008 - Geographical Distance and Being a Single Hispanic Parent Predict Retention for Underserved Hispanic Women with Concurrent Major Depression and Breast Cancer

Purpose: Depression is one of the most common comorbid psychiatric disorders for breast cancer patients and can decrease patient's quality of life and negatively affect cancer treatment results if untreated. Our goal was to identify treatment barriers to women with breast cancer who sought psychotherapy for depression. Such findings may help policy makers and researchers with decision making when funding and designing future studies that involve this population, especially in communities with high rates of health disparities.

Methods: We used data from a randomized trial for women with breast cancer and current diagnosis of non-psychotic unipolar major depressive disorder (MDD). Patients were randomly assigned to 12 weeks of one of three psychotherapies and attrition was assessed by whether or not subjects completed 12 weeks of treatment sessions. Descriptive analyses and logistic regression were used to identify barriers. R shiny was used to determine the residence of study participants.

Results: 134 patients were randomized of whom 104 (77.6%) were Hispanic. 59 (44%) were either nonstarters or dropouts and 49 (83.1%) of them were Hispanic. Being a Hispanic woman, less educated and having more distant residence significantly predicted attrition. Single Hispanic mothers had significantly higher attrition risk than married and/or childless women.

Conclusion: Identifying barriers to treatment is important to improve treatment adherence for depressive women with concurrent diagnosis of breast cancer, especially for traditionally underserved minorities with geographical distance from hospitals and being as a single parent. Additional support, such as affordable tele-medicine, language assistance, financial aid for transportation/child-care, and allocating more funds should be considered to improve treatment adherence and outcomes.

Dropout

Major Depression Disorder

Breast Cancer

Disadvantaged minorities

Hispanic Single Parent

Geographical Distance 

Expert

Community

International Conference on Health Policy Statistics 2023