Table 2.

Patient preferences for and practitioner/administrator perspectives on cultural tailoring

Overarching theme	Illustrative quotes
Anonymous groups Refers to a group format that includes optional attendance and/or access to a behavioral health specialist	Patient “Anonymity is key to building trust.” “Something like an AA thing but for depression.” “I like the idea of a support group for depression but with an expert there to ask questions to.” “A place where I would feel more comfortable asking questions.” Practitioner/administrator “I could understand that because trust is an issue. You’re not going to get it easily at first. This population tends to be suspicious of the medical system.” “Sometimes the patients use the waiting room and talk about their health problems with each other.”
Community involvement Refers to primary care practitioner roles in the communities in which patients reside	Patient “We want to see our practitioners in our neighborhood.” “I’ll feel better meeting with someone [for mental health] if I saw them in the community.” “What if there was a time when a physician could be at a gathering just to talk to people?” Practitioner/administrator “I think it’s how patients view this particular health center. A lot of patients actually view it as a part of the community.” “I’m looking at that as another outreach … community interaction is important to the patient.”
Culturally tailored education Refers to the type of cultural tailoring that is needed for psychoeducation in primary care settings	Patient “I would want to hear about all the medications, like herbal too, and other alternative options.” “Using [screening] questionnaires helps me feel the doctor is inviting that type of discussion.” “Having an elder come and speak and explain things would help.” Practitioner/administrator “If we had more background knowledge and more cultural awareness of this primary population that we serve on a daily basis, it could definitely improve the quality.” “With some people you have to start with psychotherapy; they prefer that to medications.”
Sensitive communication Refers to the ways in which mental health issues and topics are approached in primary care settings	Patient “It takes time to get a person to open up about depression; I need my doctor to listen.” “It’s hard for a black man to reach out in the first place, so it’s important to understand that.” Practitioner/administrator “We have to be careful not to judge and to be humble when we’re making [mental health] recommendations ... take their transportation options into account, too.” “It helps when they realize that the two practitioners are communicating and you know what the other person is doing.”
Find ways to fight stigma Ideas about how stigmas can be addressed from a cultural perspective	Patient “If my family member was there they could ask questions.” “The church is important, but that might keep a person from getting help.” “If my doctor mentioned something that made them depressed, I can open up to see what they had to say.” Practitioner/administrator “They feel like they should not be having any of these issues because they should be able to pray.” “Get buy-in from faith-based organizations. We do some work with health ministries of different churches with our residents volunteering.”