Defense Date


Document Type


Degree Name

Doctor of Philosophy



First Advisor

Heather Jones


Depression, a prominent referral reason for youth to mental health services, has well-developed evidence-based psychosocial treatments; however, many youth with depression, particularly Black youth, still have low rates of treatment attendance. Integrated pediatric primary care (IPPC) is an optimal setting for mental health treatment as it addresses many barriers to treatment attendance for Black youth. Yet, the literature on predictors of treatment attendance in IPPC is very limited. The current study seeks to address the gaps in the literature by investigating (1) predictors of treatment attendance for Black youth with depression in IPPC, (2) predictors of treatment attendance past intake session and (3) moderating sociodemographic factors. Predictors of interest included psychopathology-related (i.e., history of suicidal ideation, psychological impairment, and selective serotonin reuptake inhibitor use), and service-related factors (i.e., behavioral therapy/cognitive behavior therapy use and referral source). Gender differences were also explored. One hundred and twenty-five youth who self-identified as Black or African American who were treated for depression in an urban IPPC clinic completed a demographic and background information questionnaire, as well as an assessment of psychological impairment at their intake session. Attendance was recorded at each visit by their behavioral health clinician. Path analyses found that greater psychological impairment predicted lower treatment attendance for black boys. History of suicidal ideation or attempts predicted lower treatment attendance for boys and girls. Referral from Adolescent Medicine predicted lower treatment attendance for boys and girls but even stronger for girls and moderated by age. Overall, better understanding the factors that predict treatment attendance for depressed Black youth in IPPC may provide implications for maximizing treatment attendance and improved outcomes, reduce negative outcomes associated with low treatment attendance, and reduce the overall cost of untreated depression for Black youth.


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Available for download on Wednesday, March 22, 2028