Variations in depression care and outcomes among high-risk mothers from different racial/ethnic groups

Hsiang Huang, Ya Fen Chan, Wayne Katon, Karen Tabb, Nida Sieu, Amy M. Bauer, Jessica Knaster Wasse, Jürgen Unützer

Research output: Contribution to journalArticle

Abstract

Purpose. To examine variations in depression care and outcomes among high-risk pregnant and parenting women from different racial/ethnic groups served in community health centres.Methods. As part of a collaborative care programme that provides depression treatment in primary care clinics for high-risk mothers, 661 women with probable depression (Patient Health Questionnaire-9 ≥ 10), who self-reported race/ethnicity as Latina (n = 393), White (n = 126), Black (n = 75) or Asian (n = 67), were included in the study. Primary outcomes include quality of depression care and improvement in depression. A Cox proportional hazard model adjusting for sociodemographic and clinical characteristics was used to examine time to treatment response.Results. We observed significant differences in both depression processes and outcomes across ethnic groups. After adjusting for other variables, Blacks were found to be significantly less likely to improve than Latinas [hazard ratio (HR): 0.53, 95% confidence interval (CI): 0.44-0.65]. Other factors significantly associated with depression improvement were pregnancy (HR: 1.52, 95% CI: 1.27-1.82), number of clinic visits (HR: 1.26, 95% CI: 1.17-1.36) and phone contacts (HR: 1.45, 95% CI: 1.32-1.60) by the care manager in the first month of treatment. After controlling for depression severity, having suicidal thoughts at baseline was significantly associated with a decreased likelihood of depression improvement (HR: 0.75, 95% CI: 0.67-0.83).Conclusions. In this racially and ethnically diverse sample of pregnant and parenting women treated for depression in primary care, the intensity of care management was positively associated with improved depression. There was also appreciable variation in depression outcomes between Latina and Black patients.

Original languageEnglish (US)
Pages (from-to)394-400
Number of pages7
JournalFamily Practice
Volume29
Issue number4
DOIs
StatePublished - Aug 1 2012
Externally publishedYes

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Ethnic Groups
Mothers
Depression
Confidence Intervals
Hispanic Americans
Parenting
Pregnant Women
Primary Health Care
Community Health Centers
Quality of Health Care
Ambulatory Care
Quality Improvement
Proportional Hazards Models
Therapeutics
Pregnancy

Keywords

  • Collaborative care
  • Depression care
  • Mental health disparities

ASJC Scopus subject areas

  • Family Practice

Cite this

Variations in depression care and outcomes among high-risk mothers from different racial/ethnic groups. / Huang, Hsiang; Chan, Ya Fen; Katon, Wayne; Tabb, Karen; Sieu, Nida; Bauer, Amy M.; Wasse, Jessica Knaster; Unützer, Jürgen.

In: Family Practice, Vol. 29, No. 4, 01.08.2012, p. 394-400.

Research output: Contribution to journalArticle

Huang, H, Chan, YF, Katon, W, Tabb, K, Sieu, N, Bauer, AM, Wasse, JK & Unützer, J 2012, 'Variations in depression care and outcomes among high-risk mothers from different racial/ethnic groups', Family Practice, vol. 29, no. 4, pp. 394-400. https://doi.org/10.1093/fampra/cmr108
Huang, Hsiang ; Chan, Ya Fen ; Katon, Wayne ; Tabb, Karen ; Sieu, Nida ; Bauer, Amy M. ; Wasse, Jessica Knaster ; Unützer, Jürgen. / Variations in depression care and outcomes among high-risk mothers from different racial/ethnic groups. In: Family Practice. 2012 ; Vol. 29, No. 4. pp. 394-400.
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abstract = "Purpose. To examine variations in depression care and outcomes among high-risk pregnant and parenting women from different racial/ethnic groups served in community health centres.Methods. As part of a collaborative care programme that provides depression treatment in primary care clinics for high-risk mothers, 661 women with probable depression (Patient Health Questionnaire-9 ≥ 10), who self-reported race/ethnicity as Latina (n = 393), White (n = 126), Black (n = 75) or Asian (n = 67), were included in the study. Primary outcomes include quality of depression care and improvement in depression. A Cox proportional hazard model adjusting for sociodemographic and clinical characteristics was used to examine time to treatment response.Results. We observed significant differences in both depression processes and outcomes across ethnic groups. After adjusting for other variables, Blacks were found to be significantly less likely to improve than Latinas [hazard ratio (HR): 0.53, 95{\%} confidence interval (CI): 0.44-0.65]. Other factors significantly associated with depression improvement were pregnancy (HR: 1.52, 95{\%} CI: 1.27-1.82), number of clinic visits (HR: 1.26, 95{\%} CI: 1.17-1.36) and phone contacts (HR: 1.45, 95{\%} CI: 1.32-1.60) by the care manager in the first month of treatment. After controlling for depression severity, having suicidal thoughts at baseline was significantly associated with a decreased likelihood of depression improvement (HR: 0.75, 95{\%} CI: 0.67-0.83).Conclusions. In this racially and ethnically diverse sample of pregnant and parenting women treated for depression in primary care, the intensity of care management was positively associated with improved depression. There was also appreciable variation in depression outcomes between Latina and Black patients.",
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AU - Huang, Hsiang

AU - Chan, Ya Fen

AU - Katon, Wayne

AU - Tabb, Karen

AU - Sieu, Nida

AU - Bauer, Amy M.

AU - Wasse, Jessica Knaster

AU - Unützer, Jürgen

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N2 - Purpose. To examine variations in depression care and outcomes among high-risk pregnant and parenting women from different racial/ethnic groups served in community health centres.Methods. As part of a collaborative care programme that provides depression treatment in primary care clinics for high-risk mothers, 661 women with probable depression (Patient Health Questionnaire-9 ≥ 10), who self-reported race/ethnicity as Latina (n = 393), White (n = 126), Black (n = 75) or Asian (n = 67), were included in the study. Primary outcomes include quality of depression care and improvement in depression. A Cox proportional hazard model adjusting for sociodemographic and clinical characteristics was used to examine time to treatment response.Results. We observed significant differences in both depression processes and outcomes across ethnic groups. After adjusting for other variables, Blacks were found to be significantly less likely to improve than Latinas [hazard ratio (HR): 0.53, 95% confidence interval (CI): 0.44-0.65]. Other factors significantly associated with depression improvement were pregnancy (HR: 1.52, 95% CI: 1.27-1.82), number of clinic visits (HR: 1.26, 95% CI: 1.17-1.36) and phone contacts (HR: 1.45, 95% CI: 1.32-1.60) by the care manager in the first month of treatment. After controlling for depression severity, having suicidal thoughts at baseline was significantly associated with a decreased likelihood of depression improvement (HR: 0.75, 95% CI: 0.67-0.83).Conclusions. In this racially and ethnically diverse sample of pregnant and parenting women treated for depression in primary care, the intensity of care management was positively associated with improved depression. There was also appreciable variation in depression outcomes between Latina and Black patients.

AB - Purpose. To examine variations in depression care and outcomes among high-risk pregnant and parenting women from different racial/ethnic groups served in community health centres.Methods. As part of a collaborative care programme that provides depression treatment in primary care clinics for high-risk mothers, 661 women with probable depression (Patient Health Questionnaire-9 ≥ 10), who self-reported race/ethnicity as Latina (n = 393), White (n = 126), Black (n = 75) or Asian (n = 67), were included in the study. Primary outcomes include quality of depression care and improvement in depression. A Cox proportional hazard model adjusting for sociodemographic and clinical characteristics was used to examine time to treatment response.Results. We observed significant differences in both depression processes and outcomes across ethnic groups. After adjusting for other variables, Blacks were found to be significantly less likely to improve than Latinas [hazard ratio (HR): 0.53, 95% confidence interval (CI): 0.44-0.65]. Other factors significantly associated with depression improvement were pregnancy (HR: 1.52, 95% CI: 1.27-1.82), number of clinic visits (HR: 1.26, 95% CI: 1.17-1.36) and phone contacts (HR: 1.45, 95% CI: 1.32-1.60) by the care manager in the first month of treatment. After controlling for depression severity, having suicidal thoughts at baseline was significantly associated with a decreased likelihood of depression improvement (HR: 0.75, 95% CI: 0.67-0.83).Conclusions. In this racially and ethnically diverse sample of pregnant and parenting women treated for depression in primary care, the intensity of care management was positively associated with improved depression. There was also appreciable variation in depression outcomes between Latina and Black patients.

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KW - Mental health disparities

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