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

Culturally Focused Psychiatric Consultation Service for Asian American and Latino American Primary Care Patients With Depression

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.

Study Overview

• Status: Completed
• Conditions: Depression
• Intervention / Treatment: Behavioral: Culturally focused psychiatric consultation

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.

• Study Type: Interventional
• Enrollment (Actual): 122
• Phase: Not Applicable

Contacts and Locations

Study Locations

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

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
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).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
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.	6 months after baseline assessment

Secondary Outcome Measures

Outcome Measure	Time Frame
To determine the feasibility and cost associated with implementing a CFP consultation service within a primary care setting at MGH.	Two years after study enrollment began

Collaborators and Investigators

• Sponsor: Massachusetts General Hospital
• Collaborators: Robert Wood Johnson Foundation
• Investigators: Principal Investigator: Nhi-Ha Trinh, M.D., MPH, Massachusetts General Hospital; Principal Investigator: Andres Bedoya, PhD, Massachusetts General Hospital

Publications and helpful links

General Publications

• 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. doi: 10.1097/01.MLR.0000093487.78664.3C.
• 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. doi: 10.1176/ps.2008.59.6.683.
• 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. doi: 10.1002/gps.1566.
• 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. doi: 10.1186/1471-244X-11-166.

Study record dates

Study Major Dates

• Study Start: December 1, 2009
• Primary Completion (Actual): August 1, 2011
• Study Completion (Actual): August 1, 2011

Study Registration Dates

• First Submitted: November 10, 2010
• First Submitted That Met QC Criteria: November 10, 2010
• First Posted (Estimate): November 11, 2010

Study Record Updates

• Last Update Posted (Estimate): October 30, 2014
• Last Update Submitted That Met QC Criteria: October 29, 2014
• Last Verified: April 1, 2012

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Behavioral Symptoms; Depression
• Other Study ID Numbers: 2009-P-000954