1 / 14

Vivianne R. Aponte Rivera, MD Emory University Department of Psychiatry and Behavioral Sciences

Working towards true representation: Increasing Hispanic participation in a clinical research trial for depression. Vivianne R. Aponte Rivera, MD Emory University Department of Psychiatry and Behavioral Sciences. Objectives.

kalyca
Download Presentation

Vivianne R. Aponte Rivera, MD Emory University Department of Psychiatry and Behavioral Sciences

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Working towards true representation: Increasing Hispanic participation in a clinical research trial for depression Vivianne R. Aponte Rivera, MD Emory University Department of Psychiatry and Behavioral Sciences

  2. Objectives • Understand the demographic characteristics of patients attending an exclusively Hispanic psychiatric (depression) research clinic • Understand how clinical research studies can help decrease health disparities

  3. The Emory PReDICT study • 600 patient, NIH-funded study of Major Depressive Disorder • Aim: identify predictors of response to treatment in treatment naïve patients • 12 week study • Random assignment • Medication (Escitalopram or Duloxetine) • Cognitive Behavioral Therapy (CBT) • Extension study • Treatment up to 2 years from date of randomization • Evaluate factors leading to relapse or sustained remission/response

  4. The Emory PReDICT Study • Predictive factors assessed • Demographic and clinical factors • Functional Magnetic resonance imaging (fMRI) • Genetics • Hypothalamus-Pituitary-Adrenal Axis (HPA axis) activity • Immune and inflammatory markers • Personality • Early life trauma • Primary site is located in a specialized clinical research unit at Emory University in the suburbs of Atlanta, and is solely for English speaking patients

  5. Clínica Latina para el Tratamiento de la Depresión (CLTD) • Satellite research clinic for the Emory PReDICT study • Located within the International Medical Center (IMC) at Grady Memorial Hospital in Atlanta, GA • One of the largest public health hospitals in the US • IMC: health clinic for limited English proficient patients • Most patients are Spanish speaking • Bilingual and bicultural staff

  6. Clínica Latina para el Tratamiento de la Depresión • Fully established 18 months ago • Part-time clinic • 1,291 Hispanics have called expressing interest in the study • Psychoeducation and referrals provided for those who do not qualify • 146 screening evaluations performed • 42 patients randomized

  7. Clínica Latina para el Tratamiento de la Depresión • Research staff works at primary research site when CLTD is closed • Greater staff to patient ratio • Patient navigators • Offices in IMC exclusively reserved for the research team when CLTD is open • Patients first sign a consent to undergo a clinical interview/evaluation • If eligible, they are then offered the PReDICT study specific consent

  8. Informed consent process questions • Concerns about documentation/legal aspects • Concerns about confidentiality • Requests for further clarification of protocol and study related procedures • Concerns about medications and study procedures • “Guinea pig”, medication side effects

  9. CLTD Demographics:146 patients evaluated

  10. CLTD Demographics:146 patients evaluated • Average age (years old): • 37.75 ± 9.65 (SD) • Ages ranged from 18-66 y/o • Average number of years in the USA: • 11.22 ± 7.65 (SD) • Ranged from 1 to 40 years

  11. CLTD Demographics:146 patients evaluated

  12. Show and Retention Rates • No show rates for screening visit • CLTD: 50/239 (20.9%) • Main clinic: 420/1475 (28.5%) • Retention Rates • CLTD: 29/42 (69%) • Main clinic: 122/163 (74.8%)

  13. Reasons for early termination

  14. Final remarks • Adding bilingual and bicultural research clinics to ongoing or new depression research studies • Increases diversity in the study population • Leads to treatment recommendations that take ethnicity into account • Biologically • Socioculturally • Leads to more specific and effective interventions • Provides treatment to an underserved population • Increases awareness about mental health and depression within the Hispanic community and helps decrease stigma

More Related