title: The role of coping in depression treatment utilization for VA primary care patients.
abstract: OBJECTIVE
  To examine the impact of Veterans' coping strategies on mental health treatment engagement following a positive screen for depression.
  
  
  METHODS
  A mixed-methods observational study using a mailed survey and semi-structured interviews. Sample included 271 Veterans who screened positive for depression during a primary care visit at one of three VA medical centers and had not received a diagnosis of depression or prescribed antidepressants 12 months prior to screening. A subsample of 23 Veterans was interviewed.
  
  
  RESULTS
  Logistic regression models showed that Veterans who reported more instrumental support and active coping were more likely to receive depression or other mental health treatment within three months of their positive depression screen. Those who reported emotional support or self-distraction as coping strategies were less likely to receive any treatment in the same time frame. Qualitative analyses revealed that how Veterans use these and other coping strategies can impact treatment engagement in a variety of ways.
  
  
  CONCLUSIONS
  The relationship between Veterans' use of coping strategies and treatment engagement for depression may not be readily apparent without in-depth exploration.
  
  
  CONCLUSIONS
  In VA primary care clinics, nurse care managers and behavioral health providers should explore how Veterans' methods of coping may impact treatment engagement.
authors: Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, USA. Electronic address: Princess.Osei-Bonsu@va.gov.
authors: Princess E
authors: PE
authors: Osei-Bonsu
authors: Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, USA; Department of Health Policy and Management, Boston University School of Public Health, Boston, USA.
authors: Barbara G
authors: BG
authors: Bokhour
authors: Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, USA; Department of Health Policy and Management, Boston University School of Public Health, Boston, USA.
authors: Mark E
authors: ME
authors: Glickman
authors: Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, USA; Department of Psychiatry, University of Massachusetts Medical School, Worcester, USA.
authors: Stephanie
authors: S
authors: Rodrigues
authors: Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, USA.
authors: Nora M
authors: NM
authors: Mueller
authors: Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, USA.
authors: Natalie S
authors: NS
authors: Dell
authors: Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, USA.
authors: Shibei
authors: S
authors: Zhao
authors: Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, USA; Department of Health Policy and Management, Boston University School of Public Health, Boston, USA.
authors: Susan V
authors: SV
authors: Eisen
authors: Center for Healthcare Organization and Implementation Research (CHOIR), Edith Nourse Rogers Memorial Veterans Hospital, Bedford, USA; Department of Health Policy and Management, Boston University School of Public Health, Boston, USA.
authors: A Rani
authors: AR
authors: Elwy
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy* / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D011320:Primary Health Care; D036301:Qualitative Research; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*
chemical_list: D000928:Antidepressive Agents
keywords: Coping strategies; Depression; Mixed-methods research; Primary care; Veterans