2 - (SYM 127) Stakeholder Preferences for Implementation Strategies to Address Barriers to Depression Treatment Among Latinx Teens

Background: Latinx adolescents in the US experience inequities in depressive symptoms and depression treatment use in comparison to non-Latinx white peers. The purpose of this study was to determine barriers to depression treatment use and implementation strategy preferences to address these barriers among Latinx teens.

Methods: A qualitative descriptive study was conducted with Latinx (i.e., all gender) teens diagnosed with depression (n = 7), their parents (n = 7), and healthcare providers (n = 18) recruited via social media from across the US. Through individual interviews (parents/teens) and focus groups (healthcare providers), participants were asked to describe barriers to depression treatment use and preferences for candidate implementation strategies. Qualitative content analysis was conducted to determine common barriers and strategy preferences. 

Results: Individual barriers included gaps between the teen and parent in their understanding of depression. Family barriers centered on low perceived need for depression treatment influenced by parent’s knowledge and attitudes about depression and their own mental health concerns. Healthcare system barriers were driven by structural racism which made it difficult for families to schedule care at preferred times and places, find bilingual and bicultural mental health providers, and pay for care within rigid reimbursement structures that don’t allow for innovations. Strategies should be tailored based on the individual needs of the family. Social support, psychoeducation about depression, and resource navigation were preferred strategies. Participants also agreed that family involvement in strategies was crucial and that a bilingual Latinx individual with relevant lived experience should facilitate implementation of strategies. Strategies should be offered virtually or in community settings and should consider cultural context (e.g., parent-child acculturation gaps) and adolescent development (e.g., balance of confidentiality with parent involvement).



Discussion: Multi-level implementation strategies will be necessary to address multi-level barriers to depression treatment. Future research will refine and test family- and healthcare system-focused implementation strategies to determine the effect on the use of depression treatment among Latinx teens screening positive for depression in primary care settings and explore strategies that could be implemented to mitigate healthcare system-level barriers to depression treatment.