Culturally-focused Consultation for Asian Americans and Latino Americans - Full Text View

Purpose

The purpose of this study is to determine if a culturally focused psychiatric (CFP) consultation service can improve depressive symptoms and increase diagnosis and treatment of depression in Asian American and Latino American primary care patients at the Massachusetts General Hospital.

Condition	Intervention
Depression	Behavioral: Culturally focused psychiatric consultation

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	Culturally Focused Psychiatric Consultation Service for Asian American and Latino American Primary Care Patients With Depression

Resource links provided by NLM:

MedlinePlus related topics: Asian American Health Depression Mental Health

U.S. FDA Resources

Further study details as provided by Massachusetts General Hospital:

Primary Outcome Measures:

To determine if a culturally focused psychiatric (CFP) consultation service can improve depressive symptoms and increase diagnosis and treatment of depression in Asian American and Latino American primary care patients at MGH. [ Time Frame: 6 months after baseline assessment ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

To determine the feasibility and cost associated with implementing a CFP consultation service within a primary care setting at MGH. [ Time Frame: Two years after study enrollment began ] [ Designated as safety issue: No ]

Enrollment:	122
Study Start Date:	December 2009
Study Completion Date:	August 2011
Primary Completion Date:	August 2011 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
No Intervention: Treatment as usual The treatment as usual arm consists of two phone or in-person interviews: Patients are asked questions about their mental health, their views of mental health, and how they cope with their mental health (including any treatment they might be receiving). Patients are asked the same questions 6 months after the initial interview.
Experimental: Culturally focused psychiatric consultation The consultation is comprised of 3 visits: 1a. Psychiatric diagnostic interview, self-rated questionnaires (in-person consultation). 1b. Intervention focused on learning about depression and how to treat it using culturally relevant resources. 2. Follow-up visit two weeks later to go over patients' questions, homework if applicable, and patients' ability to meet the goals outlined in the first visit (in-person or phone visit). 3. 6-month follow up: 6 months after the initial consultation, patients are asked about mental health symptoms and mental health treatment they might be receiving (phone visit unless patient requests in-person).	Behavioral: Culturally focused psychiatric consultation The consultation is comprised of 3 visits: 1a. Psychiatric diagnostic interview, self-rated questionnaires (in-person consultation). 1b. Intervention focused on learning about depression and how to treat it using culturally relevant resources. 2. Follow-up visit two weeks later to go over patients' questions, homework if applicable, and patients' ability to meet the goals outlined in the first visit (in-person or phone visit). 3. 6-month follow up: 6 months after the initial consultation, patients are asked about mental health symptoms and mental health treatment they might be receiving (phone visit unless patient requests in-person).

Arms

Assigned Interventions

No Intervention: Treatment as usual

The treatment as usual arm consists of two phone or in-person interviews:

Patients are asked questions about their mental health, their views of mental health, and how they cope with their mental health (including any treatment they might be receiving).
Patients are asked the same questions 6 months after the initial interview.

Experimental: Culturally focused psychiatric consultation

The consultation is comprised of 3 visits:

1a. Psychiatric diagnostic interview, self-rated questionnaires (in-person consultation).

1b. Intervention focused on learning about depression and how to treat it using culturally relevant resources.

2. Follow-up visit two weeks later to go over patients' questions, homework if applicable, and patients' ability to meet the goals outlined in the first visit (in-person or phone visit).

3. 6-month follow up: 6 months after the initial consultation, patients are asked about mental health symptoms and mental health treatment they might be receiving (phone visit unless patient requests in-person).

Behavioral: Culturally focused psychiatric consultation

The consultation is comprised of 3 visits:

1a. Psychiatric diagnostic interview, self-rated questionnaires (in-person consultation).

1b. Intervention focused on learning about depression and how to treat it using culturally relevant resources.

2. Follow-up visit two weeks later to go over patients' questions, homework if applicable, and patients' ability to meet the goals outlined in the first visit (in-person or phone visit).

3. 6-month follow up: 6 months after the initial consultation, patients are asked about mental health symptoms and mental health treatment they might be receiving (phone visit unless patient requests in-person).

Detailed Description:

This study's aim is to determine if a culturally focused mental health consultation will help Latino and Asian Americans who are experiencing sadness, stress, or other symptoms of depression. Eligible adults must already have a primary care physician at Massachusetts General Hospital.

In this study, patients will be randomly assigned, like the flip of a coin, to receive the culturally focused intervention or treatment as usual. Those who receive the intervention will have three sessions with study personnel, during which they will generally discuss and learn techniques for dealing with their mental health. Those who receive treatment as usual, meaning the regular care they receive through their primary care practice, will have two sessions with study personnel during which they will generally discuss their mental health. All study visits and patient materials are provided in patients' language of choice - English, Spanish, Mandarin, Cantonese, or Vietnamese. All patients will be compensated for completing study visits.

About half of the study patients in both arms will also be invited to participate in optional qualitative interviews, in which they will be asked questions about their expectations for the research study and their ideas for improving culturally sensitive mental health services. In addition, a small sample of Asian American patients who did not participate in the study but who have PCPs at the sites where the study was conducted will be contacted for a qualitative interview. This interview will address reasons why Asian American recruitment for the study was so challenging.

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Capable of giving informed consent
Adults 18 years of age or older
Members of either Asian American or Latino American minority groups
Currently experiencing depressive symptoms

Exclusion Criteria:

Active unstable, untreated psychiatric illness precluding participation in study

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT01239407

Locations

United States, Massachusetts
Massachusetts General Hospital
Boston, Massachusetts, United States, 02114

Sponsors and Collaborators

Massachusetts General Hospital

Robert Wood Johnson Foundation

Investigators

Principal Investigator:	Nhi-Ha Trinh, M.D., MPH	Massachusetts General Hospital
Principal Investigator:	Andres Bedoya, PhD	Massachusetts General Hospital

More Information

Additional Information:

Description of research study on MGH website This link exits the ClinicalTrials.gov site

Publications:

Kirmayer LJ, Thombs BD, Jurcik T, Jarvis GE, Guzder J. Use of an expanded version of the DSM-IV outline for cultural formulation on a cultural consultation service. Psychiatr Serv. 2008 Jun;59(6):683-6.

Yeung A, Yu SC, Fung F, Vorono S, Fava M. Recognizing and engaging depressed Chinese Americans in treatment in a primary care setting. Int J Geriatr Psychiatry. 2006 Sep;21(9):819-23.

Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003 Nov;41(11):1284-92.

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Trinh NH, Bedoya CA, Chang TE, Flaherty K, Fava M, Yeung A. A study of a culturally focused psychiatric consultation service for Asian American and Latino American primary care patients with depression. BMC Psychiatry. 2011 Oct 13;11:166.

Responsible Party:	Nhi-Ha T. Trinh, Staff psychiatrist, Massachusetts General Hospital
ClinicalTrials.gov Identifier:	NCT01239407 History of Changes
Other Study ID Numbers:	2009-P-000954
Study First Received:	November 10, 2010
Last Updated:	April 18, 2012
Health Authority:	United States: Institutional Review Board

Additional relevant MeSH terms:

Depression
Depressive Disorder
Behavioral Symptoms
Mood Disorders
Mental Disorders

ClinicalTrials.gov processed this record on May 21, 2013

Culturally-focused Consultation for Asian Americans and Latino Americans (CFP)