Beyond the Silence: COM-B-Informed Provider Barriers to Depression Screening Among Filipino American Patients

Area of Science:

• Implementation Science
• Health Disparities
• Cultural Competency in Healthcare

Background:

• Routine depression screening is recommended in primary care.
• Depression may be underdetected in Filipino American patients due to provider-level factors.
• Culturally responsive preparation and communication are key for early identification.

Purpose of the Study:

• To examine provider perspectives on barriers to depression screening and mental health discussions with Filipino American patients.
• To utilize the Capability, Opportunity, Motivation, and Behavior (COM-B) framework to understand these barriers.
• To identify areas for improving culturally responsive mental health care.

Main Methods:

• A cross-sectional survey of 81 healthcare providers experienced with Filipino American patients in the U.S.
• Assessed provider confidence, training adequacy, cultural/communication barriers, stigma concerns, and interest in resources.
• Used adapted scales mapped to the COM-B framework; analyzed using descriptive statistics and nonparametric tests.

Main Results:

• Most providers acknowledged cultural influences on Filipino American mental health help-seeking.
• Fewer providers reported adequate training for assessing mental health in this population.
• Communication barriers, stigma, and a need for tailored resources were commonly reported; Filipino providers showed higher perceived capability/opportunity.

Conclusions:

• Provider motivation may exist, but capability and opportunity barriers (training, communication, workflow, referrals) need addressing.
• Culturally responsive training and support are vital for effective depression screening.
• Further research with validated instruments is needed due to the exploratory nature and sample limitations.