Depression treatment preferences by race/ethnicity and gender and associations between past healthcare discrimination experiences and present preferences in a nationally representative sample.
Antidepressant medication
Depression
Discrimination
Disparities
Healthcare discrimination
Talk therapy
Treatment preferences
USA
Journal
Social science & medicine (1982)
ISSN: 1873-5347
Titre abrégé: Soc Sci Med
Pays: England
ID NLM: 8303205
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
05
04
2019
revised:
12
03
2020
accepted:
15
03
2020
pubmed:
11
4
2020
medline:
28
4
2021
entrez:
11
4
2020
Statut:
ppublish
Résumé
Depression treatment disparities are well documented. Differing treatment preferences across social groups have been suggested as a cause of these disparities. However, existing studies of treatment preferences have been limited to individuals currently receiving clinical care, and existing measures of depression treatment preferences have not accounted for factors that may be disproportionately relevant to the preferences of disparities populations. This study therefore aimed to assess depression treatment preferences by race/ethnicity and gender in a representative community sample, while accounting for access to healthcare, provider characteristics, and past experiences of discrimination in healthcare settings. We conducted a nationally representative study of individuals with depression in and out of clinical care. Treatment preferences (medication versus talk therapy) were elicited through a discrete choice experiment that accounted for tradeoffs with factors related to access and provider characteristics deemed relevant by community stakeholders. Past discrimination was assessed through questions about unfair treatment from medical providers and front desk staff due to personal characteristics (e.g., race, gender). We used conditional logit models to assess treatment preferences by race/ethnicity and gender and examined whether preferences were associated with past experiences of healthcare discrimination. Non-Hispanic white respondents (OR-here, the odds of a talk therapy preference over the odds of a medication preference: 0.80, 95% CI: 0.64, 0.99) and men (OR 0.76, 95% CI: 0.60, 0.96) preferred medication over talk therapy, while non-Hispanic black respondents, Hispanic respondents, and women did not prefer one over the other. Past discrimination in healthcare settings was associated with lower preferences for talk therapy and greater preferences for medication, particularly among non-Hispanic black respondents and women respondents. Addressing previous methodological limitations yielded estimates for depression treatment preferences by race/ethnicity and gender that differed from past studies. Also, past discrimination in healthcare settings was associated with current treatment preferences.
Sections du résumé
BACKGROUND
Depression treatment disparities are well documented. Differing treatment preferences across social groups have been suggested as a cause of these disparities. However, existing studies of treatment preferences have been limited to individuals currently receiving clinical care, and existing measures of depression treatment preferences have not accounted for factors that may be disproportionately relevant to the preferences of disparities populations. This study therefore aimed to assess depression treatment preferences by race/ethnicity and gender in a representative community sample, while accounting for access to healthcare, provider characteristics, and past experiences of discrimination in healthcare settings.
METHODS
We conducted a nationally representative study of individuals with depression in and out of clinical care. Treatment preferences (medication versus talk therapy) were elicited through a discrete choice experiment that accounted for tradeoffs with factors related to access and provider characteristics deemed relevant by community stakeholders. Past discrimination was assessed through questions about unfair treatment from medical providers and front desk staff due to personal characteristics (e.g., race, gender). We used conditional logit models to assess treatment preferences by race/ethnicity and gender and examined whether preferences were associated with past experiences of healthcare discrimination.
RESULTS
Non-Hispanic white respondents (OR-here, the odds of a talk therapy preference over the odds of a medication preference: 0.80, 95% CI: 0.64, 0.99) and men (OR 0.76, 95% CI: 0.60, 0.96) preferred medication over talk therapy, while non-Hispanic black respondents, Hispanic respondents, and women did not prefer one over the other. Past discrimination in healthcare settings was associated with lower preferences for talk therapy and greater preferences for medication, particularly among non-Hispanic black respondents and women respondents.
CONCLUSIONS
Addressing previous methodological limitations yielded estimates for depression treatment preferences by race/ethnicity and gender that differed from past studies. Also, past discrimination in healthcare settings was associated with current treatment preferences.
Identifiants
pubmed: 32276182
pii: S0277-9536(20)30158-1
doi: 10.1016/j.socscimed.2020.112939
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
112939Investigateurs
Tali Fleitman Soffer
(TF)
Valeria Chambers
(V)
Catherine Rodriguez Quinerly
(CR)
Ziva Mann
(Z)
Ruth Nabisere
(R)
Farah N Shaikh
(FN)
Dierdre Jordan
(D)
Afsaneh Moradi
(A)
Selma de Castro
(S)
Heba Abolaban
(H)
Esther Lee
(E)
Sherry Shu-Yeu Hou
(S)
Susan Busch
(S)
Adam C Carle
(AC)
Dharma E Cortes
(DE)
Danny McCormick
(D)
Michael Flores
(M)
Maria Jose Sanchez Roman
(MJ)
Frederick Lu
(F)
Natasha Anjuli Kaushal
(NA)
Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.