How Important Is Intrinsic Spirituality in Depression Care?

A Comparison of White and African-American Primary Care Patients

Authors

  • Lisa A. Cooper MD, MPH,

    Corresponding author
    1. Received from the Department of Medicine, The Johns Hopkins University School of Medicine (LAC, HTV, DEF, NRP), and the Department of Health Policy and Management, The Johns Hopkins University School of Hygiene and Public Health (LAC, DEF, NRP), Baltimore, Md; and The Western Psychiatric Institute and Clinic and the Department of Psychiatry, University of Pittsburgh School of Medicine (CB), Pittsburgh, Pa.
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  • Charlotte Brown PhD,

    1. Received from the Department of Medicine, The Johns Hopkins University School of Medicine (LAC, HTV, DEF, NRP), and the Department of Health Policy and Management, The Johns Hopkins University School of Hygiene and Public Health (LAC, DEF, NRP), Baltimore, Md; and The Western Psychiatric Institute and Clinic and the Department of Psychiatry, University of Pittsburgh School of Medicine (CB), Pittsburgh, Pa.
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  • Hong Thi Vu MHS,

    1. Received from the Department of Medicine, The Johns Hopkins University School of Medicine (LAC, HTV, DEF, NRP), and the Department of Health Policy and Management, The Johns Hopkins University School of Hygiene and Public Health (LAC, DEF, NRP), Baltimore, Md; and The Western Psychiatric Institute and Clinic and the Department of Psychiatry, University of Pittsburgh School of Medicine (CB), Pittsburgh, Pa.
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  • Daniel E. Ford MD, MPH,

    1. Received from the Department of Medicine, The Johns Hopkins University School of Medicine (LAC, HTV, DEF, NRP), and the Department of Health Policy and Management, The Johns Hopkins University School of Hygiene and Public Health (LAC, DEF, NRP), Baltimore, Md; and The Western Psychiatric Institute and Clinic and the Department of Psychiatry, University of Pittsburgh School of Medicine (CB), Pittsburgh, Pa.
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  • Neil R. Powe MD, MPH, MBA

    1. Received from the Department of Medicine, The Johns Hopkins University School of Medicine (LAC, HTV, DEF, NRP), and the Department of Health Policy and Management, The Johns Hopkins University School of Hygiene and Public Health (LAC, DEF, NRP), Baltimore, Md; and The Western Psychiatric Institute and Clinic and the Department of Psychiatry, University of Pittsburgh School of Medicine (CB), Pittsburgh, Pa.
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  • Presented in part at the 15th Annual Meeting of the Association for Health Services Research, Washington, DC, June 21–23, 1998.

Address correspondence and reprint requests to Dr. Cooper: Welch Center for Prevention, Epidemiology, and Clinical Research, 2024 E. Monument St., Suite 2-500, Baltimore, MD 21205-2223 (e-mail: lcooper@mail.jhmi.edu).

Abstract

We used a cross-sectional survey to compare the views of African-American and white adult primary care patients (N = 76) regarding the importance of various aspects of depression care. Patients were asked to rate the importance of 126 aspects of depression care (derived from attitudinal domains identified in focus groups) on a 5-point Likert scale. The 30 most important items came from 9 domains: 1) health professionals' interpersonal skills, 2) primary care provider recognition of depression, 3) treatment effectiveness, 4) treatment problems, 5) patient understanding about treatment, 6) intrinsic spirituality, 7) financial access, 8) life experiences, and 9) social support. African-American and white patients rated most aspects of depression care as similarly important, except that the odds of rating spirituality as extremely important for depression care were 3 times higher for African Americans than the odds for whites.

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