Gabriela A Nagy

• Doctor of Philosophy
• Assistant Professor at Duke University Medical Center

Despite research and treatment advances in health care, the implementation of research evidence into practice remains a challenge, especially for historically marginalized populations. There have been numerous calls to action to integrate health equity into implementation science frameworks, models, and theories. Yet, progress toward better integra...

U.S. Latino/a/x adolescents experience inequities in depression treatment use in comparison to non-Latino/a/x White peers. The purpose of this study was to describe barriers to depression treatment use and implementation strategy preferences to address these barriers among Latinx teens. A qualitative descriptive study was conducted with Latino/a/x...

Multicultural peer-consultation teams represent one promising approach to supporting mental health providers by providing consultation that is multiculturally conscious and integrates front-and-center concepts related to diversity in identities and lived experiences (i.e., multiculturalism), intersectionality, inclusivity, health equity, antiracism...

This JAMA Forum discusses the cost of health inequities, the lack of attention to implementation science and the costs in the research enterprise, and provides recommendations for targeting cost in equity-grounded implementation science.

Objectives: Acculturative stress is an important factor that affects health for Latinx immigrants in the US, with multiple studies identifying a link between depression and acculturative stress in this population. However, far fewer studies have examined the specific role and relationship of acculturative stress on mental health service use in thi...

Acculturative stress is a key social driver of health impacting the mental health of immigrants and refugees from Latin America, which contributes to inequities experienced by them. While there is a robust scientific literature describing and evaluating evidence-based treatments targeting a range of psychiatric disorders, these treatments often do...

In March 2020, the novel 2019 coronavirus disease (COVID-19) was declared a pandemic. In May 2020, George Floyd was murdered, catalyzing a national racial reckoning. In the Southern United States, these events occurred in the context of a history of racism and high rates of poverty and discrimination, especially among racially and ethnically minori...

The purpose of this study was to develop the Hispanic Optimism and Personal Expectancy (HOPE), a measure of optimism related to the concept of the American Dream. This measure assesses beliefs that are shared by Hispanic/Latinx immigrants and non-immigrants about opportunities for advancement in the United States. Based on focus groups consisting o...

Background: The process of immigration and subsequent adaptation can expose Latinx immigrants to chronic and compounding challenges (i.e., acculturative stress), but little is known about how resilience factors and these stressors interact to influence syndemic conditions, intertwined epidemics that disproportionally affect historically marginaliz...

This Viewpoint discusses communication between clinicians and caregivers of racial and ethnic minoritized groups.

Objective: Homework is a key theoretical component of cognitive-behavioral therapies, however, the effects of homework on clinical outcomes have largely been evaluated between-persons rather than within-persons. Methods: The effects of homework completion on treatment response were examined in a randomized trial comparing Behavioral Activation T...

Background: Chronic stress alters reward sensitivity and contributes to the emergence of anhedonia. In clinical samples, the perception of stress is a strong predictor of anhedonia. While there is substantial evidence demonstrating psychotherapy reduces perceived stress, little is known regarding the effects of treatment-related decreases in perce...

The global rise of the COVID-19 pandemic has been accompanied by an increase in anti-Asian discrimination with potentially deleterious effects on individuals of Asian descent. In the present study, we seek to determine associations among COVID-related anti-Asian discrimination, general COVID-19 stressors, acculturative stressors, and perceptions of...

This article represents an implementation-focused evaluation of a multicultural peer-consultation team situated within a psychiatry department in a large academic medical center in the Southern United States. The evaluation comprised anonymous self-report questionnaires ( n = 14) as well as individual ( n = 3) or group interviews ( n = 10) conducte...

Objectives This article represents a call to action for the mindfulness field to be more diverse and inclusive of Latinx individuals. Building a diverse and inclusive science around mindfulness-based approaches (MBAs) that considers important group-level cultural and contextual information is an important public health challenge in need of innovati...

Introduction: Latinx immigrants who migrate to the United States (US) as young children are more likely to experience depression than those who migrate later in life. Our purpose is to test three models that may explain the relationship between age of immigration and depressive symptoms among Latinx immigrants. Methods: A secondary analysis of base...

Sleep is important for physical and mental health. Latinx individuals are thought to experience worse sleep and associated health outcomes, resulting in health disparities. There is a dearth of research on the factors (e.g., employment status, age at immigration) that predict poor sleep among Latinx immigrants. The present study aimed to (1) examin...

Background Chronic stress alters reward sensitivity and contributes to the emergence of anhedonia. In clinical samples, the perception of stress is a strong predictor of anhedonia. While there is substantial evidence demonstrating psychotherapy reduces perceived stress, little is known regarding the effects of treatment-related decreases in perceiv...

Introduction: Racial/ethnic minority communities are underrepresented in research. Medical mistrust and mistreatment, discrimination, and a lack of diverse research workforce may influence recruitment and engagement. Engaging Latinx immigrants for research presents unique recruitment challenges, especially for biobehavioral research which is not we...

Previous research has demonstrated that undocumented Latinx immigrants in the USA report worse physical health outcomes than documented immigrants. Some studies suggest that immigration-related stress and healthcare related-stress may explain this relationship, but none have tested it empirically. The purpose of this study was to determine if immig...

Introduction There is limited evidence on sociodemographic differences in osteoarthritis management, particularly in non-African American minorities. We sought to identify differences in imaging modalities, administration of intra-articular injections, and total joint arthroplasty (TJA) between racial/ethnic groups. Methods We retrospectively revi...

Background: Social inequity is a primary driver of health disparities, creating multiple barriers to good health. These inequities were exacerbated during the coronavirus disease 2019 (COVID-19) pandemic, with Latinx communities suffering more than others. Grassroots collaborations have long existed to address disparities. Objective: We describe...

The authors undertook the current study to investigate patient and provider factors and their relationship to patient show rates. The authors included as eligible all new patient appointments in psychiatry resident clinics at a large academic hospital-based psychiatry clinic between July 2017 and June 2018. Prior to data extraction, a resident focu...

We report on the adaptation and evaluation of an existing approach to multicultural education into an eight-session online, modular curriculum for psychiatric mental health nurse practitioner students (n = 6) and psychology interns (n = 10). Training participants were invited to complete verbal feedback, self-report questionnaires, and a high-fidel...

Hispanic immigrants experience more adverse childhood experiences (ACEs) and depressive symptom chronicity/severity than non-Hispanic peers. Acculturation stress relates to both depressive symptoms and ACEs, but the mechanism is not well-understood. We conducted a secondary data analysis of baseline data, from an ongoing longitudinal study to test...

An examination of the interaction of pre- and post-migration stressors is critical to understanding Canadian Muslim immigrant women’s experience of intimate partner violence (IPV). This study uses a dominant qualitative design, supplemented by quantitative data to understand eight Canadian Muslim immigrant women’s experience of IPV from six countri...

Background : The neural mechanisms associated with anhedonia treatment response are poorly understood. Additionally, no study has investigated changes in resting-state functional connectivity (rsFC) accompanying psychosocial treatment for anhedonia. Methods : We evaluated a novel psychotherapy, Behavioral Activation Therapy for Anhedonia (BATA, n=...

Predominantly Spanish‐speaking Latinx individuals are underrepresented in research, and one primary barrier is the lack of infrastructure to effectively engage, among them, adequate cultural and linguistic adaptation of research measures. Capitalizing on existing recommendations for appropriate and ethical engagement of Latinx individuals in resear...

Aim/Purpose: National and international survey studies have begun to identify heightened levels of depression, anxiety, and burnout among doctoral students. Nevertheless, little research has been done to evaluate which interventions may support doctoral student wellness. Background: To guide future interventions research, this study evaluated perc...

Efforts to integrate cultural competence and evidence-based treatments (EBTs) typically take the form of cultural adaptations of EBTs, characterized by modifications to the existing treatment based on presumed cultural notions of a given race or ethnic group. Much less attention has been given to ways EBTs can integrate a process model of cultural...

The health of Latinx immigrants decays over time and across generations. Acculturation stress influences decays in behavioral and mental health in this population, but the effect on physical health outcomes is less understood. This systematic review synthesizes findings from 22 studies that examined the influence of acculturation stress on physical...

Unstructured: The behavioral health toll of the Covid-19 pandemic and systemic racism has increased attention on the potential of digital health to increases access and quality of behavioral healthcare. However, as the pandemic continues to widen health disparities in racial and ethnic minoritized groups, concerns arise around an increased relianc...

Purpose: Previous research has demonstrated that peers may play an integral role in the development of depressive symptoms among Latina adolescents; however, little is known about the function of peers in the ongoing management of depressive symptoms for Latina adolescents. The purpose of this study was to describe how peers influence Latina adole...

The present pilot study sought to describe the development and investigate the educational impact of an innovative 14-session training package focused on increasing skills related to providing culturally conscious mental health care; that is, care that is attentive, sensitive, and responsive to contextual and cultural experiences of patients. Train...

A novel treatment for anhedonia increases sensitivity to reward.

Although doctoral students in the biomedical sciences have been recognized as a population at particular risk for mental health problems such as burnout and depression, little research has been conducted to identify candidate targets for intervention. To this end, we used the stress process model to evaluate potential mediators of stress-burnout an...

Although burnout and mental health problems may adversely impact quality of scientific research, academic productivity, and attrition in biomedical doctoral training programs, very little research has been done on this topic. Recent studies have used brief survey methods to begin to explore burnout and mental health problems in biomedical doctoral...

Background Mindfulness-Based Cognitive Therapy (MBCT) is an effective intervention for improving depressive symptoms, but the neural mechanisms associated with treatment response are unclear. Mindfulness strategies promoted in MBCT involve psychological processes supported by the Default Mode Network (DMN) such as present-moment awareness and non-j...

The present study sought to evaluate the prevalence of multicultural research in clinical psychology. This study represents a hybrid approach to content and trend analysis, utilizing both deductive and inductive techniques on article abstracts published from 1994 through 2013 in five hallmark psychology journals. Of 8,130 abstracts screened, a tota...

A major challenge for our field is to ensure we meet the growing demand for culturally sensitive and responsive evidence-based practices to keep up with changing demographics in the U.S. as well as calls to action by our field. To address the mental health imperative to improve the multicultural competence of clinicians and to provide appropriate c...

Behavioral Activation (BA) is a contemporary third-wave psychosocial treatment approach that emphasizes helping individuals become more active in ways that are meaningful to them as a means of improving mood and quality of life. BA has been designated as a well-established, validated treatment for depression by the American Psychological Associatio...

This article discusses practical steps for addressing microaggressions in clinical supervision.

Depression presents a significant public health burden for Latinos in the United States. Behavioral Activation for Latinos (BAL) has emerged as a promising treatment strategy for depressed Latinos. BAL has been shown to more successfully engage and retain clients in treatment compared with treatment-as-usual (TAU) when measured as session attendanc...

The scarcity of accessible culturally competent service providers and a general sense of mistrust in Eurocentric-based mental health settings exacerbate the lack of help seeking and effective therapeutic engagement for Latinos. Thus, clinical interventions that account for diverse values and worldviews may be an important step in the helpful treatm...

Background and objectives: Our understanding of how Behavioral Activation (BA) for depression works is limited. BA is theorized to lead to changes in depression through changes in activation. While distal support for activation as a mechanism has been obtained, more research is needed before definitive conclusions can be drawn. Research on mechani...

Depression presents a significant public health burden for Latinos, the largest and fastest growing minority group in the United States. The current study performed a randomized controlled trial of Behavioral Activation (BA) for Latinos (BAL, n = 21), with relatively minor modifications, compared to treatment-as-usual (TAU, n = 22) in a community m...

Behavioural activation holds promise to reduce the global burden of depression as a treatment approach that is effective, easy to teach, scalable and acceptable to providers and patients across settings and cultures. This editorial reviews the history of behavioural activation, what it is, current evidence for its use and future directions.