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Race/Ethnicity as a Moderator in Child and Adolescent Depression and Anxiety Trials

The inclusion of racial/ethnic minorities in treatment outcomes trials for children and adolescents with depression and anxiety is essential, particularly given the assumption, required by the NIH, that racial diversity is important to the generalizability of clinical trial outcomes. A search for randomized clinical trials on the treatment of child and adolescent depression and anxiety was conducted using the Medline and Psychinfo databases. These were then reviewed to determine whether race or ethnicity were 1) factored into recruitment strategies; 2) represented in the trial sample; and 3) included in moderator analyses to determine the extent to which they may influence trial outcomes. 37 original and 13 follow-up trials were identified (total N = 3330). None identified strategies for targeted recruitment of racial/ethnic minorities. Six did not report race. All minority groups except for Native Americans are underrepresented as compared to 2000 US Census figures; however, only one study reported Native Americans as participants. Overall, 67% of the sample was Caucasian, 26% minority, and 6% unreported. There was no trend in minority representation by year. Most studies reviewed do report the ethnic breakdown of their sample population, although methods vary. Six studies, three original and three follow-up, explored the ethnicity as a moderator. Without an increased presence of minorities in clinical trials, it is unclear that the results of these studies can reliably generalize to a diverse population. The importance of studies in minority samples becomes apparent, as does the need for a greater emphasis on recruitment.

Identiferoai:union.ndltd.org:YALE_med/oai:ymtdl.med.yale.edu:etd-06272006-121504
Date03 November 2006
CreatorsGuerrier, Natalie
ContributorsAndres Martin
PublisherYale University
Source SetsYale Medical student MD Thesis
LanguageEnglish
Detected LanguageEnglish
Typetext
Formatapplication/pdf
Sourcehttp://ymtdl.med.yale.edu/theses/available/etd-06272006-121504/
Rightsunrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to Yale School of Medicine or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report.

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