WMJ Vol 120 Issue 4: A Culturally Adapted Depression Intervention for African American Adults: An Efficacy Trial
Background: Major depressive disorder (MDD) is one of the most common, costly, and debilitating psychiatric disorders in the United States, and the World Health Organization has identified MDD as a leading cause of disability. Although the rates of MDD among African American and White populations in the US are comparable, African Americans in the US tend to experience higher rates of disability associated with MDD compared to White people. Despite the high burden of MDD among African Americans, their use of mental health services is low, in part due to suboptimal care.
Objectives: This study evaluated the efficacy of a culturally adapted depression intervention (Oh Happy Day Class [OHDC]) compared to an active control, the Coping with Depression (CWD) course.
Methods: A clustered randomized controlled trial was conducted with a sample of 132 patients with mild to moderate depressive symptoms. They were randomly assigned in a 2-armed randomized controlled trial. They received 1 of 2 (OHDC or CWD) 12-week interventions in weekly in-person group sessions. The primary outcome was a change in depressive symptoms during and post-intervention, measured with the Center for Epidemiologic Studies Depression Scale (CES-D) and the Quick Inventory of Depression Symptoms (QIDS). Analyses included log-rank test and mixed effects linear regression models.
Results: Both interventions were efficacious in reducing symptoms of depression. However, a greater dose of the culturally adapted intervention, Oh Happy Day Class, showed a greater reduction in depression symptoms.
Conclusion: This study represents the first randomized controlled trial evaluating the culturally adapted treatment depression intervention, Oh Happy Day Class. These findings provide evidence for and the need for culturally adapted treatments. Future research with larger samples of African Americans from different regions across the US could examine effectiveness and generalizability of the Oh Happy Day Class depression treatment.
The target audience for this journal-based activity is healthcare providers caring for the people and communities of Wisconsin and beyond.
As a result of this journal-based activity, learners will be able to:
- Discuss culturally adapted treatments as modifications to evidence-based treatments involving changes to service delivery, the nature of the therapeutic relationship, or the components of the treatment.
- Explain the results of a clustered randomized controlled trial with a sample of African American adults that explored the efficacy of a culturally adapted depression intervention in reducing symptoms of depression and improving self-report of mental and physical health status compared to an active control.
- Reflect on own practice and the role of healthcare team members in providing care to patients with major depressive disorder.
It is the policy of the University of Wisconsin–Madison Interprofessional Continuing Education Partnership (ICEP) to identify, mitigate and disclose all relevant financial relationships with ineligible companies* held by the speakers/presenters, authors, planners, and other persons who may influence content of this accredited continuing education (CE). In addition, speakers, presenters and authors must disclose any planned discussion of unlabeled/unapproved uses of drugs or devices during their presentation.
For this accredited continuing education activity all relevant financial relationships have been mitigated and detailed disclosures are listed below.
|Name of Individual||Individual's Role in Activity|
Financial Relationship Disclosure
|Marianna Shershneva, MD, PhD||Accreditation Specialist||No relevant relationships with ineligible companies to disclose||No|
|Earlise C. Ward, PhD, LP||Author||No relevant relationships with ineligible companies to disclose||No|
|Roger L. Brown, PhD||Author||No relevant relationships with ineligible companies to disclose||No|
|Lucretia Sullivan-Wade, BS||Author||No relevant relationships with ineligible companies to disclose||No|
|Suzie Sainvilmar, MS||Author||No relevant relationships with ineligible companies to disclose||No|
|Erica Arrington, MD||Reviewer||No relevant relationships with ineligible companies to disclose||No|
|Jeffrey A. Morzinski, PhD||Reviewer||No relevant relationships with ineligible companies to disclose||No|
|Sarina Schrager, MD||Editor||No relevant relationships with ineligible companies to disclose||No|
|Roberta Pawlak, PhD, RN, NEA-BC||Reviewer||No relevant relationships with ineligible companies to disclose||No|
Virginia Snyder, PhD, PA-C
|Reviewer||No relevant relationships with ineligible companies to disclose||No|
*Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on, patients.
The ACCME does not consider providers of clinical services directly to patients to be ineligible companies.
|In support of improving patient care, this activity has been planned and implemented by the University of Wisconsin–Madison ICEP and the Wisconsin Medical Journal. The University of Wisconsin–Madison ICEP is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.|
Credit Designation Statements
American Medical Association (AMA)
The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
American Nurses Credentialing Center (ANCC)
The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 ANCC contact hour.
AMERICAN ACADEMY OF PHYSICIAN ASSISTANTS (AAPA)
|The University of Wisconsin–Madison ICEP has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1.0 AAPA Category 1 CME credits. Approval is valid until 6/1/2023. PAs should only claim credit commensurate with the extent of their participation.|
Continuing Education Units
The University of Wisconsin–Madison ICEP, as a member of the University Professional & Continuing Education Association (UPCEA), authorizes this program for 0.1 continuing education units (CEUs) or 1 hour.
- 1.00 AAPA Category 1 CME
- 1.00 AMA PRA Category 1 Credit™
- 1.00 ANCC Contact Hours
- 1.00 University of Wisconsin–Madison Continuing Education Hours
- 1.00 Approved for AMA PRA Category 1 Credit™
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