TY - JOUR
KW - African Americans
KW - Age Factors
KW - Aged
KW - Depression/therapy
KW - Depressive Disorder, Major/therapy
KW - European Continental Ancestry Group
KW - Female
KW - Healthcare Disparities/statistics & numerical data
KW - Humans
KW - Male
KW - Middle Aged
KW - Primary Health Care
KW - Psychotherapy/statistics & numerical data
AU - J. H. Joo
AU - K. H. Morales
AU - H. F. de Vries
AU - J. J. Gallo
A1 - 
AB - The purpose of this study was to assess ethnic differences in use of psychotherapy (having met at least once with a psychotherapist) for late-life depression in primary care. Participants were identified through a two-stage, age-stratified (60-74, > or =75) depression screening of randomly sampled patients from 20 practices in New York City, Philadelphia, and Pittsburgh in a practice-randomized trial. Practices were randomly assigned to usual care or to an intervention with a depression care manager who worked with primary care physicians to provide algorithm-based care. Depression status based on clinical interview and any use of psychotherapy within the 2-year follow-up interval were the primary dependent variables under study. The focus was on 582 persons with complete data. Participants were sorted into major depression (n=385, 112 African American and 273 white) and clinically significant minor depression (n=197, 51 African American and 146 white) based on clinical diagnostic assessment. Persons who self-identified as African American were less likely than whites to use interpersonal therapy (IPT) if they had minor depression, even after adjusting for potentially influential variables including age, cognitive functioning, and whether the dose of antidepressant was adequate (adjusted odds ratio (AOR)=0.22, 95% confidence interval (CI)=0.06-0.80). Ethnicity was not significantly associated with IPT use in persons with major depression (AOR=0.71, 95% CI=0.37-1.37). Older African Americans with minor depression were less likely than whites to use psychotherapy. Targeted strategies are needed to mitigate the disparity in use of psychotherapy.
BT - Journal of the American Geriatrics Society
C5 - Healthcare Disparities
CP - 1
CY - United States
DO - 10.1111/j.1532-5415.2009.02623.x
IS - 1
JF - Journal of the American Geriatrics Society
N2 - The purpose of this study was to assess ethnic differences in use of psychotherapy (having met at least once with a psychotherapist) for late-life depression in primary care. Participants were identified through a two-stage, age-stratified (60-74, > or =75) depression screening of randomly sampled patients from 20 practices in New York City, Philadelphia, and Pittsburgh in a practice-randomized trial. Practices were randomly assigned to usual care or to an intervention with a depression care manager who worked with primary care physicians to provide algorithm-based care. Depression status based on clinical interview and any use of psychotherapy within the 2-year follow-up interval were the primary dependent variables under study. The focus was on 582 persons with complete data. Participants were sorted into major depression (n=385, 112 African American and 273 white) and clinically significant minor depression (n=197, 51 African American and 146 white) based on clinical diagnostic assessment. Persons who self-identified as African American were less likely than whites to use interpersonal therapy (IPT) if they had minor depression, even after adjusting for potentially influential variables including age, cognitive functioning, and whether the dose of antidepressant was adequate (adjusted odds ratio (AOR)=0.22, 95% confidence interval (CI)=0.06-0.80). Ethnicity was not significantly associated with IPT use in persons with major depression (AOR=0.71, 95% CI=0.37-1.37). Older African Americans with minor depression were less likely than whites to use psychotherapy. Targeted strategies are needed to mitigate the disparity in use of psychotherapy.
PP - United States
PY - 2010
SN - 1532-5415; 0002-8614
SP - 154
EP - 160
EP - 
T1 - Disparity in use of psychotherapy offered in primary care between older african-american and white adults: Results from a practice-based depression intervention trial
T2 - Journal of the American Geriatrics Society
TI - Disparity in use of psychotherapy offered in primary care between older african-american and white adults: Results from a practice-based depression intervention trial
U1 - Healthcare Disparities
U2 - 20122047
U3 - 10.1111/j.1532-5415.2009.02623.x
VL - 58
VO - 1532-5415; 0002-8614
Y1 - 2010
ER -