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ENHANCING HISPANIC PARTICIPATION IN MENTAL HEALTH CLINICAL RESEARCH: DEVELOPMENT OF A SPANISH-SPEAKING DEPRESSION RESEARCH SITE

Authors

  • Vivianne Aponte-Rivera M.D.,

    Corresponding author
    1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
    • Correspondence to: Vivianne Aponte-Rivera, Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 1256 Briarcliff Road NE, Suite 306 E, Atlanta, GA 30306. E-mail: vaponte@emory.edu

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  • Boadie W. Dunlop M.D.,

    1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
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  • Cynthia Ramirez Ph.D.,

    1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
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  • Mary E. Kelley Ph.D.,

    1. Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
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  • Rebecca Schneider B.A.,

    1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
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  • Beatriz Blastos M.S.,

    1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
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  • Jacqueline Larson B.A.,

    1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
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  • Flavia Mercado M.D.,

    1. Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
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  • Helen Mayberg M.D.,

    1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
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    • These authors contributed equally to the manuscript.

  • W. Edward Craighead Ph.D.

    1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
    2. Department of Psychology, Emory University, Atlanta, Georgia
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    • These authors contributed equally to the manuscript.


  • Contract grant sponsor: National Institute of Mental Health; Contract grant numbers: P50 MH077083 and RO1 MH080880; Contract grant sponsor: PHS; Contract grant number: UL1 RR025008; Contract grant sponsor: PHS; Contract grant number: M01 RR0039; Contract grant sponsor: National Institute of Mental Health; Contract grant number K23 MH086690.

Abstract

Background

Hispanics, particularly those with limited English proficiency, are underrepresented in psychiatric clinical research studies. We developed a bilingual and bicultural research clinic dedicated to the recruitment and treatment of Spanish-speaking subjects in the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study, a large clinical trial of treatment-naïve subjects with major depressive disorder (MDD).

Methods

Demographic and clinical data derived from screening evaluations of the first 1,174 subjects presenting for participation were compared between the Spanish-speaking site (N = 275) and the primary English-speaking site (N = 899). Reasons for ineligibility (N = 888) for the PReDICT study were tallied for each site.

Results

Compared to English speakers, Spanish speakers had a lower level of education and were more likely to be female, uninsured, and have uncontrolled medical conditions. Clinically, Spanish speakers demonstrated greater depression severity, with higher mean symptom severity scores, and a greater number of previous suicide attempts. Among the subjects who were not randomized into the PReDICT study, Spanish-speaking subjects were more likely to have an uncontrolled medical condition or refuse participation, whereas English-speaking subjects were more likely to have bipolar disorder or a non-MDD depressive disorder.

Conclusion

Recruitment of Hispanic subjects with MDD is feasible and may enhance efforts at signal detection, given the higher severity of depression among Spanish-speaking participants presenting for clinical trials. Specific approaches for the recruitment and retention of Spanish-speaking participants are required.

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