227530 Interactive voice response system pre-screening for depression with Spanish-speaking populations

Wednesday, November 10, 2010

Ivy Krull, MSW, MPH , School of Social Work, Boston University, Boston, MA
This presentation describes recent research on telephone-based Interactive Voice Response (IVR) screening for depression, using a Spanish phone-optimized adaptation of the two-item Patient Health Questionnaire-2 (PHQ-2) screener. IVR has long and successfully served hard-to-reach populations for screening, advocacy of behavior change, and other health support, including behavioral health initiatives. Tailoring messages according to a participant's age, gender, health benefit structure, and native language are crucial to connect this technology with diverse populations. This research combines quantitative and qualitative methods to better understand how Spanish-speaking populations respond to various translations of the PHQ-2 depression screening questions. First, the quantitative component compares phone-participant engagement rates for Spanish speakers with engagement rates of English speakers. Second, the qualitative component assesses feedback on several translations of the PHQ-2 questions from Spanish-speaking focus group participants. The focus group method is utilized to gather feedback to better understand issues related to culturally-appropriate translations of these sensitive, approximate, and affective questions. There are significant differences in engagement with the modified PHQ-2 question set between English and Spanish speaking populations. One hypothesis about the difference in rates is that the standard English PHQ-2 questions may be challenging to translate into Spanish. Focus group sessions will be utilized to understand more about this relationship. This analysis is on-going. Discussion points for this session include how to make PHQ-2, a powerful depression screening tool, viable for use among Hispanic and Latino populations. In the longer term, research on culturally-appropriate expression of behavioral and affective phrases may improve behavior-change initiatives in an IVR format.

Learning Areas:
Administer health education strategies, interventions and programs
Communication and informatics
Diversity and culture
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Social and behavioral sciences

Learning Objectives:
1. Describe the value of IVR health outreach as a tool for pre-screening for depression and improvements to public health. 2. Analyze how Spanish-speaking depression pre-screening rates differ from English-speaking response rates. 3. Compare different call recording focus group feedback on opportunities to culturally-optimize the translation if the depression pre-screening questions to ensure cultural sensitivity around the sensitive topic of depression. 4. Discuss key next-steps for IVR outreach as a culturally-optimized tool for depression pre-screening.

Keywords: Depression, Telecommunications

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I completed this research and conducted the focus groups to learn about depression pre-screening Spanish-optimization.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Eliza Corporation IVR outreach Employment (includes retainer), Patent holder and Stock Ownership

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.