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Improving Treatment Engagement of Underserved U.S. Racial-Ethnic Groups: A Review of Recent Interventions.
MedLine Citation:
PMID:  23203442     Owner:  NLM     Status:  Publisher    
OBJECTIVE: Unequal mental health among U.S. underserved racial-ethnic populations has become a prominent national concern. Contributing to this inequity is our limited ability to engage individuals from underserved populations into treatment. To help address this, a systematic literature review was conducted to examine the evidence base for interventions that can improve mental health treatment engagement among underserved racial-ethnic minority populations. METHODS: A MEDLINE search and bibliographic review yielded 1,611 studies that were reviewed according to several inclusion criteria: publication during or after 2001, U.S. adult sample, a randomized design, sufficient (≥50%) representation of underserved racial-ethnic groups, adequate sample size (≥27 participants per condition), explicit focus on mental health treatment engagement, and evaluation of an engagement outcome (for example, adherence or retention). RESULTS: Ten studies met inclusion criteria. Evidence supported the efficacy of collaborative care for depression as an engagement enhancement intervention among underserved racial-ethnic populations. Several other interventions demonstrated possible efficacy. The effect of the interventions on clinical outcomes, such as symptom improvement and rehospitalization, was mixed. CONCLUSIONS: Collaborative care for depression can be recommended for improving engagement in depression care in primary care among underserved racial-ethnic populations. Future research should continue to examine approaches with initial evidence of efficacy in order to expand the number of engagement enhancement interventions for underserved racial-ethnic adult populations. Additional issues for future engagement research include relative intervention efficacy across racial-ethnic groups, inclusion of other understudied groups (for example, Asian Americans and Native Americans), and greater clarification of the impact of improved engagement on clinical outcomes.
Alejandro Interian; Roberto Lewis-Fernández; Lisa B Dixon
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-3
Journal Detail:
Title:  Psychiatric services (Washington, D.C.)     Volume:  -     ISSN:  1557-9700     ISO Abbreviation:  Psychiatr Serv     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9502838     Medline TA:  Psychiatr Serv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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