title: Depression treatment preferences of Hispanic individuals: exploring the influence of ethnicity, language, and explanatory models.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Pediatrics, Division of General Pediatrics, University of California-Davis School of Medicine, USA. Erik.fernandez@ucdmc.ucdavis.edu
authors.forename: Erik
authors.initials: E
authors.lastname: Fernandez Y Garcia
authors.forename: Peter
authors.initials: P
authors.lastname: Franks
authors.forename: Anthony
authors.initials: A
authors.lastname: Jerant
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bell
authors.forename: Richard L
authors.initials: RL
authors.lastname: Kravitz
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001521:Behavior Therapy; D002140:California / Q000453:epidemiology; D016001:Confidence Intervals; D003657:Decision Making; D003863:Depression / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D005006:Ethnicity / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007406:Interview, Psychological; D007802:Language; D008297:Male; D008875:Middle Aged; D054525:Minority Health; D008960:Models, Psychological; D016017:Odds Ratio; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011594:Psychometrics; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D000928:Antidepressive Agents