Outcomes for youths from racial-ethnic minority groups in a quality improvement intervention for depression treatment.
OBJECTIVE
This study examined racial-ethnic differences in the impact of the Youth Partners in Care quality improvement intervention. The intervention was designed to improve access to evidence-based depression care, primarily cognitive-behavioral therapy and medication, through primary care. Previous analyses have shown that the quality improvement intervention was associated with improved depression and quality-of-life outcomes at the end of the six-month intervention period.


METHODS
A randomized controlled trial comparing quality improvement and usual care for youths from diverse racial-ethnic groups from five health care organizations, including managed care, the public sector, and academic center clinics, was conducted. Depressed youths (N=325), who self-identified as black (N=59), Latino (N=224), and white (N=42), aged 13-21 years, were included in these analyses. To evaluate intervention effects within racial-ethnic groups, regression models were constructed, which adjusted for baseline and study site variation in depression symptoms, mental health status, satisfaction with mental health care, and mental health service utilization.


RESULTS
Differential intervention effects were found across racial-ethnic groups. Black youths in the intervention group experienced significant reductions in depression symptoms and had higher rates of use of specialty mental health care at the six-month follow-up. Among Latino youths, the intervention was associated with significantly greater satisfaction with care. Intervention effects were weak among white youths.


CONCLUSIONS
Quality improvement interventions may help to reduce disparities in mental health care for youths from racial-ethnic minority groups. (
RAND Corporation, Santa Monica, CA 90407, USA. vngo@rand.org
Victoria K
VK
Ngo
Joan R
JR
Asarnow
Jane
J
Lange
Lisa H
LH
Jaycox
Margaret M
MM
Rea
Christopher
C
Landon
Lingqi
L
Tang
Jeanne
J
Miranda
D000293:Adolescent; D003863:Depression / Q000188:drug therapy* / Q000208:ethnology / Q000628:therapy*; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011785:Quality Assurance, Health Care; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D055815:Young Adult