Date of Award

11-3-2006

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Andres Martin

Abstract

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.

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