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Volume 27 (Supplement 1)

Volume 27, Supplement 1, Fall 2007line
J Contin Educ Health Prof 2007; 27(Suppl1):S65
RESEARCH ARTICLE

Improving depression care for ethnic and racial minorities: A concept for an intervention that integrates CME planning with improvement strategies
Donald E. Moore, Karen M. Overstreet, Robert C. Like, Robert E. Kristofco

A b s t r a c t

Depression is one of the most common reasons that individuals seek treatment in the primary care setting. Research in the past 15 years has shown that dramatic improvement in the management of patients with depression is possible. Advances in pharmacotherapy and delivery of depression care have been reported, but few currently benefit members of ethnic and racial minorities. Educating physicians and other health professionals has been suggested as one approach to address the issues related to disparities in depression care. There is little evidence, however, that education alone is effective.

The authors of this article believe that incorporating physician learning activities that are planned using approaches that have been shown to be effective in interventions currently demonstrating some success in improving depression care provided to ethnic and racial minorities will enhance the impact and sustainability of these interventions. This article—the conclusion of this supplement—will describe an intervention concept that integrates a quality improvement model (the Institute for Health Improvement’s Breakthrough Series Collaborative model) with an evidence-based approach to planning CME and supports the integration by using action inquiry technologies and community-based participatory research methods. Relevant approaches from implementation research are discussed, and suggestions for testing the intervention concept are provided.

Lessons for Practice
  • There is general consensus that education alone will not help physicians improve performance.
  • To maximize effectiveness of medical education activities and effect change in physicians’ practice behavior, educators should follow best practices that have been demonstrated in multiple research projects as effective.
  • Combining a quality improvement (QI) approach that shows promise of success with evidence-based planning of educational activities for physicians and others in the practice setting will strengthen and expand the gains made by QI.
  • Use of action inquiry technologies, such as action research and community-based participatory research, will increase the probability of successful outcomes in communities of ethnic and racial minorities as part of the effort to address disparities in depression treatment.
  • The importance of collaboration and the skills required for successful collaboration cannot be overstated. Effective CME depends on effective interaction and cooperation among all stakeholders.

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