Depression Treatment Preferences of Hispanic Individuals: Exploring the Influence of Ethnicity, Language, and Explanatory Models

作者：Fernandez y Garcia Erik; Franks Peter; Jerant Anthony; Bell Robert A; Kravitz Richard L

来源：Journal of the American Board of Family Medicine, 2011, 24(1): 39-50.

DOI：10.3122/jabfm.2011.01.100118

• Depression
• Illness Representation Models
• Minority Health
• Treatment Preferences

Purpose: There is uncertainty regarding Hispanic individuals' depression treatment preferences, particularly regarding antidepressant medication, the most available primary care option. We assessed whether this uncertainty reflected heterogeneity among subgroups of Hispanic persons and investigated possible mechanisms. Specifically, we examined factors associated with medication preferences in non-Hispanic white and Spanish-speaking and English-speaking Hispanic persons.
Methods: We analyzed data from a follow-up telephone interview of 839 non-Hispanic white and 139 Hispanic respondents originally surveyed via the 2008 California Behavioral Risk Factor Surveillance System. Measures included treatment preferences (for treatment plans including vs not including antidepressants); depression history and current symptoms; sociodemographics; and psychological measures.
Results: Compared with non-Hispanic white respondents (adjusting for age, sex, history of depression diagnosis, and current depression symptoms), Spanish-speaking Hispanic (adjusted odds ratio [AOR] 0.41; 95% CI, 0.19-0.90) but not English-speaking Hispanic (AOR, 1.18; 95% CI, 0.60-2.33) respondents had a lower preference for antidepressant inclusive options. Endorsing a biomedical explanation of depression was associated with a preference for antidepressant inclusive options (AOR, 4.76; 95% CI, 3.13-7.14) for all respondents and accounted for the effect of Spanish-language interview. Accounting for other factors did not change these relationships, although older age and history of depression diagnosis remained significant predictors of antidepressant inclusive treatment preference for all respondents.
Conclusions: Spanish-language interview and less belief in a biomedical explanation for depression were associated with Hispanic respondents' lower preferences for pharmacologic treatment of depression; ethnicity was not. Understanding treatment preferences and illness beliefs could help optimize depression treatment in primary care. (J Am Board Fam Med 2011;24:39-50.)

• 出版日期2011-2