Enhancing Hispanic participation in mental health clinical research: development of a Spanish-speaking depression research site

• Type of Material: Article
• Authors: Vivianne Aponte-Rivera, Emory University; Boadie W Dunlop, Emory University; Cynthia Ramirez, Emory University; Mary Kelley, Emory University; Rebecca Schneider, Emory University; Beatriz Blastos, Emory University; Jacqueline Larson, Emory University; Flavia Mercado, Emory University; Helen Mayberg, Emory University; W Edward Craighead, Emory University
• Language: English
• Date: 2014-03-01
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2013 Wiley Periodicals, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1002/da.22153
• Title of Journal or Parent Work: Depression and Anxiety
• ISSN: 1091-4269
• Volume: 31
• Issue: 3
• Start Page: 258
• End Page: 267
• Grant/Funding Information: Additional support was received from GCRC Grant PHS Grant UL1 RR025008 from the Clinical and Translational Science Award program; and PHS Grant M01 RR0039 from the General Clinical Research Center program; National Institutes of Health; National Center for Research Resources; and K23 MH086690 (BWD).; Funding for the study derived from two grants from the National Institute of Mental Health, P50 MH077083 and RO1 MH080880.; Forest Labs and Eli Lilly Inc donated the study medications, escitalopram and duloxetine, respectively used in this study, and are otherwise uninvolved in study design, data collection or data analysis, or interpretation of findings.
• Keywords: CARE; ETHNICITY; RECRUITMENT; Life Sciences & Biomedicine; STAR-ASTERISK-D; AFRICAN-AMERICAN; culture; LATINOS; research subject recruitment; Hispanic Americans; Psychology; Psychology, Clinical; RESOURCES; TRIAL; Science & Technology; Social Sciences; minority groups; major depressive disorder; POPULATIONS; Psychiatry; UNITED-STATES
• Research Categories: Health Sciences, Mental Health; Psychology, Clinical

Abstract

Background: Hispanics, particularly those with limited English proficiency, are underrepresented in psychiatric clinical research studies. We developed a bilingual and bicultural research clinic dedicated to the recruitment and treatment of Spanish-speaking subjects in the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study, a large clinical trial of treatment-naïve subjects with major depressive disorder (MDD). Methods: Demographic and clinical data derived from screening evaluations of the first 1,174 subjects presenting for participation were compared between the Spanish-speaking site (N = 275) and the primary English-speaking site (N = 899). Reasons for ineligibility (N = 888) for the PReDICT study were tallied for each site. Results: Compared to English speakers, Spanish speakers had a lower level of education and were more likely to be female, uninsured, and have uncontrolled medical conditions. Clinically, Spanish speakers demonstrated greater depression severity, with higher mean symptom severity scores, and a greater number of previous suicide attempts. Among the subjects who were not randomized into the PReDICT study, Spanish-speaking subjects were more likely to have an uncontrolled medical condition or refuse participation, whereas English-speaking subjects were more likely to have bipolar disorder or a non-MDD depressive disorder. Conclusion: Recruitment of Hispanic subjects with MDD is feasible and may enhance efforts at signal detection, given the higher severity of depression among Spanish-speaking participants presenting for clinical trials. Specific approaches for the recruitment and retention of Spanish-speaking participants are required.