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APHA Scientific Session and Event Listing

Recorded presentation

Christopher R. Larrison, PhD and Susan L. Schoppelrey, PhD. School of Social Work, University of Illinois at Urbana-Champaign, 1207 West Oregon Street, Urbana, IL 61801, 217-244-5237, larrison@uiuc.edu

Existing data regarding outcomes for African American clients receiving treatment at community mental health agencies (CMHAs) are quite limited and do not adhere to any discernable pattern regarding the extent of racial disparities or the potential causes of such disparities. A number of factors have been posited to explain outcome disparities at the client, intervention, and clinician levels, but no research has explicitly examined the relative importance of the three levels in producing outcome disparities.

Adult clients (n = 98) and staff (n = 42) from two CMHAs in the Midwest participated in the research. African American clients represented approximately 13% of the sample. Outcomes (level of symptomology) were measured four times over nine months. Hierarchical linear modeling was used to determine whether African American and white clients differed in their patterns of change over time and, if so, which factors (client, intervention, clinician) were associated with those differences. The primary model of interest was a 3-level model containing repeated measures of outcomes (level 1), client-level demographic and treatment variables (level 2), and clinician factors such as level of education, burnout and cultural competency (level 3).

Although African American and white clients began with similar levels of symptomatology, white clients' symptoms declined modestly while African American clients experienced moderate increases over time. The findings further indicate that clinician-level factors influence the relationship between client race and rate of change in symptomatology. Further analyses of the model residuals are being conducted to clarify the nature of this relationship.

Learning Objectives:

• 1)Participants will be able to understand how client, treatment, and clinician level factors interact to create disparities.
• 2)Participants will be able to recognize some of the factors likely to produce low levels of outcome disparities at CMHAs.
• 3)Participants will be able to identify some of the significant the barriers to conducting racially and ethnically focused multilevel research in community settings.

Keywords: African American, Outcomes Research

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation