Retaining Low-Income Minority Cancer Patients in a Depression Treatment Intervention Trial: Lessons Learned

Community Ment Health J. 2015 Aug;51(6):715-22. doi: 10.1007/s10597-014-9819-3. Epub 2014 Dec 28.

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.

MeSH terms

  • Attitude of Health Personnel
  • California / epidemiology
  • Depression / ethnology
  • Depression / etiology
  • Depression / psychology
  • Depression / therapy*
  • Depressive Disorder, Major / ethnology
  • Depressive Disorder, Major / etiology
  • Depressive Disorder, Major / psychology
  • Depressive Disorder, Major / therapy
  • Female
  • Hispanic or Latino*
  • Humans
  • Interviews as Topic
  • Male
  • Minority Groups*
  • Neoplasms / ethnology
  • Neoplasms / psychology*
  • Patient Compliance / ethnology
  • Patient Compliance / psychology*
  • Patient Compliance / statistics & numerical data
  • Patient Dropouts / ethnology
  • Patient Dropouts / psychology*
  • Patient Dropouts / statistics & numerical data
  • Poverty*
  • Professional-Patient Relations
  • Qualitative Research
  • Retrospective Studies
  • Safety-net Providers