SGM communities. Study participants were screened and recruited in person from participating programs, and will complete baseline, 6- and 12-month survey follow-ups. Participants were depressed adults (8-item Patient Health Questionnaire ≥10; ≥18 years of age) who provided contact information. Enrolled participants were individually randomised to B-RICH+ or depression QI alone. Primary outcomes are depressive symptoms; secondary outcomes are mental health quality of life, mental wellness and physical health quality of life. Data collection for this study is ongoing.Ethics and disseminationThe current study was approved by the UCLA Institutional Review Board. Study findings will be disseminated through scientific publications and community conferences.Trial registration number https://clinicaltrials.gov/ct2/show/NCT02986126

Novas perspectivas nas psicoterapias em gays e lésbicas

“…Diferentes modelos teóricos de psicoterapias foram adaptados para as necessidades e demandas das minorias sexuais. A literatura demonstra que intervenções e protocolos baseados nas terapias cognitivocomportamental, interpessoal, psicodinâmica, entre outros, podem ser adaptados e utilizados de forma efetiva para pessoas gays e lésbicas 8,9,10,11,12 . Neste sentido, emerge a psicoterapia afirmativa enquanto modelo transteórico que auxilia o indivíduo na expressão de sua identidade sexual a despeito da não-conformidade com a expectativa social 13,14 .…”

Clinical Outcomes Following Acute Residential Psychiatric Treatment in Transgender and Gender Diverse Adolescents

“…This is important to note as the intersection of gender and racial/ethnic identity may present unique challenges . Future research should focus on the experiences of TGD youth of color to better understand the interaction of these identities and how this might impact treatment outcomes …”

“…15 Future research should focus on the experiences of TGD youth of color to better understand the interaction of these identities and how this might impact treatment outcomes. 38…”

Engaging LGBTQ Communities in Community-Partnered Participatory Research: Lessons from the Resilience Against Depression Disparities Study

“…The RADD study is being conducted by academic and community partners in Los Angeles (LA) and New Orleans (NOLA), Louisiana between October 2016 and March 2021 (Clinicaltrials.gov NCT02986126). 23,24 The RADD study team at both sites have collaborated on mental health disparities research for nearly 15 years in contexts such as post-Katrina NOLA and South LA. [25][26][27][28][29][30][31] The RADD study tested the comparative effectiveness of two LGBTQ-tailored depression interventions on depression outcomes and mental health-related quality of life.…”