title: Retaining Low-Income Minority Cancer Patients in a Depression Treatment Intervention Trial: Lessons Learned.
abstract: Previously published work finds significant benefit from medical and behavioral health team care among safety-net patients with major depression. This qualitative study assessed clinical social worker, psychiatrist and patient navigator strategies to increase depression treatment among low-income minority cancer patients participating in the ADAPt-C clinical depression trial. Patient care retention strategies were elicited through in-depth, semi-structured interviews with nine behavioral health providers. Using grounded theory, concepts from the literature and dropout barriers identified by patients, guided interview prompts. Retention strategies clustered around five dropout barriers: (1) informational, (2) instrumental, (3) provider-patient therapeutic alliance, (4) clinic setting, and (5) depression treatment. All strategies emphasized the importance of communication between providers and patients. Findings suggest that strong therapeutic alliance and telephone facilitates collaborative team provider communication and depression treatment retention among patients in safety-net oncology care systems.
authors.affiliation: The Brown School of Social Work/Public Health, Washington University in St. Louis, Campus Box 1196, One Brookings Dr., St. Louis, MO, 63130, USA, awells@gwbmail.wustl.edu.
authors.forename: Anjanette A
authors.initials: AA
authors.lastname: Wells
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Palinkas
authors.forename: Sha-Lai L
authors.initials: SL
authors.lastname: Williams
authors.forename: Kathleen
authors.initials: K
authors.lastname: Ell
mesh_terms: D001291:Attitude of Health Personnel; D002140:California / Q000453:epidemiology; D003863:Depression / Q000208:ethnology / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D003865:Major Depressive Disorder / Q000208:ethnology / Q000209:etiology / Q000523:psychology / Q000628:therapy; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008913:Minority Groups; D009369:Neoplasms / Q000208:ethnology / Q000523:psychology*; D010349:Patient Compliance / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D010352:Patient Dropouts / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D011203:Poverty; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012189:Retrospective Studies; D064876:Safety-net Providers