title: Encouraging patients with depressive symptoms to seek care: a mixed methods approach to message development.
abstract: OBJECTIVE
  To assess the message preferences of individuals affected by depression as part of a project that will evaluate interventions to encourage at-risk patients to talk to their physicians about depression.
  
  
  METHODS
  Adaptive Conjoint Analysis (ACA) of 32 messages defined by 10 message attributes. Messages were developed based on input from three focus groups comprised of individuals with a personal and/or family history of depression, then tested using volunteers from an Internet health community. In an online conjoint survey, 249 respondents with depression rated their liking of the messages constructed for each attribute. They were then presented with two message sets and rated their preferences. Preference utilities were generated using hierarchical Bayes estimation.
  
  
  RESULTS
  The optimal communication approach described both psychological and physical symptoms of depression, recognized multiple treatment options, offered lifetime prevalence data, noted that depression can affect anyone, and acknowledged that finding an effective treatment can take time.
  
  
  CONCLUSIONS
  Individuals with depression respond differently to depression care messages, underscoring the need for careful message development and evaluation.
  
  
  CONCLUSIONS
  ACA, used in conjunction with focus groups, is a promising approach for developing and testing messages in the formative research stage of intervention development.
authors.affiliation: Department of Communication, University of California, Davis, CA 95616, USA. rabell@ucdavis.edu
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bell
authors.forename: Debora A
authors.initials: DA
authors.lastname: Paterniti
authors.forename: Rahman
authors.initials: R
authors.lastname: Azari
authors.forename: Paul R
authors.initials: PR
authors.lastname: Duberstein
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Epstein
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Rochlen
authors.forename: Megan Dwight
authors.initials: MD
authors.lastname: Johnson
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Orrange
authors.forename: Christina
authors.initials: C
authors.lastname: Slee
authors.forename: Richard L
authors.initials: RL
authors.lastname: Kravitz
mesh_terms: D000293:Adolescent; D000328:Adult; D003625:Data Collection; D003661:Decision Support Techniques; D003863:Depression / Q000175:diagnosis* / Q000628:therapy; D003866:Depressive Disorder / Q000175:diagnosis*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
references.citation: J Clin Psychiatry. 2007;68 Suppl 2:36-41
references.pmid: 17288506
references.citation: Psychol Med. 2006 Sep;36(9):1225-33
references.pmid: 16707028
references.citation: Arch Intern Med. 1997 May 26;157(10):1113-20
references.pmid: 9164377
references.citation: BMC Fam Pract. 2008 May 05;9:25
references.pmid: 18454878
references.citation: BMC Public Health. 2006 Aug 22;6:215
references.pmid: 16923195
references.citation: Am J Med. 2003 Jan;114(1):15-9
references.pmid: 12543284
references.citation: Psychol Med. 2007 Sep;37(9):1239-48
references.pmid: 17559705
references.citation: Ann Intern Med. 2000 May 2;132(9):743-56
references.pmid: 10787370
references.citation: Curr Psychiatry Rep. 2007 Dec;9(6):449-59
references.pmid: 18221624
references.citation: Annu Rev Med. 1996;47:473-9
references.pmid: 8712797
references.citation: Br J Gen Pract. 1999 Feb;49(439):99-102
references.pmid: 10326259
references.citation: Br J Psychiatry. 1998 Dec;173:519-22
references.pmid: 9926082
references.citation: J Fam Pract. 1993 Oct;37(4):337-44
references.pmid: 8409886
references.citation: Psychiatr Serv. 2006 Sep;57(9):1304-8
references.pmid: 16968760
references.citation: Int Rev Psychiatry. 2003 Feb-May;15(1-2):65-73
references.pmid: 12745312
references.citation: Nurs Res. 2008 May-Jun;57(3):220-4
references.pmid: 18496108
references.citation: Aust N Z J Psychiatry. 2005 Apr;39(4):248-54
references.pmid: 15777361
references.citation: Health Technol Assess. 2001;5(5):1-186
references.pmid: 11262422
references.citation: BMJ. 2006 Apr 29;332(7548):1030-2
references.pmid: 16644834
references.citation: BMJ. 2006 Apr 29;332(7548):985-6
references.pmid: 16644810
references.citation: Health Expect. 1998 Nov;1(2):117-129
references.pmid: 11281866
references.citation: J Card Fail. 2000 Sep;6(3):225-32
references.pmid: 10997749
references.citation: Psychol Med. 2007 Mar;37(3):363-72
references.pmid: 17311685
references.citation: Arch Gen Psychiatry. 2005 Jun;62(6):629-40
references.pmid: 15939840
references.citation: Patient Educ Couns. 2005 Jan;56(1):16-20
references.pmid: 15590218
references.citation: Soc Psychiatry Psychiatr Epidemiol. 2001 Sep;36(9):423-8
references.pmid: 11766973
references.citation: Patient Educ Couns. 2007 Feb;65(2):237-44
references.pmid: 16965888
references.citation: Am J Med Qual. 2004 Jan-Feb;19(1):28-36
references.pmid: 14977023
references.citation: Prim Care Companion J Clin Psychiatry. 2005;7(4):167-76
references.pmid: 16163400
references.citation: J Psychosom Res. 2002 Oct;53(4):849-57
references.pmid: 12377293
references.citation: J Clin Oncol. 2007 Feb 20;25(6):715-23
references.pmid: 17308275
references.citation: Public Health Rep. 2008 Sep-Oct;123(5):646-51
references.pmid: 18828420
references.citation: Gen Hosp Psychiatry. 2008 Jul-Aug;30(4):293-302
references.pmid: 18585531
references.citation: J Psychosoc Nurs Ment Health Serv. 2009 Jan;47(1):17-20
references.pmid: 19227105
references.citation: Psychiatr Serv. 2004 Aug;55(8):934-6
references.pmid: 15292545