Frontiers in Psychiatry
Volume 10, 2019

Predictors of Adherence to Treatment in Behavioral Health Therapy for Latino Immigrants: The Importance of Trust (Article) (Open Access)

Falgas-Bague I.* , Wang Y. , Banerjee S. , Ali N. , DiMarzio K. , Palao Vidal D. , Alegría M.
  • a Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States, Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
  • b Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
  • c Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
  • d Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
  • e Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
  • f Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain, Department of Mental Health, University Hospital Parc Tauli-I3PT, Sabadell, Spain, CIBERSAM, Barcelona, Spain
  • g Disparities Research Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States, Departments of Medicine and Psychiatry, Harvard Medical School, Boston, MA, United States

Abstract

A complex array of barriers to care influence patients' adherence to behavioral healthcare services. Understanding barriers to care is critical to ensure sufficient dosage of treatment. This study assessed the influence of perceived barriers on Latino migrants' prospective adherence to treatment for co-occurring mental health and substance use disorders as part of a clinical trial. Eligible participants (18–70 years-old) were recruited from community-based settings and classified according to their intervention session attendance. Baseline assessments included socio-demographic factors, clinical characteristics (i.e., depression, anxiety, post-traumatic stress disorder, substance use), psychosocial and cultural factors (i.e., ethnic identity, health literacy, discrimination), and perceived attitudinal and structural barriers to care. Treatment involved 10-sessions of cognitive-behavioral therapy, psychoeducation, and mindfulness (Integrated Intervention for Dual problems and Early Action) and emphasized participant's engagement in treatment. We used multinomial logistic regression models to examine the association between barriers to care reported at baseline, sociodemographic characteristics, psychosocial and cultural factors, clinical factors, and treatment adherence. Mistrust in previous behavioral health treatment(s) was the reported barrier significantly associated with completion of the program after adjusting for clinical, psychosocial, and cultural factors, with those expressing mistrust in previous treatment(s) showing higher rates of completion compared to those who did not report this barrier. Evidence-based and culturally-tailored interventions provided by ethnically matched providers may overcome cultural mistrust and increase adherence to behavioral health care among Latino immigrants. © Copyright © 2019 Falgas-Bague, Wang, Banerjee, Ali, DiMarzio, Palao Vidal and Alegría.

Author Keywords

Barriers Immigrant co-occurring disorders Adherence to treatment Ethnicity Latinos

Index Keywords

immigrant depression social psychology anxiety disorder mindfulness demography psychoeducation behavior therapy human controlled study cognitive behavioral therapy Aged drug dependence mental disease racism Hispanic Trust male female prediction cultural factor Article patient compliance major clinical study adult posttraumatic stress disorder ethnicity health literacy
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85075667301&doi=10.3389%2ffpsyt.2019.00817&partnerID=40&md5=9f86aec64f630fabcf2bac6d6768de2c
DOI: 10.3389/fpsyt.2019.00817
ISSN: 16640640
Original Language: English