title: Uptake of depression treatment recommendations among Latino primary care patients.
abstract: BACKGROUND
  Primary care providers (PCP) are the entry point for public sector depression treatment for many Latino patients. However, many Latino patients do not initiate their PCPs' recommended treatment, which likely contributes to ethnic disparities in depression treatment. This study examined factors related to Latino patients' uptake of their PCPs' recommendations for depression treatment.
  
  
  METHODS
  Ninety Latino primary care patients who received a depression treatment recommendation from their PCP participated in a telephone interview. Patients rated their working alliance with their PCP and their PCP's cultural competence. They also reported their treatment preference, the type of recommendation, and their intended and actual uptake of the recommendation. Patients were contacted at two time points (Time 1: M = 14 days after PCP appointment; Time 2: M = 84 days after PCP appointment) to report their uptake status.
  
  
  RESULTS
  At Time 1, 23% of patients had initiated uptake of the treatment recommendation, increasing to 53% at Time 2. Patients who received a medication recommendation were more likely to have followed though on the recommendation, compared with patients who received a psychotherapy recommendation. The working alliance was positively associated with intention to follow up on a treatment recommendation, and also mediated the relationship between cultural competence and intention of following up on the recommendation.
  
  
  CONCLUSIONS
  PCP's treatment recommendation and the PCP-patient alliance play a role in Latino primary care patients intention to follow a treatment recommendation for depression. An improved understanding of this role could enhance efforts to improve depression treatment uptake.
authors: Frances L. Hiatt School of Psychology, Clark University.
authors: Rachel Zack
authors: RZ
authors: Ishikawa
authors: Frances L. Hiatt School of Psychology, Clark University.
authors: Esteban V
authors: EV
authors: Cardemil
authors: Center for Multicultural Mental Health Research, Cambridge Health Alliance, Harvard Medical School.
authors: Margarita
authors: M
authors: Alegría
authors: Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School.
authors: Catherine C
authors: CC
authors: Schuman
authors: Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School.
authors: Robert C
authors: RC
authors: Joseph
authors: Department of Psychiatry, University of Washington.
authors: Amy M
authors: AM
authors: Bauer
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D065246:Culturally Competent Care; D003863:Depression / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care; D011613:Psychotherapy
chemical_list: D000928:Antidepressive Agents