title: How quality improvement interventions for depression affect stigma concerns over time: a nine-year follow-up study.
abstract: OBJECTIVE
  This study examined the long-term impact on stigma concerns of two quality improvement (QI) interventions for depression in primary care.
  
  
  METHODS
  Data were from a nine-year follow-up of 805 participants in Partners in Care, a group-level randomized trial comparing patients enrolled in interventions with enhanced resources for therapy (QI-therapy) (N=284) or medication management (QI-meds) (N=267) with those in usual care (N=254). Participants were asked about stigma in regard to friends, health insurance, and employers.
  
  
  RESULTS
  Individuals in QI-therapy were significantly less likely than those in usual care and QI-meds to report concerns about friends learning about a history of depression (odds ratio [OR]=.66 and .65, respectively), and those in QI-meds were more likely than those in QI-therapy and usual care to have concerns about getting insurance (OR=1.42 and 1.68, respectively).
  
  
  CONCLUSIONS
  Quality improvement programs for depression can raise or lower stigma concerns, depending on program design and resources for specific treatments.
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, 10920 Wilshire Blvd., Suite 300, Los Angeles, CA 90024, USA. ruth@soc.ucla.edu
authors.forename: Ruth
authors.initials: R
authors.lastname: Klap
authors.forename: Lingqi
authors.initials: L
authors.lastname: Tang
authors.forename: Terry
authors.initials: T
authors.lastname: Schell
authors.forename: Naihua
authors.initials: N
authors.lastname: Duan
authors.forename: Kenneth
authors.initials: K
authors.lastname: Wells
authors.forename: Jeanne
authors.initials: J
authors.lastname: Miranda
authors.forename: Cathy
authors.initials: C
authors.lastname: Sherbourne
mesh_terms: D003863:Depression / Q000188:drug therapy / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D011320:Primary Health Care / Q000379:methods*; D011785:Quality Assurance, Health Care; D013240:Stereotyping