Insights in Depression Screening at a Latino-Serving, Integrated FQHC Clinic
type: CreativeWork
description: Depression manifests differently in Latinos when compared to other racial-ethnic groups, but little is known regarding linguistic differences among Latinos. This mixed methods study explored the depression screening processes among patients and medical providers at a Federally Qualified Health Center (FQHC) through an ethnic-linguistic lens. Binary logistic regressions were performed to determine the effects of ethnicity and language on PHQ-2 screening rates for 10,285 adult patients seen during a primary care medical visit from 2014 to 2015; of these 4,745 (46%) patients were screened for depression. Spanish-speakers were screened for depression more often than non-Latinos and Latinos who were English-speakers. Spanish-speakers screened positive for depression 31% less often than English speaking Latinos. Additionally, a chart review was conducted on 692 patients who screened positive on the PHQ-2; 275 of these who scored ≥10 (major depression) on the PHQ-9 were included in further analysis. Controlling for demographics, we found that despite increased screening, Spanish-speakers were less likely to receive standard of care recommendations (combined psychotherapy and pharmacotherapy) than English-speaking patients. To explore these issues contextually, key informant interviews were conducted with 6 English-speaking Latinos, 6 Spanish-speaking Latinos, 6 English-speaking non-Latinos and 7 provider participants. Semi-structured, member-checking focus groups were conducted with the four groups to validate interview themes. Participants confirmed that negative perceptions about medications, patient non-compliance, and a shortage of bilingual behavioral health specialists within the clinic impacted standard of care treatment recommendations and uptake for the Spanish-speaking Latinos. However, strength of relationships with providers and family, handoff to integrated behavioral health specialists, and motivating factors (i.e. diet and exercise) helped patients to overco…
abstract: Depression manifests differently in Latinos when compared to other racial-ethnic groups, but little is known regarding linguistic differences among Latinos. This mixed methods study explored the depression screening processes among patients and medical providers at a Federally Qualified Health Center (FQHC) through an ethnic-linguistic lens. Binary logistic regressions were performed to determine the effects of ethnicity and language on PHQ-2 screening rates for 10,285 adult patients seen during a primary care medical visit from 2014 to 2015; of these 4,745 (46%) patients were screened for depression. Spanish-speakers were screened for depression more often than non-Latinos and Latinos who were English-speakers. Spanish-speakers screened positive for depression 31% less often than English speaking Latinos. Additionally, a chart review was conducted on 692 patients who screened positive on the PHQ-2; 275 of these who scored ≥10 (major depression) on the PHQ-9 were included in further analysis. Controlling for demographics, we found that despite increased screening, Spanish-speakers were less likely to receive standard of care recommendations (combined psychotherapy and pharmacotherapy) than English-speaking patients. To explore these issues contextually, key informant interviews were conducted with 6 English-speaking Latinos, 6 Spanish-speaking Latinos, 6 English-speaking non-Latinos and 7 provider participants. Semi-structured, member-checking focus groups were conducted with the four groups to validate interview themes. Participants confirmed that negative perceptions about medications, patient non-compliance, and a shortage of bilingual behavioral health specialists within the clinic impacted standard of care treatment recommendations and uptake for the Spanish-speaking Latinos. However, strength of relationships with providers and family, handoff to integrated behavioral health specialists, and motivating factors (i.e. diet and exercise) helped patients to overco…
author: Stephenson, Jacquelyn
language: English
keywords: Social and Behavioral Sciences, Social Policy, Social Psychology and Interaction, Social Work, Depression; Hispanic Americans; Language; Depression - Diagnosis, Federally Qualified Health Center; Linguistic influences on health screening
date published: 2017-06-01T07:00:00Z
date modified: 2026-07-24T02:52:45Z
provider: Loma Linda University
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Loma Linda University