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Norah Mulvaney-Day, PhD¹, Sarah Train¹, Dharma Cortes, PhD², Lisa Fortuna, MD, MPH¹, Margarita Alegria, PhD³, and Luz Santana, MA⁴. (1) Center for Multicultural Mental Health Research, Cambridge Health Alliance, 120 Beacon St., Somerville, MA 02143, 617-503-8448, nmulvaney-day@charesearch.org, (2) Department of Psychiatry, Cambridge Health Alliance/Harvard Medical School, 1493 Cambridge Street, Cambridge, MA 02139, (3) Psychiatry--Center for Multicultural MH Research, Harvard Medical School, 120 Beacon St., Somerville, MA 02143, (4) The Right Question Project, Inc., 2464 Massachusetts Avenue, Suite 314, Cambridge, MA 02140

In the mental health field, research on strategies for increasing patient involvement in the process of clinical care is in its infancy. This paper describes a qualitative analysis conducted using data collected during the Right Question Project study. This intervention taught Latino mental health patients strategies for improving decision-making skills and active participation in their care.

Open-ended questions about the effect of the intervention were asked. The qualitative data were analyzed to answer two questions: 1) what are qualitative indicators of empowerment and 2) what are the cultural differences in these indicators? The data were coded by two independent teams – one for the English interviews and one for the Spanish. The goal of the coding process was to identify the greatest variability among indicators across the two groups.

Respondents reported a shift in their ability to ask questions, the type of questions asked, and the way they asked questions. Some participants experienced changes in their relationship with their provider in the process of problem-solving. Other indicators included increased self-worth and increased trust in the provider. Cultural differences emerged. Spanish-speaking respondents were more likely to report an increase in their ability to stand up for their rights, while English-speaking respondents discussed feeling more responsible for their own care.

Improving shared decision-making with providers can be achieved for minority mental health outpatients. Indicators of empowerment may vary across cultural groups. Care should be taken to account for the potential for confounding factors inherent to the therapeutic process itself.

Learning Objectives:

• • Articulate the components of the qualitative analysis process used in the Right Question Project study
• • Identify qualitative indicators of empowerment that emerged during the qualitative analysis
• • Describe cultural differences in indicators of empowerment

Presenting author's disclosure statement:

Any relevant financial relationships? No