title: Enhancing Hispanic participation in mental health clinical research: development of a Spanish-speaking depression research site.
abstract: BACKGROUND
  Hispanics, particularly those with limited English proficiency, are underrepresented in psychiatric clinical research studies. We developed a bilingual and bicultural research clinic dedicated to the recruitment and treatment of Spanish-speaking subjects in the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study, a large clinical trial of treatment-naïve subjects with major depressive disorder (MDD).
  
  
  METHODS
  Demographic and clinical data derived from screening evaluations of the first 1,174 subjects presenting for participation were compared between the Spanish-speaking site (N = 275) and the primary English-speaking site (N = 899). Reasons for ineligibility (N = 888) for the PReDICT study were tallied for each site.
  
  
  RESULTS
  Compared to English speakers, Spanish speakers had a lower level of education and were more likely to be female, uninsured, and have uncontrolled medical conditions. Clinically, Spanish speakers demonstrated greater depression severity, with higher mean symptom severity scores, and a greater number of previous suicide attempts. Among the subjects who were not randomized into the PReDICT study, Spanish-speaking subjects were more likely to have an uncontrolled medical condition or refuse participation, whereas English-speaking subjects were more likely to have bipolar disorder or a non-MDD depressive disorder.
  
  
  CONCLUSIONS
  Recruitment of Hispanic subjects with MDD is feasible and may enhance efforts at signal detection, given the higher severity of depression among Spanish-speaking participants presenting for clinical trials. Specific approaches for the recruitment and retention of Spanish-speaking participants are required.
authors: Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.
authors: Vivianne
authors: V
authors: Aponte-Rivera
authors: Boadie W
authors: BW
authors: Dunlop
authors: Cynthia
authors: C
authors: Ramirez
authors: Mary E
authors: ME
authors: Kelley
authors: Rebecca
authors: R
authors: Schneider
authors: Beatriz
authors: B
authors: Blastos
authors: Jacqueline
authors: J
authors: Larson
authors: Flavia
authors: F
authors: Mercado
authors: Helen
authors: H
authors: Mayberg
authors: W Edward
authors: WE
authors: Craighead
mesh_terms: D000328:Adult; D035843:Biomedical Research / Q000379:methods / Q000592:standards; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000208:ethnology / Q000628:therapy; D005240:Feasibility Studies; D005260:Female; D006293:Health Promotion / Q000379:methods / Q000592:standards*; D006630:Hispanic or Latino; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000592:standards*; D012720:Severity of Illness Index
keywords: Hispanic Americans; culture; major depressive disorder; minority groups; research subject recruitment
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