The willingness of older African Americans to seek care for depressive symptoms
The purpose of this study was to explore the influence of selected variables (i.e., depressive symptoms, stigma of depression, and resilience) on the willingness of African Americans aged 65 years and over to seek health care for depressive symptoms. The specific aims were to (a) explore the relationships among depressive symptoms, the stigma associated with depression, personal resilience, and willingness to seek mental health care for depressive symptoms (b) determine the significant predictors of older African American adults' willingness to seek mental health care, and (c) determine significant direct and indirect predictors of older African Americans' willingness to seek mental health care for depressive symptoms. The long-term goal is to increase understanding about characteristics contributing to older African Americans' willingness to seek health care for depressive symptoms with the intent of developing strategies to improve the management of their mental health. A cross-sectional, correlation, causal modeling design was used to answer the research questions as guided by the aims. A sample of 158 African Americans aged 65 and over were recruited from community organizations and facilities known to provide services to this population. Human subjects protection approval preceded recruitment. Participants completed five study instruments either individually in a selected environment or with the investigator present. Instruments included a General Information Fonn (GIF), Center for Epidemiological Studies-Depression Scale (CES-D), Stigma of Depression Scale (SDS), Connor-Davidson Resilience Scale (CD-RISC), and Willingness to Seek Health Care for Depressive Symptoms Scale (WSHC-DS). The SDS was modified from an existing scale and the WSHC-DC was developed for this study. All had high internal consistency with the sample. Data analysis included descriptive statistics, multiple regression, and structural equation modeling (SEM). Testing of the theoretical model indicated that the three independent variables (i.e., depressive symptoms, resilience, and stigma) accounted for 15.8% of the variance of the dependent variable (i.e., willingness to seek mental health care). SEM analysis indicated possible modifications to the model and revealed resilience as most predictive of willingness to talk to a health care professional about mood. Data suggest further testing of the model and exploration of the specified concepts with this population.