Using patient engagement in the design and rationale of a trial for women with depression in obstetrics and gynecology practices.
BACKGROUND
Significant health disparities exist among socioeconomically disadvantaged women, who experience elevated rates of depression and increased risk for poor depression treatment engagement and outcomes. We aimed to use stakeholder input to develop innovative methods for a comparative effectiveness trial to address the needs of socioeconomically disadvantaged women with depression in women's health practices.


METHODS
Using a community advisory board, focus groups, and individual patient input, we determined the feasibility and acceptability of an electronic psychosocial screening and referral tool; developed and finalized a prioritization tool for women with depression; and piloted the prioritization tool. Two intervention approaches, enhanced screening and referral using an electronic psychosocial screening, and mentoring using the prioritization tool, were developed as intervention options for socioeconomically disadvantaged women attending women's health practices. We describe the developmental steps and the final design for the comparative effectiveness trial evaluating both intervention approaches.


CONCLUSIONS
Stakeholder input allowed us to develop an acceptable clinical trial of two patient-centered interventions with patient-driven outcomes.
Department of Psychiatry, University of Rochester, 300 Crittenden Boulevard, Rochester, NY 14642, USA; Department of Obstetrics and Gynecology, University of Rochester, 401 Elmwood Ave, Rochester, NY 14642, USA. Electronic address: Ellen_Poleshuck@urmc.rochester.edu.
Ellen
E
Poleshuck
Department of Psychiatry, University of Rochester, 300 Crittenden Boulevard, Rochester, NY 14642, USA.
Marsha
M
Wittink
School of Nursing, University of Rochester, 255 Crittenden Boulevard, Rochester, NY 14642, USA.
Hugh
H
Crean
Newark Wayne, Rochester Regional Health System, 1200 Driving Park Avenue, Newark, NY 14513, USA.
Tara
T
Gellasch
Division of Social Work, University of Rochester, 601 Elmwood Ave, Rochester, NY 14642, USA.
Mardy
M
Sandler
Department of Psychiatry, University of Rochester, 300 Crittenden Boulevard, Rochester, NY 14642, USA.
Elaine
E
Bell
Department of Psychiatry, University of Rochester, 300 Crittenden Boulevard, Rochester, NY 14642, USA.
Iwona
I
Juskiewicz
Department of Psychiatry, University of Rochester, 300 Crittenden Boulevard, Rochester, NY 14642, USA.
Catherine
C
Cerulli
D057186:Comparative Effectiveness Research; D003376:Counseling / Q000458:organization & administration; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006176:Gynecology / Q000458:organization & administration; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008603:Mental Health; D008611:Mentors; D009774:Obstetrics / Q000458:organization & administration; D062526:Patient Navigation / Q000458:organization & administration; D010358:Patient Participation / Q000379:methods*; D012017:Referral and Consultation / Q000458:organization & administration; D012107:Research Design; D012959:Socioeconomic Factors
Depression; Patient engagement; Patient preference; Quality of life; Socioeconomic disadvantage; Women's health