Abstract:

Purpose:
Integrated care provides a promising approach to improve treatment-seeking disparities; however adaptation of care models to impact African Americans is lacking. The purpose of this project is to develop a patient-centered, culturally tailored integrated care model and test this model in a population of patients seeking care through a community-based family healthcare center. Our goal is to support in the reduction of health and mental health disparities, improve health equity, and enhance the quality of life for underserved individuals, families, and communities.

Methods:
Thirty (30) adult patients of integrated Morehouse Healthcare Clinics and its affiliates participated in focus groups discussing their individual health experiences. Twenty (20) healthcare providers/administrators from five different integrated practice settings participated in key informant interviews. Transcripts were analyzed for key themes related to depression care, perceived unmet cultural needs, and desired adaptations.

Results:
Preliminary results show common themes such as the importance of peer-support and community engagement as general areas of patient interest. Perceived needs and barriers from the administrative and provider perspective will be discussed. Themes from patient’s perspectives will be contrasted with these findings. It is anticipated that empirical exploration of these themes will provide the foundation for a culturally tailored treatment model to be utilized by healthcare providers.

Discussion / Conclusion:
It is critical that strategies and models are developed to improve healthcare among underserved minorities as current models offer variable efficacy among this population. A qualitative approach to identifying common themes deemed important by both patients and providers/administrators is a first step in improving the cultural sensitivity of integrated care treatment models. The qualitative results will be used to design, implement, and evaluate the effectiveness of a culturally centered integrated healthcare model to address depression and selected co-morbid chronic diseases among underserved ethnically and culturally diverse adults.

In particular, our multidisciplinary team will use a mixed methods approach to:
1) test the feasibility of the integrated care model in community based primary healthcare centers, with a focus on measuring clinic/system level, provider level, and patient level outcomes; and
2) compare these outcomes at primary care and behavioral health integrated care sites with those of a primary care clinic implementing a standard integrated depression in primary care treatment protocol.

The implications of research outcomes for clinical practice include:
1) strategies to promote culturally centered integrated care, particularly concerning assessment and treatment of depression and co-occurring medical conditions among African Americans; and
2) community and patient education about mental health issues, stigma, prevention, help-seeking, and benefits of utilization of services.

Regarding health policy, we aim to:
1) inform clinic and health care system policies that guide staff training and education, clinical service provision, and health information technology that support culturally centered integrated care models.

Keywords:

Integrated Care, Education for Clinical Researchers, Academic Medicine Research.